Improving Maternal and Newborn Health: Effectiveness of a Community Health Worker Program in Rural Kenya
Improving Maternal and Newborn Health: Effectiveness of a Community Health Worker Program in Rural Kenya
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DOI：
10.1371/journal.pone.0104027
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发表时间：
2014-08-04
期刊：
影响因子：
3.7
通讯作者：
Meissner, Peter
中科院分区：
文献类型：
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作者：
Adam, Mary B.;Dillmann, Maria;Meissner, Peter
背景资料：志愿社区卫生工作者（CHW）是许多卫生系统的重要组成部分，在肯尼亚，这些志愿者是通过健康教育、早期病例识别和及时转诊到训练有素的卫生保健提供者来促进行为改变的基础。本研究探讨了肯尼亚农村社区卫生工作者项目的有效性，该项目旨在促进提高孕产妇新生儿健康知识，并增加熟练护理下的分娩。该研究采用了准-一项实验性非等效设计，采用口头访谈，检查相关人口统计学项目和有关孕产妇和新生儿健康的知识，并结合全面回顾性分娩史接触过社区卫生工作者提供的健康信息的妇女和没有接触过这些信息的妇女的比例。该项目培训CHWs在三个不同的地理areas.Results：平均知识得分较高，在那些妇女报告被暴露于健康信息的CHWs，Eburru 32.3比29.2，Kinale 21.8比20.7，Nyakio 26.6比23.8。与未报告接触过一种或多种健康信息的母亲相比，报告接触过一种或多种健康信息的母亲在熟练护理下分娩的人数更多。接受保健工作者健康信息的妇女与未接受保健信息的妇女在保健机构分娩的比例分别为：Eburru 46%对19%; Kinale 94%对73%; Nyakio 80%对78%。结论：保健工作者提供的健康信息增加了当地社区妇女对孕产妇和新生儿护理的认识，并鼓励在熟练护理下分娩。
Background: Volunteer community health workers (CHWs) form an important element of many health systems, and in Kenya these volunteers are the foundation for promoting behavior change through health education, earlier case identification, and timely referral to trained health care providers. This study examines the effectiveness of a community health worker project conducted in rural Kenya that sought to promote improved knowledge of maternal newborn health and to increase deliveries under skilled attendance.Methods: The study utilized a quasi-experimental nonequivalent design that examined relevant demographic items and knowledge about maternal and newborn health combined with a comprehensive retrospective birth history of women's children using oral interviews of women who were exposed to health messages delivered by CHWs and those who were not exposed. The project trained CHWs in three geographically distinct areas.Results: Mean knowledge scores were higher in those women who reported being exposed to the health messages from CHWs, Eburru 32.3 versus 29.2, Kinale 21.8 vs 20.7, Nyakio 26.6 vs 23.8. The number of women delivering under skilled attendance was higher for those mothers who reported exposure to one or more health messages, compared to those who did not. The percentage of facility deliveries for women exposed to health messages by CHWs versus non-exposed was: Eburru 46% versus 19%; Kinale 94% versus 73%: and Nyakio 80% versus 78%.Conclusion: The delivery of health messages by CHWs increased knowledge of maternal and newborn care among women in the local community and encouraged deliveries under skilled attendance.