Cited by 55Global Maternal and Child HealthChild Nutrition and Water AccessMaternal and Neonatal Healthcare

Comprehensive review of the evidence regarding the effectiveness of community–based primary health care in improving maternal, neonatal and child health: 4. child health findings

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Freeman, Paul A, Schleiff, Meike, Sacks, Emma, Rassekh, Bahie M, Gupta, Sundeep, Perry, Henry B·2017·Journal of Global Health

Abstract

Comprehensive review of the evidence regarding the effectiveness of community-based primary health care in improving maternal, neonatal and child health: 4. child health findings Background This paper assesses the effectiveness of communitybased primary health care (CBPHC) in improving child health beyond the neonatal period.Although there has been an accelerated decline in global under-5 mortality since 2000, mortality rates remain high in much of sub-Saharan Africa and in some south Asian countries where under-5 mortality is also decreasing more slowly.Essential interventions for child health at the community level have been identified.Our review aims to contribute further to this knowledge by examining how strong the evidence is and exploring in greater detail what specific interventions and implementation strategies appear to be effective. MethodsWe reviewed relevant documents from 1950 onwards using a detailed protocol.Peer reviewed documents, reports and books assessing the impact of one or more CBPHC interventions on child health (defined as changes in population coverage of one or more key child survival interventions, nutritional status, serious morbidity or mortality) among children in a geographically defined population were examined for inclusion.Two separate reviews took place of each document followed by an independent consolidated summative review.Data from the latter review were transferred to an electronic database for analysis. ResultsThe findings provide strong evidence that the major causes of child mortality in resource-constrained settings can be addressed at the community level largely by engaging communities and supporting community-level workers.For all major categories of interventions (nutritional interventions; control of pneumonia, diarrheal disease and malaria; HIV prevention and treatment; immunizations; integrated management of childhood diseases; and comprehensive primary health care) we have presented randomized controlled trials that have consistently produced statistically significant and operationally important effects. ConclusionsThis review shows that there is strong evidence of effectiveness for CBPHC implementation of an extensive range of interventions to improve child health and that four major strategies for delivering these interventions are effective.

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  • Robust evidence demonstrates that tasks such as managing dispensing medication for childhood pneumonia and malaria can be performed safely and effectively by well-trained and supervised CHWs.

    “This has occurred even where we have robust evidence demonstrating that these tasks can be performed safely and effectively by well-trained and supervised CHWs [110].”

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  1. [27]27. Perry H, Davis T. The effectiveness of the census-based, impact-oriented (CBIO) approach in addressing global health goals. In: E. B, editor. Aid Effectiveness in Global Health. New York: Springer; 2015.

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Authors
Freeman, P. A., Schleiff, M., Sacks, E., Rassekh, B. M., Gupta, S., & Perry, H. B.
Affiliations
  • University of Washington (US)
  • Johns Hopkins University (US)
  • World Bank (US)
Corresponding author
Perry, Henry B
Venue
Journal of Global Health
Published
2017-06
Volume
7
Issue
1
ISSN
  • 2047-2978 (ISSN-L)
  • 2047-2986
OpenAlex
W4243367267
Cited by
55
References
26
Citations by year
2026: 2 · 2025: 3 · 2024: 3 · 2023: 5 · 2022: 11 · 2021: 8 · 2020: 9 · 2019: 6 · 2018: 3 · 2017: 5
FWCI
6.89
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
Journal of Global Health (publishedVersion, cc-by)
Funders
  • United States Agency for International Development
  • Bill and Melinda Gates Foundation
  • World Bank Group
  • World Health Organization
Topics
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
  • Health Sciences › Nursing › Nutrition and Dietetics › Child Nutrition and Water Access
  • Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
Keywords
community-based primary care, child health, child mortality, under-five mortality, community health workers, community participation, dietary intervention, diarrheal disease, malaria control, HIV prevention and treatment, immunization, Integrated Management of Childhood Illness, comprehensive primary health care, resource-limited settings

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