Comprehensive review of the evidence regarding the effectiveness of community–based primary health care in improving maternal, neonatal and child health: 7. shared characteristics of projects with evidence of long–term mortality impact
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BACKGROUND: There is limited evidence about the long-term effectiveness of integrated community-based primary health care (CBPHC) in improving maternal, neonatal and child health. However, the interventions implemented and the approaches used by projects with such evidence can provide guidance for ending preventable child and maternal deaths by the year 2030. METHODS: A database of 700 assessments of the effectiveness of CBPHC in improving maternal, neonatal and child health has been assembled, as described elsewhere in this series. A search was undertaken of these assessments of research studies, field project and programs (hereafter referred to as projects) with more than a single intervention that had evidence of mortality impact for a period of at least 10 years. Four projects qualified for this analysis: the Matlab Maternal Child Health and Family Planning (MCH-FP) P in Bangladesh; the Hôpital Albert Schweitzer in Deschapelles, Haiti; the Comprehensive Rural Health Project (CRHP) in Jamkhed, India; and the Society for Education, Action and Research in Community Health (SEARCH) in Gadchiroli, India. RESULTS: These four projects have all been operating for more than 30 years, and they all have demonstrated reductions in infant mortality, 1- to 4-year mortality, or under-5 mortality for at least 10 years. They share a number of characteristics. Among the most notable of these are: they provide comprehensive maternal, child health and family planning services, they have strong community-based programs that utilize community health workers who maintain regular contact with all households, they have develop strong collaborations with the communities they serve, and they all have strong referral capabilities and provide first-level hospital care. CONCLUSIONS: The shared features of these projects provide guidance for how health systems around the world might improve their effectiveness in improving maternal, neonatal and child health. Strengthening these features will contribute to achieving the goal of ending preventable child and maternal deaths by the year 2030.
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Evidence has shown that a robust PHC system can improve population health outcomes, reduce all-cause mortality and is cost-effective in achieving UHC in LMICs.
“Evidence has shown that a robust PHC system can improve population health outcomes, reduce all-cause mortality and is cost-effective in achieving UHC in LMICs [44–46].”
From Assessment of the compliance with minimum quality standards by public primary healthcare facilities in Nigeria (2024) · cites this paper as [45]
The Abstract (Results) reports sustained reductions in infant, child, or under-five mortality in four community-based primary health care projects, and the Haiti Results section gives a cost per under-five death averted. These findings support improved maternal and child health outcomes, but the paper does not establish reductions in all-cause mortality or cost-effectiveness in achieving universal health coverage across LMICs. Page numbers were not available in the indexed passages. (LLM, conf=0.88)
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References 22 · Cited by 42
Research works printed but not linked: 26
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- Authors
- Perry, H. B., Rassekh, B. M., Gupta, S., & Freeman, P. A.
- Affiliations
- Johns Hopkins University (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
- 010907-010907
- ISSN
- 2047-2978 (ISSN-L)
- 2047-2986
- PMC
- PMC5491946
- OpenAlex
- W2727256170
- Cited by
- 42
- References
- 22
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 2 · 2023: 7 · 2022: 3 · 2021: 4 · 2020: 5 · 2019: 5 · 2018: 2 · 2017: 7
- FWCI
- 0.97
- 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 health, newborn health, child health, infant mortality, under-five mortality, community health workers, family planning, referral systems, community participation, search, Gadchiroli, Bangladesh, Haiti, India
- MeSH terms
- Child, Preschool, Community Health Services, Developing Countries, Female, Humans, Infant, Infant Mortality, Infant, Newborn, Maternal Mortality, Pregnancy, Primary Health Care, Program Evaluation, Databases, Factual, Child Mortality
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