Home visits by community health workers in rural South Africa have a limited, but important impact on maternal and child health in the first two years of life

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dc.contributor.authorKatzen, Linnea Stanserten_ZA
dc.contributor.authorTomlinson, Marken_ZA
dc.contributor.authorChristodoulou, Joanen_ZA
dc.contributor.authorLaurenzi, Christinaen_ZA
dc.contributor.authorLe Roux, Ingriden_ZA
dc.contributor.authorBaker, Venetiaen_ZA
dc.contributor.authorMbewu, Nokwaneleen_ZA
dc.contributor.authorLe Roux, Karl W.en_ZA
dc.contributor.authorBorus, Mary Jane Rotheramen_ZA
dc.date.accessioned2020-07-27T07:07:29Z
dc.date.available2020-07-27T07:07:29Z
dc.date.issued2020-06-29
dc.date.updated2020-07-05T05:03:36Z
dc.descriptionCITATION: Katzen, L. S., et al. 2020. Home visits by community health workers in rural South Africa have a limited, but important impact on maternal and child health in the first two years of life. BMC Health Services Research, 20:594, doi:10.1186/s12913-020-05436-7.
dc.descriptionThe original publication is available at https://bmchealthservres.biomedcentral.com
dc.description.abstractBackground: More than 50% of Africa’s population lives in rural areas, which have few professional health workers. South Africa has adopted task shifting health care to Community Health Workers (CHWs) to achieve the Sustainable Development Goals, but little is known about CHWs’ efficacy in rural areas. Methods: In this longitudinal prospective cohort study, almost all mothers giving birth (N = 470) in the Zithulele Hospital catchment area of the OR Tambo District were recruited and repeatedly assessed for 2 years after birth with 84.7–96% follow-up rates. During the cohort assessment we found that some mothers had received standard antenatal and HIV care (SC) (n = 313 mothers), while others had received SC, supplemented with home-visiting by CHWs before and after birth (HV) (n = 157 mothers, 37 CHWs). These visits were unrelated to the cohort study. Multiple linear and logistic regressions evaluated maternal comorbidities, maternal caretaking, and child development outcomes over time. Results: Compared to mothers receiving SC, mothers who also received home visits by CHWs were more likely to attend the recommended four antenatal care visits, to exclusively breastfeed at 3 months, and were less likely to consult traditional healers at 3 months. Mothers in both groups were equally likely to secure the child grant, and infant growth and achievement of developmental milestones were similar over the first 2 years of life. Conclusion: CHW home visits resulted in better maternal caretaking, but did not have direct benefits for infants in the domains assessed. The South African Government is planning broad implementation of CHW programmes, and this study examines a comprehensive, home-visiting model in a rural region.en
dc.description.urihttps://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-020-05436-7
dc.description.versionPublisher's version
dc.description.versionAuthors retain copyright
dc.format.extent10 pages
dc.identifier.citationKatzen, L. S., et al. 2020. Home visits by community health workers in rural South Africa have a limited, but important impact on maternal and child health in the first two years of life. BMC Health Services Research, 20:594, doi:10.1186/s12913-020-05436-7
dc.identifier.issn1472-6963 (online)
dc.identifier.otherdoi:10.1186/s12913-020-05436-7
dc.identifier.urihttp://hdl.handle.net/10019.1/108732
dc.language.isoen_ZAen_ZA
dc.publisherBMC (part of Springer Nature)
dc.subjectPostpartum depression -- South Africa
dc.subjectCommunity health aides -- South Africaen_ZA
dc.subjectMaternal health services -- Effectiveness -- South Africaen_ZA
dc.subjectMotherhood -- Psychological aspects -- South Africaen_ZA
dc.subjectInfants -- Health -- South Africaen_ZA
dc.subjectRural health -- South Africaen_ZA
dc.titleHome visits by community health workers in rural South Africa have a limited, but important impact on maternal and child health in the first two years of lifeen_ZA
dc.typeArticle
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