The roles of community health workers who provide maternal and newborn health services: case studies from Africa and Asia

Introduction A variety of community health workers (CHWs) provide maternal and newborn health (MNH) services in low-income and middle-income settings. However, there is a need for a better understanding of the diversity in type of CHW in each setting and responsibility, role, training duration and t...

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Main Authors: Barbara Madaj, Nynke van den Broek, Abimbola Olaniran, Sarah Bar-Zev
Format: Article
Language:English
Published: BMJ Publishing Group 2019-07-01
Series:BMJ Global Health
Online Access:https://gh.bmj.com/content/4/4/e001388.full
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author Barbara Madaj
Nynke van den Broek
Abimbola Olaniran
Sarah Bar-Zev
author_facet Barbara Madaj
Nynke van den Broek
Abimbola Olaniran
Sarah Bar-Zev
author_sort Barbara Madaj
collection DOAJ
description Introduction A variety of community health workers (CHWs) provide maternal and newborn health (MNH) services in low-income and middle-income settings. However, there is a need for a better understanding of the diversity in type of CHW in each setting and responsibility, role, training duration and type of remuneration.Methods We identified CHWs providing MNH services in Bangladesh, India, Kenya, Malawi and Nigeria by reviewing 23 policy documents and conducting 36 focus group discussions and 131 key informant interviews. We analysed the data using thematic analysis.Results Irrespective of training duration (8 days to 3 years), all CHWs identify pregnant women, provide health education and screen for health conditions that require a referral to a higher level of care. Therapeutic care, antenatal care and skilled birth attendance, and provision of long-acting reversible contraceptives are within the exclusive remit of CHWs with training greater than 3 months. In contrast, community mobilisation and patient tracking are often done by CHWs with training shorter than 3 months. Challenges CHWs face include pressure to provide MNH services beyond their scope of practice during emergencies, and a tendency in some settings to focus CHWs on facility-based roles at the expense of their traditional community-based roles.Conclusion CHWs are well positioned geographically and socially to deliver some aspects of MNH care. However, there is a need to review and revise their scope of practice to reflect the varied duration of training and in-country legislation.
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spelling doaj-art-4edfba4e77b64f318d6bdf1cc4ac9c012024-12-14T14:20:09ZengBMJ Publishing GroupBMJ Global Health2059-79082019-07-014410.1136/bmjgh-2019-001388The roles of community health workers who provide maternal and newborn health services: case studies from Africa and AsiaBarbara Madaj0Nynke van den Broek1Abimbola Olaniran2Sarah Bar-Zev31 Centre for Maternal and Newborn Health, Liverpool School of Tropical Medicine, Liverpool, UKCentre for Maternal and Newborn Health, Liverpool School of Tropical Medicine, Liverpool, UKCentre for Maternal and Newborn Health, Liverpool School of Tropical Medicine, Liverpool, Merseyside, UKCentre for Maternal and Newborn Health, Liverpool School of Tropical Medicine, Liverpool, Merseyside, UKIntroduction A variety of community health workers (CHWs) provide maternal and newborn health (MNH) services in low-income and middle-income settings. However, there is a need for a better understanding of the diversity in type of CHW in each setting and responsibility, role, training duration and type of remuneration.Methods We identified CHWs providing MNH services in Bangladesh, India, Kenya, Malawi and Nigeria by reviewing 23 policy documents and conducting 36 focus group discussions and 131 key informant interviews. We analysed the data using thematic analysis.Results Irrespective of training duration (8 days to 3 years), all CHWs identify pregnant women, provide health education and screen for health conditions that require a referral to a higher level of care. Therapeutic care, antenatal care and skilled birth attendance, and provision of long-acting reversible contraceptives are within the exclusive remit of CHWs with training greater than 3 months. In contrast, community mobilisation and patient tracking are often done by CHWs with training shorter than 3 months. Challenges CHWs face include pressure to provide MNH services beyond their scope of practice during emergencies, and a tendency in some settings to focus CHWs on facility-based roles at the expense of their traditional community-based roles.Conclusion CHWs are well positioned geographically and socially to deliver some aspects of MNH care. However, there is a need to review and revise their scope of practice to reflect the varied duration of training and in-country legislation.https://gh.bmj.com/content/4/4/e001388.full
spellingShingle Barbara Madaj
Nynke van den Broek
Abimbola Olaniran
Sarah Bar-Zev
The roles of community health workers who provide maternal and newborn health services: case studies from Africa and Asia
BMJ Global Health
title The roles of community health workers who provide maternal and newborn health services: case studies from Africa and Asia
title_full The roles of community health workers who provide maternal and newborn health services: case studies from Africa and Asia
title_fullStr The roles of community health workers who provide maternal and newborn health services: case studies from Africa and Asia
title_full_unstemmed The roles of community health workers who provide maternal and newborn health services: case studies from Africa and Asia
title_short The roles of community health workers who provide maternal and newborn health services: case studies from Africa and Asia
title_sort roles of community health workers who provide maternal and newborn health services case studies from africa and asia
url https://gh.bmj.com/content/4/4/e001388.full
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