A systematic review of vital events tracking by community health agents

Nichols, Erin; Ragunanthan, Nina W; Ragunanthan, Braveen; Gebrehiwet, Hermon; Kamara, Karim

doi:10.1080/16549716.2019.1597452

Cited by 15 publications

(16 citation statements)

References 41 publications

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“… Support further research on the potential contributions of CHWs to vital events registration as well as to civil birth and death certification, and verbal autopsies. Engagement of local communities with the findings as well as field trials of these activities [ 60 – 63 ]. Explore real-world implementation issues for CHW programmes with these expanded roles, determining what is necessary—in specific settings—for CHWs to perform these tasks effectively under routine programme conditions (including assessing the implications for the numbers of CHWs required to avoid overburden of tasks).…”

Section: How Can National Chw Programmes Be Strengthened?mentioning

confidence: 99%

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Community health workers at the dawn of a new era: 11. CHWs leading the way to “Health for All”

Perry

Chowdhury

Were

et al. 2021

Health Res Policy Sys

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Background This is the concluding paper of our 11-paper supplement, “Community health workers at the dawn of a new era”. Methods We relied on our collective experience, an extensive body of literature about community health workers (CHWs), and the other papers in this supplement to identify the most pressing challenges facing CHW programmes and approaches for strengthening CHW programmes. Results CHWs are increasingly being recognized as a critical resource for achieving national and global health goals. These goals include achieving the health-related Sustainable Development Goals of Universal Health Coverage, ending preventable child and maternal deaths, and making a major contribution to the control of HIV, tuberculosis, malaria, and noncommunicable diseases. CHWs can also play a critical role in responding to current and future pandemics. For these reasons, we argue that CHWs are now at the dawn of a new era. While CHW programmes have long been an underfunded afterthought, they are now front and centre as the emerging foundation of health systems. Despite this increased attention, CHW programmes continue to face the same pressing challenges: inadequate financing, lack of supplies and commodities, low compensation of CHWs, and inadequate supervision. We outline approaches for strengthening CHW programmes, arguing that their enormous potential will only be realized when investment and health system support matches rhetoric. Rigorous monitoring, evaluation, and implementation research are also needed to enable CHW programmes to continuously improve their quality and effectiveness. Conclusion A marked increase in sustainable funding for CHW programmes is needed, and this will require increased domestic political support for prioritizing CHW programmes as economies grow and additional health-related funding becomes available. The paradigm shift called for here will be an important step in accelerating progress in achieving current global health goals and in reaching the goal of Health for All.

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Section: How Can National Chw Programmes Be Strengthened?mentioning

confidence: 99%

“…Engagement of local communities with the findings as well as field trials of these activities [ 60 – 63 ].…”

Section: How Can National Chw Programmes Be Strengthened?mentioning

confidence: 99%

Community health workers at the dawn of a new era: 11. CHWs leading the way to “Health for All”

Perry

Chowdhury

Were

et al. 2021

Health Res Policy Sys

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“…However, we risk being under-powered if under-five mortality has declined more rapidly than we presumed, or we are unable to reliably record death events. Community-reported mortality surveillance poses challenges and can suffer from under-reporting and misclassification of stillbirths and early neonatal deaths [ 21 , 22 , 24 ]. In order to mitigate this concern, we re-designed the study from protocol version 1.0, which relied solely on retrospective death reporting through cross-sectional surveys, to incorporate prospective vital events surveillance.…”

Section: Discussionmentioning

confidence: 99%

Integrated Sustainable childhood Pneumonia and Infectious disease Reduction in Nigeria (INSPIRING) through whole system strengthening in Jigawa, Nigeria: study protocol for a cluster randomised controlled trial

Bakare

MacCalla

King

et al. 2022

Trials

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Background Child mortality remains unacceptably high, with Northern Nigeria reporting some of the highest rates globally (e.g. 192/1000 live births in Jigawa State). Coverage of key protect and prevent interventions, such as vaccination and clean cooking fuel use, is low. Additionally, knowledge, care-seeking and health system factors are poor. Therefore, a whole systems approach is needed for sustainable reductions in child mortality. Methods This is a cluster randomised controlled trial, with integrated process and economic evaluations, conducted from January 2021 to September 2022. The trial will be conducted in Kiyawa Local Government Area, Jigawa State, Nigeria, with an estimated population of 230,000. Clusters are defined as primary government health facility catchment areas (n = 33). The 33 clusters will be randomly allocated (1:1) in a public ceremony, and 32 clusters included in the impact evaluation. The trial will evaluate a locally adapted ‘whole systems strengthening’ package of three evidence-based methods: community men’s and women’s groups, Partnership Defined Quality Scorecard and healthcare worker training, mentorship and provision of basic essential equipment and commodities. The primary outcome is mortality of children aged 7 days to 59 months. Mortality will be recorded prospectively using a cohort design, and secondary outcomes measured through baseline and endline cross-sectional surveys. Assuming the following, we will have a minimum detectable effect size of 30%: (a) baseline mortality of 100 per 1000 livebirths, (b) 4480 compounds with 3 eligible children per compound, (c) 80% power, (d) 5% significance, (e) intra-cluster correlation of 0.007 and (f) coefficient of variance of cluster size of 0.74. Analysis will be by intention-to-treat, comparing intervention and control clusters, adjusting for compound and trial clustering. Discussion This study will provide robust evidence of the effectiveness and cost-effectiveness of community-based participatory learning and action, with integrated health system strengthening and accountability mechanisms, to reduce child mortality. The ethnographic process evaluation will allow for a rich understanding of how the intervention works in this context. However, we encountered a key challenge in calculating the sample size, given the lack of timely and reliable mortality data and the uncertain impacts of the COVID-19 pandemic. Trial registration ISRCTN 39213655. Registered on 11 December 2019

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“…However, this limitation may have been partially mitigated since CHWs belong to the same community as the women they serve, and have built trust with them through continued engagement during care delivery [ 38 ]. Future studies should attempt to use a more advanced and in-depth method, such as verbal and social autopsy and participatory analytic methods, and strengthen linkages with government reporting systems, to identify stillbirth and mortality events with greater accuracy [ 8 , 14 ].…”

Section: Discussionmentioning

confidence: 99%

Comparing two data collection methods to track vital events in maternal and child health via community health workers in rural Nepal

Choudhury

Tiwari²,

Wu³

et al. 2022

Popul Health Metrics

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Background Timely tracking of health outcomes is difficult in low- and middle-income countries without comprehensive vital registration systems. Community health workers (CHWs) are increasingly collecting vital events data while delivering routine care in low-resource settings. It is necessary, however, to assess whether routine programmatic data collected by CHWs are sufficiently reliable for timely monitoring and evaluation of health interventions. To study this, we assessed the consistency of vital events data recorded by CHWs using two methodologies—routine data collected while delivering an integrated maternal and child health intervention, and data from a birth history census approach at the same site in rural Nepal. Methods We linked individual records from routine programmatic data from June 2017 to May 2018 with those from census data, both collected by CHWs at the same site using a mobile platform. We categorized each vital event over a one-year period as ‘recorded by both methods,’ ‘census alone,’ or ‘programmatic alone.’ We further assessed whether vital events data recorded by both methods were classified consistently. Results From June 2017 to May 2018, we identified a total of 713 unique births collectively from the census (birth history) and programmatic maternal ‘post-delivery’ data. Three-fourths of these births (n = 526) were identified by both. There was high consistency in birth location classification among the 526 births identified by both methods. Upon including additional programmatic ‘child registry’ data, we identified 746 total births, of which 572 births were identified by both census and programmatic methods. Programmatic data (maternal ‘post-delivery’ and ‘child registry’ combined) captured more births than census data (723 vs. 595). Both methods consistently classified most infants as ‘living,’ while infant deaths and stillbirths were largely classified inconsistently or recorded by only one method. Programmatic data identified five infant deaths and five stillbirths not recorded in census data. Conclusions Our findings suggest that data collected by CHWs from routinely tracking pregnancies, births, and deaths are promising for timely program monitoring and evaluation. Despite some limitations, programmatic data may be more sensitive in detecting vital events than cross-sectional census surveys asking women to recall these events.

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A systematic review of vital events tracking by community health agents

Cited by 15 publications

References 41 publications

Community health workers at the dawn of a new era: 11. CHWs leading the way to “Health for All”

Community health workers at the dawn of a new era: 11. CHWs leading the way to “Health for All”

Integrated Sustainable childhood Pneumonia and Infectious disease Reduction in Nigeria (INSPIRING) through whole system strengthening in Jigawa, Nigeria: study protocol for a cluster randomised controlled trial

Comparing two data collection methods to track vital events in maternal and child health via community health workers in rural Nepal

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