Comprehensive review of the evidence regarding the effectiveness of community–based primary health care in improving maternal, neonatal and child health: 6. strategies used by effective projects
Open accessAbstract
BACKGROUND: As part of our review of the evidence of the effectiveness of community-based primary health care (CBPHC) in improving maternal, neonatal and child health (MNCH), we summarize here the common delivery strategies of projects, programs and field research studies (collectively referred to as projects) that have demonstrated effectiveness in improving child mortality. Other articles in this series address specifically the effects of CBPHC on improving MNCH, while this paper explores the specific strategies used. METHODS: We screened 12 166 published reports in PubMed of community-based approaches to improving maternal, neonatal and child health in high-mortality, resource-constrained settings from 1950-2015. A total of 700 assessments, including 148 reports from other publicly available sources (mostly unpublished evaluation reports and books) met the criteria for inclusion and were reviewed using a data extraction form. Here we identify and categorize key strategies used in project implementation. RESULTS: Six categories of strategies for program implementation were identified, all of which required working in partnership with communities and health systems: (a) program design and evaluation, (b) community collaboration, (c) education for community-level staff, volunteers, beneficiaries and community members, (d) health systems strengthening, (e) use of community-level workers, and (f) intervention delivery. Four specific strategies for intervention delivery were identified: (a) recognition, referral, and (when possible) treatment of serious childhood illness by mothers and/or trained community agents, (b) routine systematic visitation of all homes, (c) facilitator-led participatory women's groups, and (d) health service provision at outreach sites by mobile health teams. CONCLUSIONS: The strategies identified here provide useful starting points for program design in strengthening the effectiveness of CBPHC for improving MNCH.
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A review of community-based PHC in improving maternal, neonatal, and child health identified four strategies with good evidence of effectiveness: home visitation, participatory women's groups, community case management of childhood illness, and provision of outreach services by mobile health teams.
“A review of community-based PHC in improving maternal, neonatal, and child health [20] identified four strategies for which there is good evidence of effectiveness:home visitation,participatory women’s groups,community case management of childhood illness, andprovision of outreach services by mobile health teams [112].”
From Community health workers at the dawn of a new era: 11. CHWs leading the way to “Health for All” (2021) · cites this paper as [112]
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References 61 · Cited by 68
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- [6]Hill Z, Kirkwood B, Edmond KM. Family and community practices that promote child survival, growth and development: a review of the evidence. Geneva, Switzerland: World Health Organization; 2004.
- [33]Chowdhury AMR, Cash RA. A Simple Solution: Teaching Millions to Treat Diarrhoea at Home. Dhaka, Bangladesh: University Press Limited; 1996.
- [37]WHO. UNICEF. WHO/UNICEF Joint Statement: Home Visits for the Newborn Child: A Strategy to Improve Survival. 2009. Available: http://apps.who.int/iris/bitstream/10665/70002/1/WHO_FCH_CAH_09.02_eng.pdf. Accessed: 26 April 2017. 24809117
- [43]Perry H Morrow M Borger S Weiss J DeCoster M Davis T Care Groups I: an emerging innovative community-based delivery strategy for improving maternal, neonatal and child health in high-mortality, resource-constrained settings. Glob Health Sci Pract 2015 3 358 69 10.9745/GHSP-D-15-00051 26374798 PMC4570011 · DOI
- Authors
- Perry, H. B., Sacks, E., Schleiff, M., Kumapley, R., Gupta, S., Rassekh, B. M., & Freeman, P. A.
- Affiliations
- Johns Hopkins University (US)
- United Nations Children's Fund (US)
- World Bank (US)
- University of Washington (US)
- Corresponding author
- Perry, Henry B
- Venue
- Journal of Global Health
- Published
- 2017-06
- Volume
- 7
- Issue
- 1
- Pages
- 010906-010906
- ISSN
- 2047-2978 (ISSN-L)
- 2047-2986
- PMC
- PMC5491945
- OpenAlex
- W2730449391
- Cited by
- 68
- References
- 61
- Citations by year
- 2025: 5 · 2024: 12 · 2023: 7 · 2022: 5 · 2021: 11 · 2020: 7 · 2019: 7 · 2018: 8 · 2017: 6
- FWCI
- 1.43
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Journal of Global Health (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- United States Agency for International Development
- Bill and Melinda Gates Foundation
- World Bank Group
- World Health Organization
- UNICEF
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
- Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
- Health Sciences › Nursing › Nutrition and Dietetics › Child Nutrition and Water Access
- Keywords
- community-based primary care, maternal, neonatal and child health, child mortality, program implementation strategies, community collaboration, health system strengthening, community health workers, home visits, women's organizations, mobile medical teams, resource-limited settings
- MeSH terms
- Child Health, Maternal Health, Infant Health, Child, Preschool, Community Health Services, Developing Countries, Female, Humans, Infant, Infant, Newborn, Pregnancy, Primary Health Care, Program Evaluation
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