title: The promise of home visitation by community health workers in rural Kenya: A protective effect that reduces neonatal illness.
abstract: 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Pediatrics, School of Medicine, University of New Mexico, NM, USA.
authors.forename: Danielle N
authors.initials: DN
authors.lastname: Mascarenas
authors.forename: Riana
authors.initials: R
authors.lastname: Wurzburger
authors.forename: Brittany N
authors.initials: BN
authors.lastname: Garcia
authors.forename: Angelo
authors.initials: A
authors.lastname: Tomedi
authors.forename: Mutuku A
authors.initials: MA
authors.lastname: Mwanthi
mesh_terms: D003150:Community Health Workers; D005260:Female; D006792:House Calls; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D007630:Kenya / Q000453:epidemiology; D008297:Male; D010342:Patient Acceptance of Health Care; D016730:Program Development; D015397:Program Evaluation; D019035:Rural Health Services / Q000458:organization & administration*; D012424:Rural Population; D000078329:Workforce