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Year : 2015  |  Volume : 28  |  Issue : 3  |  Page : 181-186

The promise of home visitation by community health workers in rural Kenya: A protective effect that reduces neonatal illness

1 Department of Pediatrics, School of Medicine, University of New Mexico, NM, USA
2 Department of Public Health and Community Medicine, University of New South Wales, New South Wales, Australia
3 Department of Orthopaedic Surgery, School of Medicine, University of Utah, Utah, USA
4 Department of Family and Community Medicine, School of Medicine, Albuquerque, NM, USA
5 Department of Community Health, School of Public Health, University of Nairobi, Nairobi, Kenya

Correspondence Address:
Danielle N Mascarenas
UNM School of Medicine, MSC09 5040, 1 University of New Mexico, Albuquerque, NM 87131
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1357-6283.178600

Background: Nearly three million neonates die each year, largely from preventable illnesses in developing countries. Sub-Saharan Africa has disproportionately high neonatal mortality. Community health worker (CHW) programs are a promising intervention to reduce mortality rates. This research evaluates a CHW newborn home visitation program in rural Kenya by assessing the frequency of health service utilization and overnight hospitalization. Methods: This quasi-experimental study encompassed two consecutive years and compared the rate of medical service utilization for neonatal illness in an intervention group with that of a control group using a household survey. Severity of neonatal illness was assessed by need for overnight hospitalization. Household, maternal, and child characteristics were collected. Results: A total of 489 surveys were completed and showed that 35% of not-visited families reported taking their infant to a healthcare facility, compared with 21% of CHW-visited families (P < 0.01). Rates of overnight hospitalization were 6% for not-visited infants and 1% for visited infants (P < 0.01). Few significant differences were found in household, maternal, and child characteristics. Discussion: This study found that a CHW newborn home visitation program in rural Kenya significantly decreased rates of health service utilization and overnight hospitalization, but did not have the power to detect an effect on neonatal mortality.

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