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Can Volunteer Community Health Workers Decrease Child Morbidity and Mortality in Southwestern Uganda? An Impact Evaluation

Author

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  • Jennifer L Brenner
  • Jerome Kabakyenga
  • Teddy Kyomuhangi
  • Kathryn A Wotton
  • Carolyn Pim
  • Moses Ntaro
  • Fred Norman Bagenda
  • Ndaruhutse Ruzazaaza Gad
  • John Godel
  • James Kayizzi
  • Douglas McMillan
  • Edgar Mulogo
  • Alberto Nettel-Aguirre
  • Nalini Singhal

Abstract

Background: The potential for community health workers to improve child health in sub-Saharan Africa is not well understood. Healthy Child Uganda implemented a volunteer community health worker child health promotion model in rural Uganda. An impact evaluation was conducted to assess volunteer community health workers' effect on child morbidity, mortality and to calculate volunteer retention. Methodology/Principal Findings: Two volunteer community health workers were selected, trained and promoted child health in each of 116 villages (population ∼61,000) during 2006–2009. Evaluation included a household survey of mothers at baseline and post-intervention in intervention/control areas, retrospective reviews of community health worker birth/child death reports and post-intervention focus group discussions. Retention was calculated from administrative records. Main outcomes were prevalence of recent child illness/underweight status, community health worker reports of child deaths, focus group perception of effect, and community health worker retention. After 18–36 months, 86% of trained volunteers remained active. Post-intervention surveys in intervention households revealed absolute reductions of 10.2% [95%CI (−17.7%, −2.6%)] in diarrhea prevalence and 5.8% [95%CI (−11.5%, −0.003%)] in fever/malaria; comparative decreases in control households were not statistically significant. Underweight prevalence was reduced by 5.1% [95%CI (−10.7%, 0.4%)] in intervention households. Community health worker monthly reports revealed a relative decline of 53% in child deaths (

Suggested Citation

  • Jennifer L Brenner & Jerome Kabakyenga & Teddy Kyomuhangi & Kathryn A Wotton & Carolyn Pim & Moses Ntaro & Fred Norman Bagenda & Ndaruhutse Ruzazaaza Gad & John Godel & James Kayizzi & Douglas McMilla, 2011. "Can Volunteer Community Health Workers Decrease Child Morbidity and Mortality in Southwestern Uganda? An Impact Evaluation," PLOS ONE, Public Library of Science, vol. 6(12), pages 1-9, December.
  • Handle: RePEc:plo:pone00:0027997
    DOI: 10.1371/journal.pone.0027997
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    References listed on IDEAS

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    1. Walt, Gill & Perera, Myrtle & Heggenhougen, Kris, 1989. "Are large-scale volunteer community health worker programmes feasible? The case of Sri Lanka," Social Science & Medicine, Elsevier, vol. 29(5), pages 599-608, January.
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    1. Agnes Nanyonjo & Fredrick Makumbi & Patrick Etou & Göran Tomson & Karin Källander & for the inSCALE study group, 2013. "Perceived Quality of Care for Common Childhood Illnesses: Facility versus Community Based Providers in Uganda," PLOS ONE, Public Library of Science, vol. 8(11), pages 1-1, November.
    2. Shehla Zaidi & Maryam Huda & Ammarah Ali & Xaher Gul & Rawshan Jabeen & Mashal Murad Shah, 2020. "Pakistan’s Community-based Lady Health Workers (LHWs): Change Agents for Child Health?," Global Journal of Health Science, Canadian Center of Science and Education, vol. 12(11), pages 177-187, October.
    3. Qian, Nancy & Deserranno, Erika, 2020. "Aid Crowd-Out: The Effect of NGOs on Government-Provided Public Services," CEPR Discussion Papers 14755, C.E.P.R. Discussion Papers.
    4. Erika Deserranno & Aisha Nansamba & Nancy Qian, 2020. "The Unintended Consequences of NGO-Provided Aid on Government Services in Uganda," NBER Working Papers 26928, National Bureau of Economic Research, Inc.

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