In African countries including Kenya, contraceptive use, fertility rates and other reproductive health indicators in rural areas lag behind urban areas. Even though Kenya's fertility rate declined from 8.1 in 1978 to 4.6 in 2008, the figures are much higher in rural areas, 5.2 compared to an urban rate of 2.9. The persistent high fertility rate has been attributed to many factors including inadequate provision of family planning services.
Globally, there is increasing interest in community health worker’s (CHW) performance; however, there are gaps in the evidence with respect to CHWs’ role in community participation and empowerment. Accredited Social Health Activists (ASHAs), whose roles include social activism, are the key cadre in India’s CHW programme which is designed to improve maternal and child health. In a diverse country like India, there is a need to understand how the ASHA programme operates in different underserved Indian contexts, such as rural Manipur.
Nigeria’s maternal mortality ratio is the tenth highest in the world, with an estimated 630 maternal deaths per 100,000 live births, and 40,000 maternal deaths annually. There is now a critical need to support Nigeria’s efforts to make significant progress in achieving the Millennium Development Goal 5 target of reducing maternal mortality by 2015 through the government’s recently launched Saving One Million Lives (SOML) initiative. With a dearth of skilled personnel at the primary health care level, Community Health Extension Workers (CHEWs) have increasingly filled the gap at primary heal
Malaria, pneumonia and diarrhoea are among the leading killer diseases among children aged five years and below. Efforts in realizing the Millennium Development Goals are tailored towards tackling the three diseases at community level through integrated community case management (iCCM). iCCM involves diagnosis and treatment of malaria, pneumonia and diarrhoea by community health workers (CHWs) in addition to referral of severely sick children, children whose conditions cannot be treated by CHWs, and newborns.
In 2004, the Government of Ethiopia introduced the Health Extension Programme (HEP), a free primary health care package with four components: disease prevention and control, family health, hygiene and environmental sanitation, and health education and communication. A female cadre of salaried community health workers (CHWs) called health extension workers (HEWs) was introduced nationally. HEWs are linked to the community through a network of community volunteers, who are members of the health development army (HDA).
Community health workers are reemerging as an essential component of health systems in low-income countries. However, there are concerns that unless they are adequately supported, their motivation and performance will be suboptimal. mHealth presents an opportunity to improve support for community health workers; however, most interventions to date have been designed through a top-down approach, rarely involve the end user, and have not focused on motivation.
Maternal antenatal depression has long-term consequences for children’s health. We examined if home visits by community health workers (CHW) can improve growth outcomes for children of mothers who are antenatally depressed.
An estimated 2.8 million neonatal deaths occur annually worldwide, three-quarters in Africa and Asia. These deaths are due largely to preventable causes, with neonatal infection accounting for 24% of all neonatal deaths. In low-resource community-based settings, care-seeking for neonatal illnesses can be triggered through two paths.
Pneumonia and diarrhoea disproportionately affect children living in low-income countries. As a vehicle to increase coverage of lifesaving treatment for children suffering from these three child killers, a joint statement was produced by the World Health Organisation (WHO) and United Nations Children's Fund (UNICEF) in 2004 calling for integrated community case management (iCCM) of pneumonia and diarrhoea in addition to malaria in countries where these diseases are common
Under-five mortality has fallen globally from 12.6 million deaths in 1990 to 6.6 million deaths in 2012. The share of neonatal mortality among under-five deaths increased from 37% in 1990 to about 44% in 2012, because of a slower decline in the neonatal mortality rate compared to deaths in older children. In Pakistan, over 60% of deaths under 5 years occur during the neonatal period (55 per 1000 live births) and have not changed over the past 6 years. These national averages mask considerable disparities between provinces and districts.