Evidence map›Paper›PMID 29983113›Full record

ArticleBMC medicine2018

Can community health worker home visiting improve care-seeking and maternal and newborn care practices in fragile states such as Afghanistan? A population-based intervention study.

Karen M Edmond, Khaksar Yousufi, Zelaikha Anwari, Sayed Masoud Sadat, Shah Mansoor Staniczai, Ariel Higgins-Steele, Alexandra L Bellows, Emily R Smith

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
37citing papers in PubMed, 2 pooled it
9.4field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

37 citing papers in PubMed, 2 syntheses or guidelines pooled it, 56 citations in OpenAlex.

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  19. Effectiveness Evaluation of a Primary School-Based Intervention against Heatwaves in China.International journal of environmental research and public health · 2022
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 2 countries.

Karen M EdmondUNICEF Afghanistan, UNOCA, Jalalabad Road, Kabul, Afghanistan. kedmond@unicef.org.
Khaksar YousufiUNICEF Afghanistan, UNOCA, Jalalabad Road, Kabul, Afghanistan.
Zelaikha AnwariMinistry of Public Health, Reproductive, Maternal, Newborn, Child and Adolescent Directorate, Kabul, Afghanistan.
Sayed Masoud SadatMinistry of Public Health, Community Based Health Care Department, Kabul, Afghanistan.
Shah Mansoor StaniczaiSave The Children, Kabul, Afghanistan.
Ariel Higgins-SteeleUNICEF Afghanistan, UNOCA, Jalalabad Road, Kabul, Afghanistan.
Alexandra L BellowsDepartment of Global Health and Population, Harvard TH Chan School of Public Health, Boston, USA.
Emily R SmithDepartment of Global Health and Population, Harvard TH Chan School of Public Health, Boston, USA.
World Health Organization - Afghanistan · AFHarvard Global Health Institute · USMinistry of Public Health · AF

Funding

Used own funds Used own funds
6 · The paper itself

Abstract

backgroundThe effects of community health worker (CHW) home visiting during the antenatal and postnatal periods in fragile- and conflicted-affected countries such as Afghanistan are not known.

methodsWe conducted a non-randomised population-based intervention study from March 2015 to February 2016. Two intervention and two control districts were selected. All female CHWs in the intervention districts were trained to provide eight home visits and behaviour change communication messages from pregnancy to 28 days postpartum. The primary outcome was the proportion of women who reported delivering in a health facility. Secondary outcomes were the proportion of women who reported attending a health facility for at least one antenatal and one postnatal visit. Outcomes were analysed at 12 months using multivariable difference-in-difference linear regression models adjusted for clustering.

resultsOverall, 289 female CHWs in the intervention districts performed home visits and 1407 eligible women (less than 12 months postpartum) at baseline and 1320 endline women provided outcome data (94% response rate). Facility delivery increased in intervention villages by 8.2% and decreased in the control villages by 6.3% (adjusted mean difference (AMD) 11.0%, 95% confidence interval (CI) 4.0-18.0%, p = 0.002). Attendance for at least one antenatal care visit (AMD 10.5%, 95% CI 4.2-16.9%, p = 0.001) and postnatal care visit (AMD 7.2%, 95% CI 0.2-14.2%, p = 0.040) increased in the intervention compared to the control districts.

conclusionsCHW home visiting during the antenatal and postnatal periods can improve health service use in fragile- and conflict-affected countries. Commitment to scale-up from Ministries and donors is now needed.

trial registrationThis trial was retrospectively registered at the Australian and New Zealand Clinical Trial Registry ( ACTRN12618000609257 ).

Indexed as

AdultAfghanistanCommunity Health WorkersFemaleHouse CallsHumansInfant, NewbornMaleMaternal-Child Health ServicesPregnancyPrenatal CareCommunitymaternalnewborn

Identifiers

PMID29983113
PMCPMC6036669
OpenAlexW2809956114

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.