Effectiveness of the BRAC community health workers in improving safe motherhood and newborn care in the urban community of Bangladesh

Background: The community health workers (CHWs) of BRAC MANOSHI programme are promoting safe motherhood and neonatal health across urban slums of Bangladesh where a lack of awareness and unaffordability of medically trained... [ view full abstract ]

Background:
The community health workers (CHWs) of BRAC MANOSHI programme are promoting safe motherhood and neonatal health across urban slums of Bangladesh where a lack of awareness and unaffordability of medically trained providers (MTPs) are prevalent. They advise pregnant women on appropriate care practices for delivery, post-delivery and essential newborn care (ENC) including wiping, warping, breastfeeding and cutting and tying cord with sterile materials during antenatal care (ANC) checkup. This study aims to investigate the effectiveness of ANC checkup of BRAC CHW in improving safe motherhood and newborn care in the urban community.

Methodology:
This cross-sectional study was conducted during March to July 2015 in Chittagong, Dhaka and Sylhet city corporations. A census was conducted among 25,000 households covering 10 branch offices of MANOSHI programme in these three areas to identify women with a delivery outcome preceding the last three years. A total of 1100 respondents were interviewed randomly based on the census through a structured questionnaire. Logistic regression was performed for data analysis and results showed an odds ratio with a 95% confidence interval.

Results:
Institutional delivery significantly improved from 11% to 57.6% in the three years period among women who received one or more ANC checkups from BRAC CHWs (P<0.001). MTP assisted delivery was 72% higher among women who received ≥four ANC checkups from BRAC CHWs compared to those who received ≤3 ANC checkups from them [1.72 (1.26-2.35)]. Similarly, components of ENC all together was 37% higher among those newborn whose mothers had received ≥four ANC checkups from BRAC CHWs [1.37 (1.05-1.80)].

Conclusion:
Four or more ANC checkups by BRAC CHWs had an effective role in improving skilled assisted delivery with a comprehensive provision of ENC service in the urban community.