Impact of a newborn community health project in rural Kenya
Background In sub-Saharan Africa 1 in 11 children dies before the age of five and 1 in 200 mothers does not survive pregnancy or delivery. Kenya’s newborn mortality rate is high with 27 deaths per 1,000 live births. This study examined the effectiveness of a community health worker project conducted in rural Kenya that sought to promote improved knowledge of maternal and newborn health and to increase deliveries under skilled attendance. Secondary objectives were to identify factors influencing the place of birth and to analyze post-partum deaths. Methods This study utilized a quasi-experimental nonequivalent design that examined demographic items and perinatal-related knowledge, combined with a comprehensive retrospective birth history of women’s children. Systematic random sampling was used. In three intervention-sites (n=1,398) in rural Kenya and three adjacent control-sites (n=1,200) interviews were conducted. Results Participants of the project had higher mean knowledge scores and delivered more frequently under skilled attendance compared to non participants. Increasing percentages of deliveries under skilled attendance were associated with attending Antenatal Care-clinic for at least four times, a good educational and economic background, and being a primipara. Within the first 24 hours of life, almost 21% less deaths occur in children born at a health facility compared to home deliveries, but this gain is not maintained beyond the end of the first week of life. In this study, 48 % of all deaths in children happened within the neonatal period. Conclusion The delivery of health messages by non-medical volunteers increased the perinatal-related knowledge among women in the local community and encouraged deliveries under skilled attendance. Special attention must be given to the first month of life and postnatal home-visits should be conducted in order to sustainably reduce child mortality.
Subject HeadingsKenia [GND]
Öffentliches Gesundheitswesen [GND]
Community health services [MeSH]
Infant mortality [MeSH]
Infant, newborn [MeSH]