1. Community health workers impact on maternal and child health outcomes in rural South Africa – a non-randomized two-group comparison study
- Author
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le Roux, Karl W, Almirol, Ellen, Rezvan, Panteha Hayati, le Roux, Ingrid M, Mbewu, Nokwanele, Dippenaar, Elaine, Stansert-Katzen, Linnea, Baker, Venetia, Tomlinson, Mark, and Rotheram-Borus, MJ
- Subjects
Pediatric ,Clinical Trials and Supportive Activities ,Rural Health ,Clinical Research ,Behavioral and Social Science ,Prevention ,Reproductive health and childbirth ,Good Health and Well Being ,Adolescent ,Adult ,Community Health Workers ,Effect Modifier ,Epidemiologic ,Female ,Health Behavior ,House Calls ,Humans ,Infant ,Infant Health ,Infant ,Newborn ,Maternal Health ,Middle Aged ,Outcome Assessment ,Health Care ,Pregnancy ,Program Evaluation ,Rural Population ,South Africa ,Young Adult ,Community health workers ,Rural ,Eastern cape ,Wasting ,Depression ,Public Health and Health Services ,Public Health - Abstract
BackgroundHome visits by paraprofessional community health workers (CHWs) has been shown to improve maternal and child health outcomes in research studies in many countries. Yet, when these are scaled or replicated, efficacy disappears. An effective CHW home visiting program in peri-urban Cape Town found maternal and child health benefits over the 5 years point but this study examines if these benefits occur in deeply rural communities.MethodsA non-randomized, two-group comparison study evaluated the impact of CHW in the rural Eastern Cape from August 2014 to May 2017, with 1310 mother-infant pairs recruited in pregnancy and 89% were reassessed at 6 months post-birth.ResultsHome visiting had limited, but important effects on child health, maternal wellbeing and health behaviors. Mothers reported fewer depressive symptoms, attended more antenatal visits and had better baby-feeding practices. Intervention mothers were significantly more likely to exclusively breastfeed for 6 months (OR: 1.8; 95% CI: 1.1, 2.9), had lower odds of mixing formula with baby porridge (regarded as detrimental) (OR: 0.4; 95% CI: 0.2, 0.8) and were less likely to consult traditional healers. Mothers living with HIV were more adherent with co-trimoxazole prophylaxis (p
- Published
- 2020