Community health workers impact on maternal and child health outcomes in rural South Africa : a non-randomized two-group comparison study

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dc.contributor.authorLe Roux, Karl W.en_ZA
dc.contributor.authorAlmirol, Ellenen_ZA
dc.contributor.authorRezvan, Panteha Hayatien_ZA
dc.contributor.authorLe Roux, Ingrid M.en_ZA
dc.contributor.authorMbewu, Nokwaneleen_ZA
dc.contributor.authorDippenaar, Elaineen_ZA
dc.contributor.authorStansert-Katzen, Linneaen_ZA
dc.contributor.authorBaker, Venetiaen_ZA
dc.contributor.authorTomlinson, Marken_ZA
dc.contributor.authorRotheram-Borus, M. J.en_ZA
dc.date.accessioned2020-10-12T10:40:48Z
dc.date.available2020-10-12T10:40:48Z
dc.date.issued2020-09-17
dc.date.updated2020-09-20T03:32:45Z
dc.descriptionCITATION: Le Roux, K. W., et al. 2020. Community health workers impact on maternal and child health outcomes in rural South Africa – a non-randomized two-group comparison study. BMC Public Health, 20:1404, doi:10.1186/s12889-020-09468-w.
dc.descriptionThe original publication is available at http://bmcpublichealth.biomedcentral.com
dc.description.abstractBackground: Home visits by paraprofessional community health workers (CHWs) has been shown to improve maternal and child health outcomes in research studies in many countries. Yet, when these are scaled or replicated, efficacy disappears. An effective CHW home visiting program in peri-urban Cape Town found maternal and child health benefits over the 5 years point but this study examines if these benefits occur in deeply rural communities. Methods: A non-randomized, two-group comparison study evaluated the impact of CHW in the rural Eastern Cape from August 2014 to May 2017, with 1310 mother-infant pairs recruited in pregnancy and 89% were reassessed at 6 months post-birth. Results: Home visiting had limited, but important effects on child health, maternal wellbeing and health behaviors. Mothers reported fewer depressive symptoms, attended more antenatal visits and had better baby-feeding practices. Intervention mothers were significantly more likely to exclusively breastfeed for 6 months (OR: 1.8; 95% CI: 1.1, 2.9), had lower odds of mixing formula with baby porridge (regarded as detrimental) (OR: 0.4; 95% CI: 0.2, 0.8) and were less likely to consult traditional healers. Mothers living with HIV were more adherent with co-trimoxazole prophylaxis (p < 0.01). Intervention-group children were significantly less likely to be wasted (OR: 0.5; 95% CI 0.3–0.9) and had significantly fewer symptoms of common childhood illnesses in the preceding two weeks (OR: 0.8; 95% CI: 0.7,0.9). Conclusion: The impact of CHWs in a rural area was less pronounced than in peri-urban areas. CHWs are likely to need enhanced support and supervision in the challenging rural context.en
dc.description.urihttps://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-020-09468-w
dc.description.versionPublisher's version
dc.format.extent14 pages ; maps
dc.identifier.citationLe Roux, K. W., et al. 2020. Community health workers impact on maternal and child health outcomes in rural South Africa – a non-randomized two-group comparison study. BMC Public Health, 20:1404, doi:10.1186/s12889-020-09468-w
dc.identifier.issn1471-2458 (online)
dc.identifier.otherdoi:10.1186/s12889-020-09468-w
dc.identifier.urihttp://hdl.handle.net/10019.1/108880
dc.language.isoen_ZAen_ZA
dc.publisherBioMed Central
dc.rights.holderAuthors retain copyright
dc.subjectCommunity health aides -- South Africa
dc.subjectMaternal health services -- South Africaen_ZA
dc.subjectCommunity health services -- South Africaen_ZA
dc.titleCommunity health workers impact on maternal and child health outcomes in rural South Africa : a non-randomized two-group comparison studyen_ZA
dc.typeArticle
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