The effect of community nurses and health volunteers on child mortality: the Navrongo Community Health and Family Planning Project.
Scand J Public Health
; 35(6): 599-608, 2007.
Article
em En
| MEDLINE
| ID: mdl-17852975
ABSTRACT
BACKGROUND:
Despite effective treatments and preventive measures for the major causes of child illness and death in less wealthy nations, child mortality remains high in resource-poor settings due in part to ineffective health service delivery models.METHODS:
The Navrongo Community Health and Family Planning Project is a longitudinal community trial of alternative organizational strategies for health service delivery in a rural, impoverished area of Ghana. In one area, nurses are placed in communities with doorstep visitation and service responsibilities. A second area includes training of a local health volunteer and community involvement in health delivery. A third area combines both strategies. Under-five mortality rates were calculated and Poisson regression was used to adjust for potential confounding characteristics.RESULTS:
In areas with village-based community nurse services, under-five child mortality fell by 14% during five years of program implementation compared with before the intervention, with reductions in infant (5%), early child (18%), and late child (39%) mortality. The volunteer intervention was associated with a 14% increase in mortality, primarily driven by a 135% increase in early child mortality. Areas with both nurses and volunteers saw an 8% increase, with small increases in all age groups. Mortality in a comparison area with standard Ministry of Health services fell by 4% during the same time period.CONCLUSIONS:
These results suggest that convenient, accessible professional nursing care can reduce child mortality in impoverished African settings. However, they do not demonstrate a beneficial effect of community volunteers and suggest a possible negative impact on children's survival.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Mortalidade Infantil
/
Enfermagem em Saúde Comunitária
/
Mortalidade da Criança
/
Serviços de Planejamento Familiar
Tipo de estudo:
Prognostic_studies
Limite:
Adult
/
Child, preschool
/
Female
/
Humans
/
Infant
/
Male
País/Região como assunto:
Africa
Idioma:
En
Revista:
Scand J Public Health
Assunto da revista:
MEDICINA SOCIAL
/
SAUDE PUBLICA
Ano de publicação:
2007
Tipo de documento:
Article
País de afiliação:
Estados Unidos