Women’s development group leaders’ promotion of maternal, neonatal and child health care in Ethiopia: a cross-sectional study

ABSTRACT

Background

Women’s development group leaders are volunteer community health workers in Ethiopia who, among other duties, promote health and prevention of diseases. They link and extend essential health services from health posts to households.

Objective

To assess the characteristics, knowledge, and practice of women’s development group leaders in the field of maternal, neonatal, and child health care.

Method

This study used a cluster-sampled cross-sectional survey conducted from December 2016 to February 2017 in four regions of Ethiopia: Oromia, Amhara, Tigray and Southern Nations, Nationalities and Peoples. One of the volunteers, who was available at the time of the survey, was included from each cluster. A total of 187 women’s development group leaders participated in this quantitative study.

Result

Close to half of the women’s development group leaders were illiterate. The leaders had a wide variation in the number of women in their groups. Two-thirds had received some training during the last year, covering a broad range of health topics. Their knowledge of maternal, newborn, and child health was relatively low. Two-thirds had monthly contact with health extension workers. Around half had interacted with other local stakeholders on maternal and child health matters during the last three months. Two-thirds had visited pregnant women, and half had made home visits after delivery in the previous quarter. Activities regarding sick newborns and under-five children were less frequent.

Conclusion

The women leaders were given a wide range of tasks, despite having a low educational level and receiving training through brief orientations. They also showed limited knowledge but had a relatively high level of activities related to maternal health, while less so on neonatal and child health.

KEYWORDS:

• Community health volunteers
• health extension program
• knowledge
• performance
• training

Responsible Editor

Jennifer Stewart Williams, Umeå University, Sweden

Responsible Editor

Jennifer Stewart Williams, Umeå University, Sweden

Acknowledgments

We want to thank all staff at the Tigray Regional Health Bureau, the Ethiopian Federal Ministry of Health, and Mekelle University for all their support. We also thank the Dagu project team for managing the data collection process and their unreserved support. Special thanks to Dr. Hagos Godefay, Dr. Ephrem Tekle, Teame G/Mariam, Mulugeta Chernet, and Zinabu Hadush for their technical advice. Our gratitude also goes to all participants, data collectors, and regional health bureaus in the study areas for contributing to the data collection process.

Authors contribution

FA was overall responsible for conducting the study, analysing the data and drafting the manuscript. AM, AM, LÅP, and DB supervised this research and contributed to analyses and revision of the manuscript. All authors approved the final version of the manuscript.

Disclosure statement

The authors report no conflicts of interest.

Ethics and consent

Ethical approval was obtained from the Ethiopia Public Health Institute (protocol number SERO 012 8 2016), London School of Hygiene & Tropical Medicine (protocol number 11235) and Mekelle University, College of Health Sciences (protocol number 1433/2018). Support letters were also obtained from the Regional Health Bureaus in Amhara, Oromia, Tigray and Southern Nations and Nationalities Peoples. Informed consent was obtained from all study participants. Training on research ethics was provided for field supervisors and data collection teams using a field guide. An information sheet about the study was available in Amharic, Oromifaa, and Tigrigna. Informed consent was obtained from all study participants. Confidentiality was assured to all study participants.

Paper context

The women’s development group strategy includes volunteer women who lead groups of women in the local community. This strategy has evolved, and their support to the primary health care for pregnant women, newborns, and children has grown over time. Earlier research showed that active women’s development group may have reinforced the primary health care services. We describe the leaders’ characteristics, knowledge, and health-related activities and suggest some modifications to strengthen this community engagement strategy.

Data availability statement

The dataset used in this study can be made available from the Ethiopian Public Health Institute, after contacting Dr. Della Berhanu, email [email protected].

Additional information

Funding

This work was supported by the Bill and Melinda Gates Foundation under a grant to the London School of Hygiene & Tropical Medicine (OPP1132551).