Profile, knowledge, and work patterns of a cadre of maternal, newborn, and child health CHWs focusing on preventive and promotive services in Morogoro Region, Tanzania.
Hum Resour Health
; 13: 98, 2015 Dec 24.
Article
en En
| MEDLINE
| ID: mdl-26703439
ABSTRACT
BACKGROUND:
Despite impressive decreases in under-five mortality, progress in reducing maternal and neonatal mortality in Tanzania has been slow. We present an evaluation of a cadre of maternal, newborn, and child health community health worker (MNCH CHW) focused on preventive and promotive services during the antenatal and postpartum periods in Morogoro Region, Tanzania. Study findings review the effect of several critical design elements on knowledge, time allocation, service delivery, satisfaction, and motivation.METHODS:
A quantitative survey on service delivery and knowledge was administered to 228 (of 238 trained) MNCH CHWs. Results are compared against surveys administered to (1) providers in nine health centers (n = 88) and (2) CHWs (n = 53) identified in the same districts prior to the program's start. Service delivery outputs were measured by register data and through a time motion study conducted among a sub-sample of 33 randomly selected MNCH CHWs.RESULTS:
Ninety-seven percent of MNCH CHWs (n = 228) were interviewed 55% male, 58% married, and 52% with secondary school education or higher. MNCH CHWs when compared to earlier CHWs were more likely to be unmarried, younger, and more educated. Mean MNCH CHW knowledge scores were <50% for 8 of 10 MNCH domains assessed and comparable to those observed for health center providers but lower than those for earlier CHWs. MNCH CHWs reported covering a mean of 186 households and were observed to provide MNCH services for 5 h weekly. Attendance of monthly facility-based supervision meetings was nearly universal and focused largely on registers, yet data quality assessments highlighted inconsistencies. Despite program plans to provide financial incentives and bicycles for transport, only 56% of CHWs had received financial incentives and none received bicycles.CONCLUSIONS:
Initial rollout of MNCH CHWs yields important insights into addressing program challenges. The social profile of CHWs was not significantly associated with knowledge or service delivery, suggesting a broader range of community members could be recruited as CHWs. MNCH CHW time spent on service delivery was limited but comparable to the financial incentives received. Service delivery registers need to be simplified to reduce inconsistencies and yet expanded to include indicators on the timing of antenatal and postpartum visits.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Servicios Preventivos de Salud
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Servicios de Salud del Niño
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Conocimientos, Actitudes y Práctica en Salud
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Agentes Comunitarios de Salud
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Servicios de Salud Materna
Tipo de estudio:
Clinical_trials
/
Prognostic_studies
/
Qualitative_research
Límite:
Adult
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Child, preschool
/
Female
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Humans
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Infant
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Male
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Newborn
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Pregnancy
País/Región como asunto:
Africa
Idioma:
En
Revista:
Hum Resour Health
Año:
2015
Tipo del documento:
Article
País de afiliación:
Estados Unidos