Dear HIFA colleagues,
Our recent publication, “The roles of community health workers who provide maternal and newborn health services: case studies from Africa and Asia” explores the roles of 10 cadres of CHWs providing maternal and newborn health services in five countries across Africa and Asia.
Published: August 12, 2019, https://gh.bmj.com/content/4/4/e001388
Introduction: A variety of community health workers (CHWs) provide maternal and newborn health (MNH) services in low-income and middle-income settings. However, there is a need for a better understanding of the diversity in the type of CHW in each setting and responsibility, role, training duration and type of remuneration.
Methods: We identified CHWs providing MNH services in Bangladesh, India, Kenya, Malawi and Nigeria by reviewing 23 policy documents and conducting 36 focus group discussions and 131 key informant interviews. We analysed the data using thematic analysis.
Results: Irrespective of training duration (8 days to 3 years), all CHWs identify pregnant women, provide health education and screen for health conditions that require a referral to a higher level of care. Therapeutic care, antenatal care and skilled birth attendance, and provision of long-acting reversible contraceptives are within the exclusive remit of CHWs with training greater than 3 months. In contrast, community mobilisation and patient tracking are often done by CHWs with training shorter than 3 months. Challenges CHWs face include pressure to provide MNH services beyond their scope of practice during emergencies, and a tendency in some settings to focus CHWs on facility-based roles at the expense of their traditional community-based roles.
Conclusion: CHWs are well-positioned geographically and socially to deliver some aspects of MNH care. However, there is a need to review and revise their scope of practice to reflect the varied duration of training and in-country legislation.
HIFA profile: Abimbola Olaniran is a 3rd year Ph.D candidate at the Liverpool School of Tropical Medicine. His Ph.D titled, "Community health workers for maternal and newborn health: case studies from Africa and Asia" focuses on the challenges of CHWs in these countries. He is a member of the CHW thematic working group. israelolaniran AT gmail.com