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Cited by 182Global Maternal and Child HealthMaternal and Neonatal HealthcarePublic Health and Nutrition

Comprehensive review of the evidence regarding the effectiveness of community–based primary health care in improving maternal, neonatal and child health: 8. summary and recommendations of the Expert Panel

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Black, Robert E, Taylor, Carl E, Arole, Shobha, Bang, Abhay, Bhutta, Zulfiqar A, Chowdhury, A Mushtaque R, Kirkwood, Betty R, Kureshy, Nazo +6 more·2017·Journal of Global Health
DOI 10.7189/jogh.07.010908PMC PMC5475312
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Abstract

BACKGROUND: The contributions that community-based primary health care (CBPHC) and engaging with communities as valued partners can make to the improvement of maternal, neonatal and child health (MNCH) is not widely appreciated. This unfortunate reality is one of the reasons why so few priority countries failed to achieve the health-related Millennium Development Goals by 2015. This article provides a summary of a series of articles about the effectiveness of CBPHC in improving MNCH and offers recommendations from an Expert Panel for strengthening CBPHC that were formulated in 2008 and have been updated on the basis of more recent evidence. METHODS: An Expert Panel convened to guide the review of the effectiveness of community-based primary health care (CBPHC). The Expert Panel met in 2008 in New York City with senior UNICEF staff. In 2016, following the completion of the review, the Panel considered the review's findings and made recommendations. The review consisted of an analysis of 661 unique reports, including 583 peer-reviewed journal articles, 12 books/monographs, 4 book chapters, and 72 reports from the gray literature. The analysis consisted of 700 assessments since 39 were analyzed twice (once for an assessment of improvements in neonatal and/or child health and once for an assessment in maternal health). RESULTS: The Expert Panel recommends that CBPHC should be a priority for strengthening health systems, accelerating progress in achieving universal health coverage, and ending preventable child and maternal deaths. The Panel also recommends that expenditures for CBPHC be monitored against expenditures for primary health care facilities and hospitals and reflect the importance of CBPHC for averting mortality. Governments, government health programs, and NGOs should develop health systems that respect and value communities as full partners and work collaboratively with them in building and strengthening CBPHC programs - through engagement with planning, implementation (including the full use of community-level workers), and evaluation. CBPHC programs need to reach every community and household in order to achieve universal coverage of key evidence-based interventions that can be implemented in the community outside of health facilities and assure that those most in need are reached. CONCLUSIONS: Stronger CBPHC programs that foster community engagement/empowerment with the implementation of evidence-based interventions will be essential for achieving universal coverage of health services by 2030 (as called for by the Sustainable Development Goals recently adopted by the United Nations), ending preventable child and maternal deaths by 2030 (as called for by the World Health Organization, UNICEF, and many countries around the world), and eventually achieving Health for All as envisioned at the International Conference on Primary Health Care in 1978. Stronger CBPHC programs can also create entry points and synergies for expanding the coverage of family planning services as well as for accelerating progress in the detection and treatment of HIV/AIDS, tuberculosis, malaria, hypertension, and other chronic diseases. Continued strengthening of CBPHC programs based on rigorous ongoing operations research and evaluation will be required, and this evidence will be needed to guide national and international policies and programs.

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  • Evidence of the effectiveness of adequately trained and supported CHWs in providing quality health services and improving population health continues to grow.

    “Evidence of the effectiveness of adequately trained and supported CHWs in providing quality health services and improving population health continues to grow [13, 20–23].”

    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 [21]

  • The number of lives of mothers and their children that can be saved each year by increasing population coverage of the evidence-based promotive, preventive, and curative interventions provided by CHWs is greater than the number that can be saved by expanding facility-based services at PHC centres and hospitals (1.7 million versus 2.3 million).

    “This evidence indicates that the number of lives of mothers and their children that can be saved each year by increasing the population coverage of the evidence-based promotive, preventive, and curative interventions provided by CHWs is even greater than the number that can be saved by expanding facility-based services at PHC centres and hospitals (1.7 million versus 2.3 million) [21, 24]”

    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 [21]

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Research works printed but not linked: 9

  1. [6]Perry H Rassekh B Gupta S Freeman P 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. J Glob Health 2017 7 010906 28685044 PMC5491945
  2. [10]Perry H, Freeman P, Gupta S, Rassekh B. How Effective Is Community-based Primary Health Care in Improving the Health of Children? Summary Findings and Report to the Expert Review Panel: American Public Health Association; 2009. Available: http://www.coregroup.org/storage/documents/finalcbphcreport_july2009.pdf and http://aimdb.files.wordpress.com/2009/08/finalcbphcreporttoerp-7july2009.pdf. Accessed: 26 February 2017.
  3. [14]World Health Organization. UNICEF. Declaration of Alma-Ata: International Conference on Primary Health Care. 1978. Available: http://www.who.int/publications/almaata_declaration_en.pdf. Accessed: 27 February 2017.
  4. [15]World Health Organization. UNICEF, editors. Declaration of Alma-Ata. International Conference on Primary Health Care, 6-12 September 1978; 1978; Alma-Ata, USSR. Geneva, Switzerland: World Health Organization; 1978.
  5. [40]Taylor C, Parker R, DongLu D. China's model counties: Going to scale with health care. In: Taylor-Ide D, Taylor CE, editors. Just and Lasting Change: When Communities Own Their Futures. Baltimore and London: Johns Hopkins University Press; 2002. p. 284-95.
  6. [41]Taylor-Ide D, Taylor C. How to go to scale. In: Taylor-Ide D, Taylor CE, editors. Just and Lasting Change: When Communities Own Their Futures. Baltimore and London: Johns Hopkins University Press; 2002.
  7. [42]Arole M, Arole R. Jamkhed, India: The Evolution of a World Training Center. In: Taylor-Ide D, Taylor C, editors. Just and Lasting Change: When Communities Own Their Futures. Baltimore: Johns Hopkins University Press; 2002.
  8. [43]Paredes P, Taylor CE. Peru: Communities and Government Learning to Work Together. In: Taylor-Ide D, Taylor CE, editors. Just and Lasting Change: When Communities Own Their Futures. Baltimore and London: Johns Hopkins University Press; 2002.
  9. [44]Chowdhury AMR, Cash RA. A Simple Solution: Teaching Millions to Treat Diarrhoea at Home. Dhaka, Bangladesh: University Press Limited; 1996.

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Authors
Black, R. E., Taylor, C. E., Arole, S., Bang, A., Bhutta, Z. A., Chowdhury, A. M. R., Kirkwood, B. R., Kureshy, N., Lanata, C. F., Phillips, J. F., Taylor, M., Victora, C. G., Zhu, Z., & Perry, H. B.
Affiliations
  • Johns Hopkins University (US)
  • Aga Khan University (PK)
  • London School of Hygiene & Tropical Medicine (GB)
  • United States Agency for International Development (US)
  • Instituto de Investigación Nutricional (PE)
  • Columbia University (US)
  • Universidade Federal de Pelotas (BR)
  • Capital Institute of Pediatrics (CN)
ORCID
Venue
Journal of Global Health
Publisher
International Society of Global Health
Published
2017-06
Volume
7
Issue
1
Pages
010908-010908
ISSN
  • 2047-2978 (ISSN-L)
  • 2047-2986
DOI
10.7189/jogh.07.010908
PMC
PMC5475312
OpenAlex
W2623666123
Cited by
182
References
34
Citations by year
2026: 17 · 2025: 17 · 2024: 17 · 2023: 17 · 2022: 20 · 2021: 25 · 2020: 26 · 2019: 25 · 2018: 13 · 2017: 5
FWCI
3.53
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Journal of Global Health (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
  • eCommons - AKU (Aga Khan University) (submittedVersion)
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 › Medicine › Pediatrics, Perinatology and Child Health › Public Health and Nutrition
Keywords
community-based primary care, maternal health, newborn health, child health, community participation, community health workers, universal health coverage, Millennium Development Goals, Sustainable Development Goals, health system strengthening, evidence-based interventions, health care financing, community empowerment, health service coverage, Millennium Challenge Corporation, UNICEF, World Health Organization, Global Fund
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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