Community based weighing of newborns and use of mobile phones by village elders in rural settings in Kenya: a decentralised approach to health care provision

BMC Pregnancy and Childbirth

Fabian Esamai⁴  Edward Liechty²  Janet Moore³  Sherri Bucher²  Hillary Mabeya⁴  Constance Tenge⁴  Irene Marete⁴  Betsy Rono¹  Kevin Otieno¹  Evelyn Shipala¹  Peter Gisore¹ 

[1] Department of Child Health, Moi University School of Medicine, Eldoret, Kenya;Department of Pediatrics, Indiana University School of Medicine, Riley R208 699 Riley Hospital Drive, Indianapolis, IN, USA;RTI International, Research Triangle Park, NC, USA;Moi Teaching and Referral Hospital, Eldoret, Kenya

关键词: Community health workers;    Birth registry;    Village elders;   

Others  :  1153053
DOI  :  10.1186/1471-2393-12-15

 received in 2011-09-14, accepted in 2012-03-19,  发布年份 2012

【 摘 要 】

Background

Identifying every pregnancy, regardless of home or health facility delivery, is crucial to accurately estimating maternal and neonatal mortality. Furthermore, obtaining birth weights and other anthropometric measurements in rural settings in resource limited countries is a difficult challenge. Unfortunately for the majority of infants born outside of a health care facility, pregnancies are often not recorded and birth weights are not accurately known. Data from the initial 6 months of the Maternal and Neonatal Health (MNH) Registry Study of the Global Network for Women and Children's Health study area in Kenya revealed that up to 70% of newborns did not have exact weights measured and recorded by the end of the first week of life; nearly all of these infants were born outside health facilities.

Methods

To more completely obtain accurate birth weights for all infants, regardless of delivery site, village elders were engaged to assist in case finding for pregnancies and births. All elders were provided with weighing scales and mobile phones as tools to assist in subject enrollment and data recording. Subjects were instructed to bring the newborn infant to the home of the elder as soon as possible after birth for weight measurement.

The proportion of pregnancies identified before delivery and the proportion of births with weights measured were compared before and after provision of weighing scales and mobile phones to village elders. Primary outcomes were the percent of infants with a measured birth weight (recorded within 7 days of birth) and the percent of women enrolled before delivery.

Results

The recorded birth weight increased from 43 ± 5.7% to 97 ± 1.1. The birth weight distributions between infants born and weighed in a health facility and those born at home and weighed by village elders were similar. In addition, a significant increase in the percent of subjects enrolled before delivery was found.

Conclusions

Pregnancy case finding and acquisition of birth weight information can be successfully shifted to the community level.

【 授权许可】

   
2012 Gisore et al; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

Figure 3.

【 参考文献 】

• [1]Abbatt F: Scaling Up Health And Education Workers: Community Health Workers: Literature Review. DFID Health Systems Resource Centre; 2005.
• [2]Celletti F, Wright A, Palen J, Frehywot S, Markus A, Greenberg A, de Aguiar RA, Campos F, Buch E, Samb B: Can the deployment of community health workers for the delivery of HIV services represent an effective and sustainable response to health workforce shortages? Results of a multicountry study. AIDS 2010, 24(Suppl 1):S45-57.
• [3]Dhaene G, Goufack J, Tatah EA: The Douala Action Plan. Human resource for Health in Africa, Experiences Challenges and Realities. Geneva 27, Switzerland: WHO; 2008.
• [4]Belizan JM, McClure EM, Goudar SS, Pasha O, Esamai F, Patel A, Chomba E, Garces A, Wright LL, Koso-Thomas M, et al.: Neonatal death in Low-Middle Income Countries: A Global Network Study. Amer J Perinatology 2012, in press.
• [5]Mullany LC, Darmstadt GL, Coffey P, Khatry SK, LeClerq SC, Tielsch JM: A low cost, colour coded, hand held spring scale accurately categorises birth weight in low resource settings. Arch Dis Child 2006, 91(5):410-413.
• [6]Chhanabhai PN, Holt A: The Disparity Information and Communication Technology for Developing Countries has in the Delivery of Healthcare Information. The Open Medical Informatics Journal 2010, 4:195-201.
• [7]Kaplan WA: Can the ubiquitous power of mobile phones be used to improve health outcomes in developing countries? Global Health 2006, 2:9. BioMed Central Full Text
• [8]Hoffman JA, Cunningham JR, Suleh AJ, Sundsmo A, Dekker D, Vago F, Munly K, Igonya EK, Hunt-Glassman J: Mobile direct observation treatment for tuberculosis patients: a technical feasibility pilot using mobile phones in Nairobi, Kenya. Am J Prev Med 2010, 39(1):78-80.
• [9]Chan CV, Kaufman DR: A technology selection framework for supporting delivery of patient-oriented health interventions in developing countries. J Biomed Inform 2010, 43(2):300-306.
• [10]Tomlinson M, Solomon W, Singh Y, Doherty T, Chopra M, Ijumba P, Tsai AC, Jackson D: The use of mobile phones as a data collection tool: a report from a household survey in South Africa. BMC Med Inform Decis Mak 2009, 9:51. BioMed Central Full Text
• [11]Bielli E, Carminati F, La Capra S, Lina M, Brunelli C, Tamburini M: A Wireless Health Outcomes Monitoring System (WHOMS): development and field testing with cancer patients using mobile phones. BMC Med Inform Decis Mak 2004, 4:7. BioMed Central Full Text
• [12]WHO: Task-Shifting: Global Recommendations and Guidelines. Edited by WHO HSaSH. Geneva: World Health Organization; 2007:1-92.
• [13]KenyaMOH: Taking the Kenya Essential Package of Health to the Community. A strategy for Delivery of Level One Services. In Health Sector Reform Secretariat, Nairobi, Republic of Kenya. Edited by Health Mo. Nairobi, Republic of Kenya: Health Sector Reform Secretariat; 2006.
• [14]Lehmann U, Sanders D: Community health workers: What do we know about them? The state of the evidence on programmes, activities, costs and impact on health outcomes of using community health workers. Evidence and Information for Policy. 2007.
• [15]Swider SM: Outcome effectiveness of community health workers: an integrative literature review. Public Health Nurs 2002, 19(1):11-20.
• [16]Nemcek MA, Sabatier R: State of evaluation: community health workers. Public Health Nurs 2003, 20(4):260-270.
• [17]Bolton-Moore C, Mubiana-Mbewe M, Cantrell RA, Chintu N, Stringer EM, Chi BH, Sinkala M, Kankasa C, Wilson CM, Wilfert CM, et al.: Clinical outcomes and CD4 cell response in children receiving antiretroviral therapy at primary health care facilities in Zambia. JAMA 2007, 298(16):1888-1899.
• [18]Simon AL, Susan AM-B, Claire AG, Karen AD, Xavier AB-C, E AvWB, Jan AO-J, Marit AJ, N AAG, Merrick AZ, et al.: Lay health workers in primary and community health care for maternal and child health and the management of infectious diseases. Cochrane Database of Systematic Reviews: Reviews 2010 2010., (3)