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Cited by 53Global Maternal and Child HealthMaternal and Neonatal HealthcareChild Nutrition and Water Access

Expanding the population coverage of evidence–based interventions with community health workers to save the lives of mothers and children: an analysis of potential global impact using the Lives Saved Tool (LiST)

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Chou, Victoria B, Friberg, Ingrid K, Christian, Mervyn, Walker, Neff, Perry, Henry B·2017·Journal of Global Health
DOI 10.7189/jogh.07.020401PMC PMC5592116
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Abstract

BACKGROUND: Evidence has been accumulating that community health workers (CHWs) providing evidence-based interventions as part of community-based primary health care (CBPHC) can lead to reductions in maternal, neonatal and child mortality. However, investments to strengthen and scale-up CHW programs still remain modest. METHODS: We used the Lives Saved Tool (LiST) to estimate the number of maternal, neonatal and child deaths and stillbirths that could be prevented if 73 countries effectively scaled up the population coverage of 30 evidence-based interventions that CHWs can deliver in these high-burden countries. We set population coverage targets at 50%, 70%, and 90% and summed the country-level results by region and by all 73 high-burden countries combined. We also estimated which specific interventions would save the most lives. FINDINGS: LiST estimates that a total of 3.0 (sensitivity bounds 1.8-4.0), 4.9 (3.1-6.3) and 6.9 (3.7-8.7) million deaths would be prevented between 2016 and 2020 if CBPHC is gradually scaled up during this period and if coverage of key interventions reaches 50%, 70%, and 90% respectively. There would be 14%, 23%, and 32% fewer deaths in the final year compared to a scenario assuming no intervention coverage scale up. The Africa Region would receive the most benefit by far: 58% of the lives saved at 90% coverage would be in this region. The interventions contributing the greatest impact are nutritional interventions during pregnancy, treatment of malaria with artemisinin compounds, oral rehydration solution for childhood diarrhea, hand washing with soap, and oral antibiotics for pneumonia. CONCLUSIONS: Scaling up CHW programming to increase population-level coverage of life-saving interventions represents a very promising strategy to achieve universal health coverage and end preventable maternal and child deaths by 2030. Numerous practical challenges must be overcome, but there is no better alternative at present. Expanding the coverage of key interventions for maternal nutrition and treatment of childhood illnesses, in particular, may produce the greatest gains. Recognizing the millions of lives of mothers and their young offspring that could be achieved by expanding coverage of evidence-based interventions provided by CHWs and strengthening the CBPHC systems that support them underscores the pressing need for commitment from governments and donors over the next 15 years to prioritize funding, so that robust CHW platforms can be refined, strengthened, and expanded.

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  • Based on modelling, if population coverage of current evidence-based maternal-child interventions that can be implemented at community level by CHWs were raised to 90% in the 74 countries with 97% of child and maternal mortality, an additional 2.6 million maternal and child deaths could be averted each year.

    “Based on modelling, it has been estimated that if we could raise the population coverage of current evidence-based maternal-child interventions that can be implemented at the community level by CHWs to 90% in the 74 countries with 97% of the child and maternal mortality in the world, an additional 2.6 million maternal and child deaths could be averted each year [111].”

    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 [111]

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  1. [12]Black R, Walker N, Laxminarayan R, Temmerman M. Reproductive, maternal, newborn, and child health: Key messages of this volume. In: Black R, Laxminarayan R, Temmerman M, Walker N, editors. Reproductive, maternal, newborn, and child health. Washington, DC: World Bank; 2016. p. 1-23. 27227235

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Authors
Chou, V. B., Friberg, I. K., Christian, M., Walker, N., & Perry, H. B.
Affiliations
  • Johns Hopkins University (US)
  • Norwegian Institute of Public Health (NO)
Corresponding author
Perry, Henry B
ORCID
Venue
Journal of Global Health
Publisher
International Society of Global Health
Published
2017-09-15
Volume
7
Issue
2
Pages
020401-020401
ISSN
  • 2047-2978 (ISSN-L)
  • 2047-2986
DOI
10.7189/jogh.07.020401
PMC
PMC5592116
OpenAlex
W2750852651
Cited by
53
References
44
Citations by year
2026: 2 · 2025: 5 · 2024: 13 · 2023: 8 · 2022: 2 · 2021: 6 · 2020: 3 · 2019: 10 · 2018: 3 · 2017: 1
FWCI
5.07
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Journal of Global Health (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • NORA - Norwegian Open Research Archives (submittedVersion, other-oa)
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 health workers, community-based primary care, maternal mortality, neonatal mortality, child mortality, Lives Saved Tool, scaling up interventions, population coverage, malaria treatment, artemisinin, childhood diarrhea, oral rehydration solution, handwashing with soap, pneumonia, oral antibiotics, maternal nutrition, universal health coverage, high-burden countries, Africa, stillbirth
MeSH terms
Maternal-Child Health Services, Africa, Child, Preschool, Community Health Workers, Female, Humans, Infant, Infant Mortality, Infant, Newborn, Maternal Mortality, Pregnancy, Primary Health Care, Global Health, Child Mortality, Stillbirth, Evidence-Based Practice

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