Improving access to maternal health services among rural hard-to-reach fishing communities in Uganda, the role of community health workers
Authors & affiliation
Ali Ssetaala, Julius Ssempiira, Mathias Wambuzi, Gertrude Nanyonjo, Brenda Okech, Kundai Chinyenze, Bernard Bagaya, Matt Price, Noah Kiwanuka, Olivier Degomme
Abstract
Objectives: To explore whether community health worker household-based maternal health visits improve antenatal care and skilled birth attendance among hard-to-reach fishing villages on Lake Victoria, Uganda. Methods: This quasi-experimental 18-month prospective study involved 486 consenting women aged 15-49 years, who were pregnant or had a pregnancy outcome in the past 6 months, from 6 island fishing communities. The community health worker household-based intervention (community health workers' household visits to provide counseling, blood pressure measurement, anemia, and HIV testing) involved 243 women from three fishing communities. Random effects logistic regression was used to determine the association between the community health worker intervention and antenatal care and skilled birth attendance among women who had at least 5 months of pregnancy or childbirth at follow-up. Results: Almost all women accepted the community health worker intervention (90.9% (221/243)). Hypertension was at 12.5% (27/216) among those who accepted blood pressure measurements, a third (33.3% (9/27)) were pregnant. HIV prevalence was 23.5% (52/221). Over a third (34.2% (69/202)) of women tested had anemia (hemoglobin levels less than 11 g/dL). The community health worker intervention was associated with attendance of first antenatal care visit within 20 weeks of pregnancy (adjusted odd ratio = 2.1 (95% confidence interval 0.6-7.6)), attendance of at least four antenatal care visits (adjusted odd ratio = 0.9 (95% confidence interval 0.4-2.0)), and skilled birth attendance (adjusted odd ratio = 0.5 (95% confidence interval 0.1-1.5)), though not statistically significant. Conclusion: Community health workers have a crucial role in improving early antenatal care attendance, early community-based diagnosis of anemia, hypertensive disorders, and HIV among women in these hard-to-reach fishing communities.
Publication date:
2022
Staff members:
Link to publication
Attachments
Ssetaala_CHW_improving_MH_Publication_Jun2022.pdf (open)Related publications
Frances H. Ampt, Megan S. C. Lim, Paul A. Agius, Matthew Chersich, Griffins Manguro, Caroline M. Gichuki, Mark Stoové, Marleen Temmerman, Walter Jaoko, Margaret Hellard, Peter Gichangi, Stanley Lüchters
2017 The impact of facility audits, evaluation reports and incentives on motivation and supply management among family planning service providers : an interventional study in two districts in Maputo Province, MozambiqueHeleen Vermandere, Anna Galle, Sally Griffin, Málica de Melo, Lino Machaieie, Dirk Van Braeckel, Olivier Degomme
2014 Determinants of acceptance and subsequent uptake of the HPV vaccine in a cohort in Eldoret, KenyaHeleen Vermandere, Violet Naanyu, Hillary Mabeya, Davy Vanden Broeck, Kristien Michielsen, Olivier Degomme