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

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Olaniran, Abimbola, Madaj, Barbara ORCID: https://orcid.org/0000-0002-4073-3191, Bar-Zeev, Sarah and van den Broek, Nynke ORCID: https://orcid.org/0000-0001-8523-2684 (2019) 'The roles of community health workers who provide maternal and newborn health services: case studies from Africa and Asia'. BMJ Global Health, Vol 4, e001388.

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Abstract

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.

Item Type: Article
Subjects: WA Public Health > Health Problems of Special Population Groups > WA 310 Maternal welfare
WA Public Health > Health Administration and Organization > WA 546 Local Health Administration. Community Health Services
WQ Obstetrics > WQ 100 General works
WQ Obstetrics > Childbirth. Prenatal Care > WQ 160 Midwifery
WQ Obstetrics > Childbirth. Prenatal Care > WQ 175 Prenatal care
WQ Obstetrics > Pregnancy > WQ 200 General works
WY Nursing > WY 106 Community health nursing
Faculty: Department: Clinical Sciences & International Health > International Public Health Department
Digital Object Identifer (DOI): https://doi.org/10.1136/bmjgh-2019-001388
Depositing User: Caroline Hercod
Date Deposited: 02 Sep 2019 09:52
Last Modified: 02 Sep 2019 09:52
URI: https://archive.lstmed.ac.uk/id/eprint/11551

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