| Title |
Can community health worker home visiting improve care-seeking and maternal and newborn care practices in fragile states such as Afghanistan? A population-based intervention study
|
|---|---|
| Published in |
BMC Medicine, July 2018
|
| DOI | 10.1186/s12916-018-1092-9 |
| Pubmed ID | |
| Authors |
Karen M. Edmond, Khaksar Yousufi, Zelaikha Anwari, Sayed Masoud Sadat, Shah Mansoor Staniczai, Ariel Higgins-Steele, Alexandra L. Bellows, Emily R. Smith |
| Abstract |
The effects of community health worker (CHW) home visiting during the antenatal and postnatal periods in fragile- and conflicted-affected countries such as Afghanistan are not known. We conducted a non-randomised population-based intervention study from March 2015 to February 2016. Two intervention and two control districts were selected. All female CHWs in the intervention districts were trained to provide eight home visits and behaviour change communication messages from pregnancy to 28 days postpartum. The primary outcome was the proportion of women who reported delivering in a health facility. Secondary outcomes were the proportion of women who reported attending a health facility for at least one antenatal and one postnatal visit. Outcomes were analysed at 12 months using multivariable difference-in-difference linear regression models adjusted for clustering. Overall, 289 female CHWs in the intervention districts performed home visits and 1407 eligible women (less than 12 months postpartum) at baseline and 1320 endline women provided outcome data (94% response rate). Facility delivery increased in intervention villages by 8.2% and decreased in the control villages by 6.3% (adjusted mean difference (AMD) 11.0%, 95% confidence interval (CI) 4.0-18.0%, p = 0.002). Attendance for at least one antenatal care visit (AMD 10.5%, 95% CI 4.2-16.9%, p = 0.001) and postnatal care visit (AMD 7.2%, 95% CI 0.2-14.2%, p = 0.040) increased in the intervention compared to the control districts. CHW home visiting during the antenatal and postnatal periods can improve health service use in fragile- and conflict-affected countries. Commitment to scale-up from Ministries and donors is now needed. This trial was retrospectively registered at the Australian and New Zealand Clinical Trial Registry ( ACTRN12618000609257 ). |
X Demographics
The data shown below were collected from the profiles of 13 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 3 | 23% |
| South Africa | 2 | 15% |
| United Kingdom | 1 | 8% |
| Switzerland | 1 | 8% |
| Sweden | 1 | 8% |
| Unknown | 5 | 38% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Scientists | 6 | 46% |
| Members of the public | 5 | 38% |
| Practitioners (doctors, other healthcare professionals) | 2 | 15% |
Mendeley readers
The data shown below were compiled from readership statistics for 149 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 149 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 29 | 19% |
| Researcher | 17 | 11% |
| Student > Bachelor | 16 | 11% |
| Student > Ph. D. Student | 15 | 10% |
| Other | 5 | 3% |
| Other | 16 | 11% |
| Unknown | 51 | 34% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 37 | 25% |
| Nursing and Health Professions | 26 | 17% |
| Social Sciences | 7 | 5% |
| Economics, Econometrics and Finance | 5 | 3% |
| Psychology | 3 | 2% |
| Other | 13 | 9% |
| Unknown | 58 | 39% |
Attention Score in Context
This research output has an Altmetric Attention Score of 9. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 12 November 2018.
All research outputs
#3,602,282
of 23,094,276 outputs
Outputs from BMC Medicine
#1,907
of 3,466 outputs
Outputs of similar age
#69,367
of 326,642 outputs
Outputs of similar age from BMC Medicine
#43
of 65 outputs
Altmetric has tracked 23,094,276 research outputs across all sources so far. Compared to these this one has done well and is in the 84th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 3,466 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 43.7. This one is in the 44th percentile – i.e., 44% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 326,642 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 78% of its contemporaries.
We're also able to compare this research output to 65 others from the same source and published within six weeks on either side of this one. This one is in the 33rd percentile – i.e., 33% of its contemporaries scored the same or lower than it.