Community Health Worker Impact on Knowledge, Antenatal Care, And Birth Outcomes: A Systematic Review

25 February, 2022

With thanks to CHW Central. Citation, abstract and a comment from me below.

'Community health worker (CHW) interventions have been associated with improved birth outcomes. Through a systematic review, the authors explored the relationship between patient health knowledge and attitude and birth outcomes. The review suggests that CHW interventions increased antenatal care utilization, enhanced knowledge of pregnancy related danger signs, and contributed to improvement of infant mortality rates, perinatal mortality rates and low birth weight. In conjunction with clinical interventions, CHW interventions have the ability to significantly impact maternal and child health outcomes throughout pregnancy and the birthing process.'

CITATION: Review Matern Child Health J. 2022 Jan;26(1):79-101. doi: 10.1007/s10995-021-03299-w. Epub 2022 Jan 4.

Community Health Worker Impact on Knowledge, Antenatal Care, And Birth Outcomes: A Systematic Review

Darcell Scharff et al

PMID: 34981332 DOI: 10.1007/s10995-021-03299-w


Objectives: Community health worker (CHW) interventions have been shown to be effective in areas of maternal and child health (MCH), mostly in relation to infant and neonatal mortality. The specific aims of this review were to expand outcomes to include improving knowledge related to pregnancy and infant health and the receipt of antenatal care (ANC), along with birth outcomes. We also summarized the role, characteristics and activities of CHWs in interventions conducted in settings with demonstrated improvements in key MCH outcomes.

Methods: Articles were retrieved from: PubMed, CINAHL, Global Health, Scopus, Web of Science, and the Cochrane Library from January 2008 through 2018. We included evaluation studies that utilized CHWs as all or part of an intervention to improve outcomes, were printed in English, and published in peer-reviewed journals.

Results: Initial electronic database search identified 816 studies and 123 studies met inclusion criteria for full text review. The quality assessment resulted in 0 strong-, 19 moderate-, and 25 weak-rated studies. In most interventions, CHWs were a component of a larger intervention. The majority of the studies (n = 10) found that a CHW intervention can have a positive impact on outcomes. CHW interventions showed improvements in knowledge and ANC. When combined with clinical services, the interventions positively impacted birth outcomes. Most conducted home visits and utilized CHW that were members of the community.

Conclusions for practice: CHWs serve an important role as health educators conducting home visits as a member of the community they serve. They should also continue to collaborate with clinical providers to address MCH outcomes.

COMMENT (NPW): Unfortunately the full text is restricted access so many of us cannot benefit fully. It would be interesting to carry out a complementary systematic review to compare the effectiveness of different approaches to meeting the information and learning needs of community health workers.

Neil Pakenham-Walsh, HIFA Coordinator,