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Profile, knowledge, and work patterns of a cadre of maternal, newborn, and child health CHWs focusing on preventive and promotive services in Morogoro Region, Tanzania

Overview of attention for article published in Human Resources for Health, December 2015
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Title
Profile, knowledge, and work patterns of a cadre of maternal, newborn, and child health CHWs focusing on preventive and promotive services in Morogoro Region, Tanzania
Published in
Human Resources for Health, December 2015
DOI 10.1186/s12960-015-0086-3
Pubmed ID
Authors

Amnesty E. LeFevre, Rose Mpembeni, Dereck Chitama, Asha S. George, Diwakar Mohan, David P Urassa, Shivam Gupta, Isabelle Feldhaus, Audrey Pereira, Charles Kilewo, Joy J Chebet, Chelsea M Cooper, Giulia Besana, Harriet Lutale, Dunstan Bishanga, Emmanuel Mtete, Helen Semu, Abdullah H Baqui, Japhet Killewo, Peter J Winch

Abstract

Despite impressive decreases in under-five mortality, progress in reducing maternal and neonatal mortality in Tanzania has been slow. We present an evaluation of a cadre of maternal, newborn, and child health community health worker (MNCH CHW) focused on preventive and promotive services during the antenatal and postpartum periods in Morogoro Region, Tanzania. Study findings review the effect of several critical design elements on knowledge, time allocation, service delivery, satisfaction, and motivation. A quantitative survey on service delivery and knowledge was administered to 228 (of 238 trained) MNCH CHWs. Results are compared against surveys administered to (1) providers in nine health centers (n = 88) and (2) CHWs (n = 53) identified in the same districts prior to the program's start. Service delivery outputs were measured by register data and through a time motion study conducted among a sub-sample of 33 randomly selected MNCH CHWs. Ninety-seven percent of MNCH CHWs (n = 228) were interviewed: 55% male, 58% married, and 52% with secondary school education or higher. MNCH CHWs when compared to earlier CHWs were more likely to be unmarried, younger, and more educated. Mean MNCH CHW knowledge scores were <50% for 8 of 10 MNCH domains assessed and comparable to those observed for health center providers but lower than those for earlier CHWs. MNCH CHWs reported covering a mean of 186 households and were observed to provide MNCH services for 5 h weekly. Attendance of monthly facility-based supervision meetings was nearly universal and focused largely on registers, yet data quality assessments highlighted inconsistencies. Despite program plans to provide financial incentives and bicycles for transport, only 56% of CHWs had received financial incentives and none received bicycles. Initial rollout of MNCH CHWs yields important insights into addressing program challenges. The social profile of CHWs was not significantly associated with knowledge or service delivery, suggesting a broader range of community members could be recruited as CHWs. MNCH CHW time spent on service delivery was limited but comparable to the financial incentives received. Service delivery registers need to be simplified to reduce inconsistencies and yet expanded to include indicators on the timing of antenatal and postpartum visits.

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X Demographics

The data shown below were collected from the profiles of 3 X users who shared this research output. Click here to find out more about how the information was compiled.
Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 184 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Sierra Leone 1 <1%
Tanzania, United Republic of 1 <1%
Unknown 182 99%

Demographic breakdown

Readers by professional status Count As %
Student > Master 33 18%
Researcher 29 16%
Student > Ph. D. Student 19 10%
Student > Postgraduate 16 9%
Student > Bachelor 13 7%
Other 35 19%
Unknown 39 21%
Readers by discipline Count As %
Medicine and Dentistry 43 23%
Nursing and Health Professions 33 18%
Social Sciences 25 14%
Psychology 7 4%
Economics, Econometrics and Finance 6 3%
Other 28 15%
Unknown 42 23%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 2. 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 06 January 2016.
All research outputs
#16,720,137
of 25,371,288 outputs
Outputs from Human Resources for Health
#1,125
of 1,261 outputs
Outputs of similar age
#228,833
of 396,492 outputs
Outputs of similar age from Human Resources for Health
#15
of 17 outputs
Altmetric has tracked 25,371,288 research outputs across all sources so far. This one is in the 32nd percentile – i.e., 32% of other outputs scored the same or lower than it.
So far Altmetric has tracked 1,261 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 13.3. This one is in the 9th percentile – i.e., 9% 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 396,492 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 39th percentile – i.e., 39% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 17 others from the same source and published within six weeks on either side of this one. This one is in the 1st percentile – i.e., 1% of its contemporaries scored the same or lower than it.