Authors: Caroline Whidden,Kassoum Kayentao, Naimatou Koné, Jenny Liu, Mohamed Bana Traoré, Djoumé Diakité, Mama Coumaré, Mohamed Berthé, Mahamadou Guindo, Brian Greenwood, Daniel Chandramohan,Clémence Leyrat, Emily Treleaven,and Ari Johnson
The purpose of this paper was to determine whether proactive CHW service delivery (i.e., involving routine door-to-door home visits to search for and identify prospective patients) reduced mortality and improved access to health care among children under five years in rural Malawi, when compared with passive service delivery. Village-clusters were randomized to receive CHW services delivered via proactive home visits (intervention) or only at a fixed community health site (control), and all outcome measures were collected using surveys. The primary outcome was prompt treatment within the health sector, while secondary outcomes included any prompt treatment, health sector evaluation, and any care (inside or outside the home). Results demonstrated that prompt health sector treatment more than doubled compared to baseline across arms. At twelve months, children in intervention clusters had 22% higher odds of receiving prompt health sector treatment than those in the control. These findings suggest a CHW-led health system redesign could be beneficial in improving rapid child access to care, though some limitations remain as per the study findings.
Link: Effects of proactive vs fixed community health care delivery on child health and access to care: a cluster randomized trial secondary endpoint analysis
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Resource Topic: Access to care, CHW, Child health
Resource Type: Research
Year: 2023
Region: Asia
Country: Mali
Publisher May Restrict Access: No