Enhancing the capacity and effectiveness of community health volunteers to improve maternal, newborn and child health: Experience from Kenya

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Study Justification:
– The study aimed to enhance the capacity and effectiveness of community health volunteers (CHVs) in Kenya to improve maternal, newborn, and child health (MNCH).
– The use of a simple monitoring and tracking tool, called Mwanzo Mwema Monitoring and Tracking Tool (MMATT), was tested to determine its impact on CHVs’ ability to plan their workloads, identify those most in need of MNCH interventions, and improve key MNCH indicators.
– The study aimed to address disparities in service delivery and health outcomes, and identify barriers to MNCH care.
Study Highlights:
– The study used a mixed methods approach, including household surveys and focus group discussions with CHVs.
– Qualitative findings showed that CHVs found the MMATT tool useful in planning their activities and prioritizing beneficiaries requiring more support to access MNCH services.
– At the endline, there were improvements in key MNCH indicators, such as increased antenatal care visits, facility delivery, postnatal care, early breastfeeding, and exclusive breastfeeding for the first six months.
– These improvements remained even after adjusting for factors like age, subcounty, gravida, mother’s education, and asset index.
Study Recommendations:
– The study recommends the use of simple tools, like MMATT, to enable CHVs to identify disparities in service delivery and health outcomes, as well as barriers to MNCH care.
– Tools that enhance CHVs’ ability to plan and prioritize the women and children most in need can increase their potential impact on MNCH.
Key Role Players:
– Community health volunteers (CHVs)
– Local health authorities and policymakers
– Non-governmental organizations (NGOs) working in MNCH
– Community leaders and influencers
– Health facility staff
Cost Items for Planning Recommendations:
– Training and capacity building for CHVs on using the MMATT tool
– Development and distribution of the MMATT tool
– Monitoring and evaluation of the tool’s implementation
– Supportive supervision and mentorship for CHVs
– Community sensitization and awareness campaigns
– Data collection and analysis
– Coordination and collaboration with local health authorities and NGOs

OBJECTIVE: To determine whether a simple monitoring and tracking tool, Mwanzo Mwema Monitoring and Tracking Tool (MMATT), would enable community health volunteers (CHVs) in Kenya to 1) plan their workloads and activities, 2) identify the women, newborns and children most in need of accessing critical maternal, newborn and child health (MNCH) interventions and 3) improve key MNCH indicators. METHODS: A mixed methods approach was used. Household surveys at baseline (n = 912) and endline (n = 1143) collected data on key MNCH indicators in the four subcounties of Taita Taveta County, Kenya. Eight focus group discussions were held with 40 CHVs to ascertain their perspectives on using the tool. RESULTS: Qualitative findings revealed that the CHVs found the MMATT to be useful in planning their activities and prioritizing beneficiaries requiring more support to access MNCH services. They also identified potential barriers to care at both the community and health system levels. At endline, previously pregnant women were more likely to have received four or more antenatal care visits, facility delivery, postnatal care within two weeks of delivery and a complete package of care than baseline respondents. Among women with children under 24 months, those at endline were more likely to report early breastfeeding and exclusive breastfeeding for the first six months. These results remained after adjustment for age, subcounty, gravida, mother’s education and asset index. CONCLUSION: Our results demonstrate that simple tools enable CHVs to identify disparities in service delivery and health outcomes, and to identify barriers to MNCH care. Tools that enhance CHVs’ ability to plan and prioritize the women and children most in need increase CHVs’ potential impact.

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The recommendation to improve access to maternal health in Kenya is to enhance the capacity and effectiveness of community health volunteers (CHVs) through the use of a monitoring and tracking tool called Mwanzo Mwema Monitoring and Tracking Tool (MMATT). This tool enables CHVs to plan their workloads and activities, identify women, newborns, and children most in need of accessing critical maternal, newborn, and child health (MNCH) interventions, and improve key MNCH indicators.

The recommendation is based on a study conducted in Taita Taveta County, Kenya. The study used a mixed methods approach, including household surveys at baseline and endline to collect data on key MNCH indicators, and focus group discussions with CHVs to gather their perspectives on using the MMATT tool.

The study found that CHVs found the MMATT tool to be useful in planning their activities and prioritizing beneficiaries requiring more support to access MNCH services. The tool also helped identify potential barriers to care at both the community and health system levels.

The results of the study showed improvements in key MNCH indicators at endline compared to baseline. Previously pregnant women were more likely to have received four or more antenatal care visits, facility delivery, postnatal care within two weeks of delivery, and a complete package of care. Among women with children under 24 months, those at endline were more likely to report early breastfeeding and exclusive breastfeeding for the first six months.

Overall, the study demonstrates that simple tools like MMATT enable CHVs to identify disparities in service delivery and health outcomes, as well as barriers to MNCH care. By enhancing CHVs’ ability to plan and prioritize the women and children most in need, the potential impact of CHVs in improving maternal health can be increased.

The recommendation and findings were published in the Canadian Journal of Public Health in 2017.
AI Innovations Description
The recommendation to improve access to maternal health is to enhance the capacity and effectiveness of community health volunteers (CHVs) through the use of a monitoring and tracking tool called Mwanzo Mwema Monitoring and Tracking Tool (MMATT). This tool enables CHVs in Kenya to plan their workloads and activities, identify women, newborns, and children most in need of accessing critical maternal, newborn, and child health (MNCH) interventions, and improve key MNCH indicators.

The recommendation is based on a study conducted in Taita Taveta County, Kenya, where household surveys were conducted at baseline and endline to collect data on key MNCH indicators. Additionally, focus group discussions were held with CHVs to gather their perspectives on using the MMATT tool.

The study found that CHVs found the MMATT tool to be useful in planning their activities and prioritizing beneficiaries requiring more support to access MNCH services. The tool also helped identify potential barriers to care at both the community and health system levels.

The results of the study showed that at endline, compared to baseline, previously pregnant women were more likely to have received four or more antenatal care visits, facility delivery, postnatal care within two weeks of delivery, and a complete package of care. Among women with children under 24 months, those at endline were more likely to report early breastfeeding and exclusive breastfeeding for the first six months.

Overall, the study demonstrates that simple tools like MMATT enable CHVs to identify disparities in service delivery and health outcomes, as well as barriers to MNCH care. By enhancing CHVs’ ability to plan and prioritize the women and children most in need, the potential impact of CHVs in improving maternal health can be increased.

The recommendation and findings were published in the Canadian Journal of Public Health in 2017.
AI Innovations Methodology
To simulate the impact of the main recommendations mentioned in the abstract on improving access to maternal health, a possible methodology could involve the following steps:

1. Selection of study sites: Identify a similar setting to Taita Taveta County in Kenya, where the original study was conducted. This could be another county or region with comparable characteristics in terms of maternal health indicators, healthcare infrastructure, and community health volunteer programs.

2. Baseline data collection: Conduct household surveys to collect baseline data on key maternal, newborn, and child health (MNCH) indicators in the selected study sites. This could involve interviewing a representative sample of women who have been pregnant or have children under 24 months to gather information on their access to MNCH services and health outcomes.

3. Implementation of the MMATT tool: Introduce the Mwanzo Mwema Monitoring and Tracking Tool (MMATT) to community health volunteers (CHVs) in the study sites. Provide training and support to CHVs on how to effectively use the tool for planning their workloads, identifying beneficiaries in need of MNCH interventions, and tracking key MNCH indicators.

4. Monitoring and tracking: Monitor the implementation of the MMATT tool by CHVs over a specified period of time. Regularly collect data on the utilization of the tool, the activities planned and carried out by CHVs, and the beneficiaries identified and supported by CHVs for accessing MNCH services.

5. Endline data collection: After a sufficient period of time, conduct endline household surveys to collect data on the same key MNCH indicators as in the baseline survey. This will allow for a comparison of the impact of the MMATT tool on improving access to maternal health between the baseline and endline.

6. Data analysis: Analyze the collected data to assess the impact of the MMATT tool on key MNCH indicators. Compare the findings from the baseline and endline surveys to determine if there have been improvements in access to MNCH services and health outcomes among the target population.

7. Adjustments and recommendations: Take into account any confounding factors or limitations in the study design and make appropriate adjustments in the analysis. Based on the findings, provide recommendations on the effectiveness of using the MMATT tool to enhance the capacity and effectiveness of CHVs in improving maternal health.

By following this methodology, researchers can simulate the impact of the main recommendations mentioned in the abstract and evaluate the effectiveness of using the MMATT tool in improving access to maternal health in the selected study sites.

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