In: Human Resources for Health, 17 (2019), Nr. 23. pp. 1-8. ISSN 1478-4491
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Abstract
Background: There is a dearth of evidence on the causal effects of different care delivery approaches on health system satisfaction. A better understanding of public satisfaction with the health system is particularly important within the context of task shifting to community health workers (CHWs). This paper determines the effects of a CHW program focused on maternal health services on public satisfaction with the health system among women who are pregnant or have recently delivered.
Methods: From January 2013 to April 2014, we carried out a cluster-randomized controlled health system implementation trial of a CHW program. Sixty wards in Dar es Salaam, Tanzania, were randomly allocated to either a maternal health CHW program (36 wards) or the standard of care (24 wards). From May to August 2014, we interviewed a random sample of women who were either currently pregnant or had recently delivered a child. We used five-level Likert scales to assess women’s satisfaction with the CHW program and with the public-sector health system in Dar es Salaam.
Results: In total, 2329 women participated in the survey (response rate 90.2%). Households in intervention areas were 2.3 times as likely as households in control areas to have ever received a CHW visit (95% CI 1.8, 3.0). The intervention led to a 16-percentage-point increase in women reporting they were satisfied or very satisfied with the CHW program (95% CI 3, 30) and a 15-percentage-point increase in satisfaction with the public-sector health system (95% CI 3, 27).
Conclusions: A CHW program for maternal and child health in Tanzania achieved better public satisfaction than the standard CHW program. Policy-makers and implementers who are involved in designing and organizing CHW programs should consider the potential positive impact of the program on public satisfaction.
Trial registration: ClinicalTrials.gov, EJF22802
Document type: | Article |
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Journal or Publication Title: | Human Resources for Health |
Volume: | 17 |
Number: | 23 |
Publisher: | Biomed Central |
Place of Publication: | London |
Date Deposited: | 24 May 2019 14:00 |
Date: | 2019 |
ISSN: | 1478-4491 |
Page Range: | pp. 1-8 |
Faculties / Institutes: | Medizinische Fakultät Heidelberg > Institut für Public Health (IPH) |
DDC-classification: | 610 Medical sciences Medicine |
Uncontrolled Keywords: | Community health workers, Satisfaction, Sub-Saharan Africa, Maternal and child health, Task shifting |