title: Effectiveness of Kenya's Community Health Strategy in delivering community-based maternal and newborn health care in Busia County, Kenya: non-randomized pre-test post test study.
abstract: BACKGROUND
  Maternal mortality ratio and neonatal mortality rate trends in Kenya have remained unacceptably high in a decade. In 2007, the Ministry of Public Health and Sanitation adopted a community health strategy to reverse the poor health outcomes in order to meet Millennium Development Goals 4 and 5. It aims at strengthening community participation and its ability to take action towards health. The study aimed at evaluating the effectiveness of the strategy in improving maternal and neonatal health outcomes in Kenya.
  
  
  METHODS
  Between 2008 and 2010, the African Medical and Research Foundation implemented a community-based maternal and newborn care intervention package in Busia County using the community health strategy approach. An interventional, non-randomized pre-test post test study design was used to evaluate change in essential maternal and neonatal care practices among mothers with children aged 0 - 23 months.
  
  
  RESULTS
  There was statistically significant (p < 0.05) increase in attendance of at least four antenatal care visits (39% to 62%), deliveries by skilled birth attendants (31% to 57%), receiving intermittent preventive treatment (23% to 57%), testing for HIV during pregnancy (73% to 90%) and exclusive breastfeeding (20% to 52%).
  
  
  CONCLUSIONS
  The significant increase in essential maternal and neonatal care practices demonstrates that, community health strategy is an appropriate platform to deliver community based interventions. The findings will be used by actors in the child survival community to improve current approaches, policies and practice in maternal and neonatal care.
authors: AMREF in Kenya, Nairobi, Kenya.
authors: Gilbert
authors: G
authors: Wangalwa
authors: Bennett
authors: B
authors: Cudjoe
authors: David
authors: D
authors: Wamalwa
authors: Yvonne
authors: Y
authors: Machira
authors: Peter
authors: P
authors: Ofware
authors: Meshack
authors: M
authors: Ndirangu
authors: Festus
authors: F
authors: Ilako
mesh_terms: D001942:Breast Feeding / Q000706:statistics & numerical data; D002662:Child Health Services / Q000458:organization & administration*; D003153:Community Health Services / Q000458:organization & administration*; D036861:Delivery, Obstetric / Q000592:standards; D005260:Female; D015658:HIV Infections / Q000175:diagnosis; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D007630:Kenya; D008427:Maternal Health Services / Q000458:organization & administration*; D008428:Maternal Mortality; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis / Q000821:virology; D011295:Prenatal Care / Q000458:organization & administration
keywords: AMREF; Busia; Child survival; community health strategy; community health worker; community-based care; maternal care; neonatal care