title: Improving maternal and newborn health: effectiveness of a community health worker program in rural Kenya.
abstract: BACKGROUND
  Volunteer community health workers (CHWs) form an important element of many health systems, and in Kenya these volunteers are the foundation for promoting behavior change through health education, earlier case identification, and timely referral to trained health care providers. This study examines the effectiveness of a community health worker project conducted in rural Kenya that sought to promote improved knowledge of maternal newborn health and to increase deliveries under skilled attendance.
  
  
  METHODS
  The study utilized a quasi-experimental nonequivalent design that examined relevant demographic items and knowledge about maternal and newborn health combined with a comprehensive retrospective birth history of women's children using oral interviews of women who were exposed to health messages delivered by CHWs and those who were not exposed. The project trained CHWs in three geographically distinct areas.
  
  
  RESULTS
  Mean knowledge scores were higher in those women who reported being exposed to the health messages from CHWs, Eburru 32.3 versus 29.2, Kinale 21.8 vs 20.7, Nyakio 26.6 vs 23.8. The number of women delivering under skilled attendance was higher for those mothers who reported exposure to one or more health messages, compared to those who did not. The percentage of facility deliveries for women exposed to health messages by CHWs versus non-exposed was: Eburru 46% versus 19%; Kinale 94% versus 73%: and Nyakio 80% versus 78%.
  
  
  CONCLUSIONS
  The delivery of health messages by CHWs increased knowledge of maternal and newborn care among women in the local community and encouraged deliveries under skilled attendance.
authors.affiliation: AIC Kijabe Medical Center, Kijabe, Kenya.
authors.forename: Mary B
authors.initials: MB
authors.lastname: Adam
authors.affiliation: Department of Pediatric and Adolescent Medicine, Ulm University, Ulm, Germany.
authors.forename: Maria
authors.initials: M
authors.lastname: Dillmann
authors.affiliation: University of Arizona, Tucson, Arizona, United States of America.
authors.forename: Mei-kuang
authors.initials: MK
authors.lastname: Chen
authors.affiliation: AIC Kijabe Medical Center, Kijabe, Kenya.
authors.forename: Simon
authors.initials: S
authors.lastname: Mbugua
authors.affiliation: AIC Kijabe Medical Center, Kijabe, Kenya.
authors.forename: Joram
authors.initials: J
authors.lastname: Ndung'u
authors.affiliation: AIC Kijabe Medical Center, Kijabe, Kenya.
authors.forename: Priscilla
authors.initials: P
authors.lastname: Mumbi
authors.affiliation: AIC Kijabe Medical Center, Kijabe, Kenya.
authors.forename: Eunice
authors.initials: E
authors.lastname: Waweru
authors.affiliation: Department of Pediatric and Adolescent Medicine, Ulm University, Ulm, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Meissner
mesh_terms: D000328:Adult; D002662:Child Health Services / Q000706:statistics & numerical data*; D003150:Community Health Workers / Q000193:education / Q000706:statistics & numerical data*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007630:Kenya; D008427:Maternal Health Services / Q000706:statistics & numerical data*; D009321:Natural Childbirth / Q000706:statistics & numerical data*; D011247:Pregnancy; D012189:Retrospective Studies; D012424:Rural Population; D011795:Surveys and Questionnaires
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