A Study of Volunteer Community Health Workers Promoting Maternal Health Services in Rural Kenya: A Christian Viewpoint
Introduction: Despite the call for community-based health care interventions in the developing world, there is little research examining the effectiveness of paid versus volunteer community health worker (CHW) programs to increase women’s use of maternal health services. From a Christian perspective...
| Main Authors: | , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Health for All Nations
2014-01-01
|
| Series: | Christian Journal for Global Health |
| Subjects: | |
| Online Access: | http://journal.cjgh.org/index.php/cjgh/article/view/18/115 |
| _version_ | 1818429401957662720 |
|---|---|
| author | Bradly Alexander Kimbrough Lisa Baker |
| author_facet | Bradly Alexander Kimbrough Lisa Baker |
| author_sort | Bradly Alexander Kimbrough |
| collection | DOAJ |
| description | Introduction: Despite the call for community-based health care interventions in the developing world, there is little research examining the effectiveness of paid versus volunteer community health worker (CHW) programs to increase women’s use of maternal health services. From a Christian perspective, the CHW model is, at its root, discipleship: a credible person leads a neighbor to a source of help and health. This effective model can be expanded to address the health of the whole person, both spiritual and physical. This study of a government health center program in rural Kenya addresses these issues. Methods: The current study analyzed the change in maternal health services after a government program, starting with 30 volunteer CHWs, had been in place for nine months. The intervention was designed and carried out by the authors in collaboration with Sigoti District Health Center in the western Kenyan province of Nyanza. Results: The proportion of facility-based deliveries (FBDs) showed a statistically significant increase (p=0.003), from an average of 38 deliveries before the intervention to 60 after-wards. The proportion of health center deliveries of HIV-positive women also significantly increased (p=0.04) from an average of 6.5 to 14 FBDs. Compared to another program in rural Lesotho with paid CHWs, the Sigoti intervention led to a similar increase in FBDs. Despite their successes, the community-based strategies were time-intensive for both programs, with one CHW adding between 1.12 and 1.7 FBDs per year. Discussion: This study demonstrates that a CHW program can be successful, even when using volunteers. Using solely a metric of time and/or money, the CHW model produces value at a high cost. However, the concerns of cost-effectiveness and CHW attrition, as well as the success of the CHW model, can be meaningfully addressed from a Christian perspective. Using the outcome measure of changed lives, volunteer CHWs could be motivated by a Christian call to discipleship. CHWs may be trained and supported to contribute to the health of the whole person. Future research will test these assumptions with a CHW program operating from a Christian health center to be built soon in the study area. |
| first_indexed | 2024-12-14T15:16:56Z |
| format | Article |
| id | doaj.art-bbe97b4139fc42e88d837c53cc4b9735 |
| institution | Directory Open Access Journal |
| issn | 2167-2415 |
| language | English |
| last_indexed | 2024-12-14T15:16:56Z |
| publishDate | 2014-01-01 |
| publisher | Health for All Nations |
| record_format | Article |
| series | Christian Journal for Global Health |
| spelling | doaj.art-bbe97b4139fc42e88d837c53cc4b97352022-12-21T22:56:17ZengHealth for All NationsChristian Journal for Global Health2167-24152014-01-0112294110.15566/cjgh.v1i2.1818A Study of Volunteer Community Health Workers Promoting Maternal Health Services in Rural Kenya: A Christian ViewpointBradly Alexander Kimbrough0Lisa Baker1University Scholars Major / Undergraduate Student, Baylor UniversityMD, PhD, Clinical Professor in the Honors Program at Baylor UniversityIntroduction: Despite the call for community-based health care interventions in the developing world, there is little research examining the effectiveness of paid versus volunteer community health worker (CHW) programs to increase women’s use of maternal health services. From a Christian perspective, the CHW model is, at its root, discipleship: a credible person leads a neighbor to a source of help and health. This effective model can be expanded to address the health of the whole person, both spiritual and physical. This study of a government health center program in rural Kenya addresses these issues. Methods: The current study analyzed the change in maternal health services after a government program, starting with 30 volunteer CHWs, had been in place for nine months. The intervention was designed and carried out by the authors in collaboration with Sigoti District Health Center in the western Kenyan province of Nyanza. Results: The proportion of facility-based deliveries (FBDs) showed a statistically significant increase (p=0.003), from an average of 38 deliveries before the intervention to 60 after-wards. The proportion of health center deliveries of HIV-positive women also significantly increased (p=0.04) from an average of 6.5 to 14 FBDs. Compared to another program in rural Lesotho with paid CHWs, the Sigoti intervention led to a similar increase in FBDs. Despite their successes, the community-based strategies were time-intensive for both programs, with one CHW adding between 1.12 and 1.7 FBDs per year. Discussion: This study demonstrates that a CHW program can be successful, even when using volunteers. Using solely a metric of time and/or money, the CHW model produces value at a high cost. However, the concerns of cost-effectiveness and CHW attrition, as well as the success of the CHW model, can be meaningfully addressed from a Christian perspective. Using the outcome measure of changed lives, volunteer CHWs could be motivated by a Christian call to discipleship. CHWs may be trained and supported to contribute to the health of the whole person. Future research will test these assumptions with a CHW program operating from a Christian health center to be built soon in the study area.http://journal.cjgh.org/index.php/cjgh/article/view/18/115HIVCommunity healthCommunity health workerLay health workerVolunteer health workerMaternal healthAntenatal careHealth systems strengtheningLabor and deliveryKenyaNyanzaChristian health systemss development |
| spellingShingle | Bradly Alexander Kimbrough Lisa Baker A Study of Volunteer Community Health Workers Promoting Maternal Health Services in Rural Kenya: A Christian Viewpoint Christian Journal for Global Health HIV Community health Community health worker Lay health worker Volunteer health worker Maternal health Antenatal care Health systems strengthening Labor and delivery Kenya Nyanza Christian health systemss development |
| title | A Study of Volunteer Community Health Workers Promoting Maternal Health Services in Rural Kenya: A Christian Viewpoint |
| title_full | A Study of Volunteer Community Health Workers Promoting Maternal Health Services in Rural Kenya: A Christian Viewpoint |
| title_fullStr | A Study of Volunteer Community Health Workers Promoting Maternal Health Services in Rural Kenya: A Christian Viewpoint |
| title_full_unstemmed | A Study of Volunteer Community Health Workers Promoting Maternal Health Services in Rural Kenya: A Christian Viewpoint |
| title_short | A Study of Volunteer Community Health Workers Promoting Maternal Health Services in Rural Kenya: A Christian Viewpoint |
| title_sort | study of volunteer community health workers promoting maternal health services in rural kenya a christian viewpoint |
| topic | HIV Community health Community health worker Lay health worker Volunteer health worker Maternal health Antenatal care Health systems strengthening Labor and delivery Kenya Nyanza Christian health systemss development |
| url | http://journal.cjgh.org/index.php/cjgh/article/view/18/115 |
| work_keys_str_mv | AT bradlyalexanderkimbrough astudyofvolunteercommunityhealthworkerspromotingmaternalhealthservicesinruralkenyaachristianviewpoint AT lisabaker astudyofvolunteercommunityhealthworkerspromotingmaternalhealthservicesinruralkenyaachristianviewpoint AT bradlyalexanderkimbrough studyofvolunteercommunityhealthworkerspromotingmaternalhealthservicesinruralkenyaachristianviewpoint AT lisabaker studyofvolunteercommunityhealthworkerspromotingmaternalhealthservicesinruralkenyaachristianviewpoint |