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Open Access 01-12-2020 | Mood Disorders | Research article

Home visits by community health workers in rural South Africa have a limited, but important impact on maternal and child health in the first two years of life

Authors: Linnea Stansert Katzen, Mark Tomlinson, Joan Christodoulou, Christina Laurenzi, Ingrid le Roux, Venetia Baker, Nokwanele Mbewu, Karl W. le Roux, Mary Jane Rotheram Borus

Published in: BMC Health Services Research | Issue 1/2020

Abstract

Background

More than 50% of Africa’s population lives in rural areas, which have few professional health workers. South Africa has adopted task shifting health care to Community Health Workers (CHWs) to achieve the Sustainable Development Goals, but little is known about CHWs’ efficacy in rural areas.

Methods

In this longitudinal prospective cohort study, almost all mothers giving birth (N = 470) in the Zithulele Hospital catchment area of the OR Tambo District were recruited and repeatedly assessed for 2 years after birth with 84.7–96% follow-up rates. During the cohort assessment we found that some mothers had received standard antenatal and HIV care (SC) (n = 313 mothers), while others had received SC, supplemented with home-visiting by CHWs before and after birth (HV) (n = 157 mothers, 37 CHWs). These visits were unrelated to the cohort study. Multiple linear and logistic regressions evaluated maternal comorbidities, maternal caretaking, and child development outcomes over time.

Results

Compared to mothers receiving SC, mothers who also received home visits by CHWs were more likely to attend the recommended four antenatal care visits, to exclusively breastfeed at 3 months, and were less likely to consult traditional healers at 3 months. Mothers in both groups were equally likely to secure the child grant, and infant growth and achievement of developmental milestones were similar over the first 2 years of life.

Conclusion

CHW home visits resulted in better maternal caretaking, but did not have direct benefits for infants in the domains assessed. The South African Government is planning broad implementation of CHW programmes, and this study examines a comprehensive, home-visiting model in a rural region.

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Title: Home visits by community health workers in rural South Africa have a limited, but important impact on maternal and child health in the first two years of life
Authors: Linnea Stansert Katzen
Mark Tomlinson
Joan Christodoulou
Christina Laurenzi
Ingrid le Roux
Venetia Baker
Nokwanele Mbewu
Karl W. le Roux
Mary Jane Rotheram Borus
Publication date: 01-12-2020
Publisher: BioMed Central
Keywords: Mood Disorders
Human Immunodeficiency Virus
Affective Disorder
Published in: BMC Health Services Research / Issue 1/2020
Electronic ISSN: 1472-6963
DOI: https://doi.org/10.1186/s12913-020-05436-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Home visits by community health workers in rural South Africa have a limited, but important impact on maternal and child health in the first two years of life

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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