title: Can a community health worker and a trained traditional birth attendant work as a team to deliver child health interventions in rural Zambia?
abstract: BACKGROUND
  Teaming is an accepted approach in health care settings but rarely practiced at the community level in developing countries. Save the Children trained and deployed teams of volunteer community health workers (CHWs) and trained traditional birth attendants (TBAs) to provide essential newborn and curative care for children aged 0-59 months in rural Zambia. This paper assessed whether CHWs and trained TBAs can work as teams to deliver interventions and ensure a continuum of care for all children under-five, including newborns.
  
  
  METHODS
  We trained CHW-TBA teams in teaming concepts and assessed their level of teaming prospectively every six months for two years. The overall score was a function of both teamwork and taskwork. We also assessed personal, community and service factors likely to influence the level of teaming.
  
  
  RESULTS
  We created forty-seven teams of predominantly younger, male CHWs and older, female trained TBAs. After two years of deployment, twenty-one teams scored "high", twelve scored "low," and fourteen were inactive. Teamwork was high for mutual trust, team cohesion, comprehension of team goals and objectives, and communication, but not for decision making/planning. Taskwork was high for joint behavior change communication and outreach services with local health workers, but not for intra-team referral. Teams with members residing within one hour's walking distance were more likely to score high.
  
  
  CONCLUSIONS
  It is feasible for a CHW and a trained TBA to work as a team. This may be an approach to provide a continuum of care for children under-five including newborns.
authors.forename: Kojo
authors.initials: K
authors.lastname: Yeboah-Antwi
authors.forename: Davidson H
authors.initials: DH
authors.lastname: Hamer
authors.forename: Katherine
authors.initials: K
authors.lastname: Semrau
authors.forename: Karen Z
authors.initials: KZ
authors.lastname: Waltensperger
authors.forename: Gail
authors.initials: G
authors.lastname: Snetro-Plewman
authors.forename: Chilobe
authors.initials: C
authors.lastname: Kambikambi
authors.forename: Amon
authors.initials: A
authors.lastname: Sakala
authors.forename: Stephen
authors.initials: S
authors.lastname: Filumba
authors.forename: Bias
authors.initials: B
authors.lastname: Sichamba
authors.forename: David R
authors.initials: DR
authors.lastname: Marsh
mesh_terms: D000328:Adult; D002662:Child Health Services; D002675:Child, Preschool; D003150:Community Health Workers; D005260:Female; D006302:Health Services Research; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D008880:Midwifery; D010348:Patient Care Team / Q000458:organization & administration*; D011247:Pregnancy; D011446:Prospective Studies; D012423:Rural Health; D000078329:Workforce; D015024:Zambia