The Effectiveness of a Community Health Worker Program in Sigoti, Kenya

Abstract

Women from the Luo tribe have the highest HIV prevalence of any ethnicity and gender category in Kenya (22.8%). Due to the high prevalence of HIV, it is important that these women deliver their infants in health care facilities that provide antiretroviral treatment as a means to decrease the rate of mother to child transmission. In addition, the presence of skilled personnel during delivery can avert between 13 to 33% of maternal deaths. Volunteer community health worker programs have been created in many developing nations in order to increase the use of maternal health services. However, the effectiveness of many of these programs has not been established. The purpose of this study is to examine whether a community health worker program in Sigoti, Kenya increased the use of maternal health services from January 2009 through May 2012. Data from the maternal registry at the Sigoti Health Center was analyzed in order to determine if utilization rates changed after the institution of the community health worker program. Data was divided into non‐intervention and intervention time frames for comparisons. The number of facility‐based deliveries increased from an average of 38 in the non‐intervention time frames to 60 in the intervention time frame. This increase was statistically significant (p=0.014). However, increases in the risk profile of the women (p=0.119), the number of HIV‐positive women (p=0.102), and mean birth weight (p=0.100) were not statistically significant. These findings show that community health worker programs can be used to increase the number of facility‐based deliveries. Through such programs, developing nations can potentially increase the number of pregnant women receiving antiretroviral treatment and thereby reduce the rate of mother to child transmission of HIV.