title: [Changes in child health indicators in a municipality with community health workers: the case of Itapirapuã Paulista, Vale do Ribeira, São Paulo State, Brazil].
abstract: Twelve community health workers (CHWs) were trained to offer basic health care for children under five years of age through household visits in Itapirapuã Paulista, a municipality in Vale do Ribeira, São Paulo State, Brazil. Their tasks included diagnosis, initial treatment, and management of diarrhea and acute respiratory diseases at the household level, growth monitoring, incentives to complete basic immunization, and counseling on infant food supplementation. An average of 409 (396-417) children were visited weekly by CHWs in their homes over the course of three years. In this period, the hospitalization rate dropped drastically, and the use of oral rehydration therapy during bouts of diarrhea increased greatly. However, prevalence of stunting and incidence of low birth weight did not change. Child health indicators (CHI) in this municipality were better than those in a municipality chosen as a control. CHWs may have contributed to improved local CHI, but the results should be interpreted with caution for two reasons: (1) CHI is improving in Brazil countrywide and (2) it is a small program implemented in an area with high morbidity and mortality rates and low availability of health services.
authors.affiliation: Departamento Materno Infantil, Universidade Federal do Rio Grande, Rio Grande, RS 96201-900, Brasil.
authors.forename: Juraci A
authors.initials: JA
authors.lastname: Cesar
authors.forename: Marcelo A
authors.initials: MA
authors.lastname: Cavaleti
authors.forename: Ricardo S
authors.initials: RS
authors.lastname: Holthausen
authors.forename: Luis Gustavo S
authors.initials: LG
authors.lastname: de Lima
mesh_terms: D001938:Brazil / Q000453:epidemiology; D002669:Child Welfare; D002675:Child, Preschool; D003150:Community Health Workers / Q000193:education; D003681:Dehydration / Q000628:therapy; D005260:Female; D005440:Fluid Therapy; D006305:Health Status Indicators; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D008297:Male; D015397:Program Evaluation; D012424:Rural Population