Assessing the effectiveness of community-based health programs in improving maternal and child health in Pakistan
DOI:
https://doi.org/10.62497/irjm.119Abstract
Introduction: Mother’s and offspring’s wellbeing indicators in Pakistan remain suboptimal, particularly in rural and underserved regions like Khyber Pakhtunkhwa. Community-based health programs, especially those implemented through Lady Health Workers (LHWs), are designed to bridge gaps in healthcare access and improve essential mother and child medical reports. Evaluating the effectiveness of these programs is crucial to inform policy and optimize healthcare delivery in such settings.
Methodology: This cross-sectional research was performed over 12 months, from 21st March 2023 to 21st March 2024 in Mardan and Swat districts of KPK. A combined total of 276 women who had children under five were chosen using stratified random sampling. Data were collected through structured interviews and analyzed using SPSS version 26. Using chi-square and logistic regression helped check if there was a connection between assistance offered in communities and people’s health.
Results: Among participants, 71.7% received antenatal care, 74.3% had tetanus toxoid vaccination, and 65.9% delivered with skilled birth attendants. For children, 84.1% were fully immunized, and 64.5% were exclusively breastfed. Significant associations (p<0.05) were found between LHW visits and improved maternal and child health indicators. Logistic regression identified LHW visitation, maternal education, and antenatal care attendance as strong predictors of positive health outcomes.
Conclusion: Community-based health programs have a measurable effect on improving mother and baby fitness in KPK. Expanding and strengthening these initiatives can enhance health service utilization and outcomes across similar settings.
References
Malik MA, Rohm LR, Van Baal P, Van Doorslaer EV. Improving maternal and child health in Pakistan: a programme evaluation using a difference in difference analysis. BMJ global health. 2021 Dec 1;6(12):e006453.
Mubeen K, Baig M, Abbas S, Adnan F, Lakhani A, Bhamani SS, Rehman B, Shahid S, Jan R. Helping babies breathe: assessing the effectiveness of simulation-based high-frequency recurring training in a community-based setting of Pakistan. BMC pediatrics. 2021 Dec;21:1-0.
Memon ZA, Muhammad S, Soofi S, Khan N, Akseer N, Habib A, Bhutta Z. Effect and feasibility of district level scale up of maternal, newborn and child health interventions in Pakistan: a quasi-experimental study. BMJ open. 2020 Jul 1;10(7):e036293.
Rizwana ST, Bano S. Community Based Approach to Deliver Child Health Care Interventions: Differences between Served and Unserved areas in District Gujranwala, Punjab, Pakistan. INTERNATIONAL JOURNAL OF SPECIAL EDUCATION. 2022;37(3).
Jafree SR, Shah G, Zakar R, Muzamill A, Ahsan H, Burhan SK, Javed A, Durrani RR. Characterizing social determinants of maternal and child health: a qualitative community health needs assessment in underserved areas. InHealthcare 2023 Aug 7 (Vol. 11, No. 15, p. 2224). MDPI.
Hoodbhoy Z, Sheikh SS, Qureshi R, Memon J, Raza F, Kinshella ML, Bone JN, Vidler M, Sharma S, Payne BA, Magee LA. Role of community engagement in maternal health in rural Pakistan: Findings from the CLIP randomized trial. Journal of global health. 2021 Jul 17;11:04045.
Memon ZA, Reale S, Ahmed W, Spencer R, Lashari TH, Bhutta Z, Soltani H. Effects of integrating family planning with maternal, newborn, and child health services on uptake of voluntary modern contraceptive methods in rural Pakistan: protocol for a quasi-experimental study. JMIR research protocols. 2022 Mar 8;11(3):e35291.
Ariff S, Habib A, Memon Z, Arshad T, Samejo T, Maznani I, Umer M, Hussain A, Rizvi A, Ahmed I, Soofi SB. Effect of community-based kangaroo mother care package on neonatal mortality among preterm and low birthweight infants in rural Pakistan: protocol for a cluster randomized controlled trial. JMIR Research Protocols. 2021 Aug 10;10(8):e28156.
Das JK, Salam RA, Rizvi A, Soofi SB, Bhutta ZA. Community Mobilization and Community Incentivization (CoMIC) strategy for child health in a rural setting of Pakistan: study protocol for a randomized controlled trial. Methods and protocols. 2023 Mar 13;6(2):30.
Khalid A, Adamjee R, Sattar S, Hoodbhoy Z. Maternal and child surveillance in peri-urban communities: perceptions of women and community health workers from Pakistan. PLOS Global Public Health. 2022 Apr 26;2(4):e0000295.
Usmani A, Sultana S, Nisar I, Zaidi S, Jehan I, Zaidi A. Effect of a community based social marketing strategy on the uptake of clean delivery kits in peri-urban communities of Karachi, Pakistan. BMC Pregnancy and Childbirth. 2022 May 28;22(1):447.
Qureshi RN, Sheikh S, Hoodbhoy Z, Sharma S, Vidler M, Payne BA, Ahmed I, Ansermino JM, Bone J, Dunsmuir DT, Lee T. Community-level interventions for pre-eclampsia (CLIP) in Pakistan: a cluster randomised controlled trial. Pregnancy hypertension. 2020 Oct 1;22:109-18.
Shonchoy AS, Akram AA, Khan M, Khalid H, Mazhar S, Khan A, Kurosaki T. A Community Health Worker–Based Intervention on Anthropometric Outcomes of Children Aged 3 to 21 Months in Urban Pakistan, 2019–2021. American Journal of Public Health. 2023 Jan;113(1):105-14.
Maldonado LY, Bone J, Scanlon ML, Anusu G, Chelagat S, Jumah A, Ikemeri JE, Songok JJ, Christoffersen-Deb A, Ruhl LJ. Improving maternal, newborn and child health outcomes through a community-based women’s health education program: a cluster randomised controlled trial in western Kenya. BMJ global health. 2020 Dec 1;5(12):e003370.
Chishtie J, Chishtie F, Jaglal S. Exploring knowledge translation practices in a global health program: case study on the establishment of the Pakistan National Maternal, Neonatal, and Child Health Program. Journal of Public Health. 2021 Feb;29:215-28.
Ali M, Azmat SK, Hamza HB, Rahman MM. Assessing effectiveness of multipurpose voucher scheme to enhance contraceptive choices, equity, and child immunization coverage: results of an interventional study from Pakistan. Journal of Multidisciplinary Healthcare. 2020 Sep 30:1061-74.
Maselko J, Sikander S, Turner EL, Bates LM, Ahmad I, Atif N, Baranov V, Bhalotra S, Bibi A, Bibi T, Bilal S. Effectiveness of a peer-delivered, psychosocial intervention on maternal depression and child development at 3 years postnatal: a cluster randomised trial in Pakistan. The Lancet Psychiatry. 2020 Sep 1;7(9):775-87.
Aftab W, Piryani S, Rabbani F. Does supportive supervision intervention improve community health worker knowledge and practices for community management of childhood diarrhea and pneumonia? Lessons for scale-up from Nigraan and Nigraan Plus trials in Pakistan. Human Resources for Health. 2021 Dec;19:1-1.
Jafree SR, Bukhari N, Muzamill A, Tasneem F, Fischer F. Digital health literacy intervention to support maternal, child and family health in primary healthcare settings of Pakistan during the age of coronavirus: study protocol for a randomised controlled trial. BMJ open. 2021 Mar 1;11(3):e045163.
Ahmed S, Saleem S, Siddiqui A, Imran N, Zaidi S. Community-based interventions for improving perinatal health in Pakistan: a quasi-experimental study. BMC Health Serv Res. 2020;20(1):773.
Hafeez A, Mohamud BK, Shiekh MR, Shah SA, Jooma R. Lady Health Workers Programme in Pakistan: challenges, achievements and the way forward. J Pak Med Assoc. 2011;61(3):210–5.
Rahman MM, Haque SE, Zaman MM. Impact of community health workers on child health outcomes in Bangladesh: evidence from a cross-sectional study. PLoS One. 2021;16(9):e0256460.
Yaya S, Bishwajit G, Gunawardena N, et al. Awareness and utilization of community clinic services among women in rural Bangladesh. BMC Health Serv Res. 2017;17:597.
Adekanle DA, Adeyemi AS, Fadero FF, Ajepe AA, Adewuyi KA. Effectiveness of community health workers in improving utilization of maternal health services in rural Nigeria. Afr Health Sci. 2020;20(3):1215–22.
Perry HB, Zulliger R, Rogers MM. Community health workers in low-, middle-, and high-income countries: an overview of their history, recent evolution, and current effectiveness. Annu Rev Public Health. 2014;35:399–421.
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