ArticleAmerican journal of public health2018
A Community Health Worker Intervention to Increase Childhood Disease Treatment Coverage in Rural Liberia: A Controlled Before-and-After Evaluation.
Open access · greenAbstract readComparative Study
In one paragraph
Article in American journal of public health, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 4 of them syntheses that pooled it.
0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed, 4 pooled it
3.6field-weighted citation impact, top 7% of its field
What it found
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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.
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.
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Who cites it
20 citing papers in PubMed, 4 syntheses or guidelines pooled it, 38 citations in OpenAlex.
- Evaluating effectiveness of protective interventions towards environmental contamination among under-five children: systematic review and meta-analysis in Africa.BMC public health · 2026Pooled it
- Analysis of the institutionalisation of Integrated Community Case Management and its implications for access to community healthcare since 2019 in Sub-Saharan Africa: a systematic review.BMC primary care · 2026Pooled it
- The role of community health worker-based care in post-conflict settings: a systematic review.Health policy and planning · 2023Pooled it
- Integrated community case management of childhood illness in low- and middle-income countries.The Cochrane database of systematic reviews · 2021Pooled it
- Early impact of the Liberian National Community Health Assistant Program on under-five mortality in Grand Bassa County: A non-randomized stepped wedge evaluation.PLOS global public health · 2026Article
- Changes in child mortality and population health following 10 years of health systems strengthening in rural Madagascar: A longitudinal cohort study.PLoS medicine · 2025Article
- Bayesian Hierarchical Penalized Spline Models for Immediate and Time-Varying Intervention Effects in Stepped Wedge Cluster Randomized Trials.Statistics in medicine · 2025Article
- Risk factors for contracting malaria in six wards of Mudzi District, Zimbabwe: A case control-study.PloS one · 2025Article
- Article
- A repeated cross-sectional study of the association of community health worker intervention with the maternal continuum of care in rural Liberian communities.BMC pregnancy and childbirth · 2023Article
- Article
- Measuring health system responsiveness in a national community health worker primary care programme in rural Liberia.International journal for quality in health care : journal of the International Society for Quality in Health Care · 2023Article
- Analysis of stepped wedge cluster randomized trials in the presence of a time-varying treatment effect.Statistics in medicine · 2022Article
- Impact of the Liberian National Community Health Assistant Program on childhood illness care in Grand Bassa County, Liberia.PLOS global public health · 2022Article
- Article
- Relationship between symptoms, barriers to care and healthcare utilisation among children under five in rural Mali.Tropical medicine & international health : TM & IH · 2021Article
- Aiming beyond equality to reach equity: the promise and challenge of quality improvement.BMJ (Clinical research ed.) · 2021Article
- Measuring Knowledge of Community Health Workers at the Last Mile in Liberia: Feasibility and Results of Clinical Vignette Assessments.Global health, science and practice · 2021Article
- Article
- Results from a difference-in-differences evaluation of health facility HIV and key population stigma-reduction interventions in Ghana.Journal of the International AIDS Society · 2020Article
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Authors and funding
16 authors.
Emily E WhiteEmily E. White is with Last Mile Health, Boston, MA. Jordan Downey, Vidiya Sathananthan, Avi Kenny, Ami Waters, Jenny Rabinowich, Mallika Raghavan, Lorenzo Dorr, Amal Halder, and Joseph Nyumah are with Last Mile Health, Monrovia, Liberia. Zahir Kanjee is with the Division of Global Health Equity, Brigham and Women's Hospital, Boston, and the Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston. Derry Duokie is with the Rivercess County Health Team, Cestos City, Liberia. Tamba Boima is with the Liberia Ministry of Health, Community Health Services Division, Monrovia. Raj Panjabi is with Last Mile Health, Boston, and the Division of Global Health Equity, Brigham and Women's Hospital. Mark J. Siedner is with Massachusetts General Hospital, Boston. John D. Kraemer is with the Department of Health Systems Administration, Georgetown University, Washington, DC.
Jordan DowneyEmily E. White is with Last Mile Health, Boston, MA. Jordan Downey, Vidiya Sathananthan, Avi Kenny, Ami Waters, Jenny Rabinowich, Mallika Raghavan, Lorenzo Dorr, Amal Halder, and Joseph Nyumah are with Last Mile Health, Monrovia, Liberia. Zahir Kanjee is with the Division of Global Health Equity, Brigham and Women's Hospital, Boston, and the Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston. Derry Duokie is with the Rivercess County Health Team, Cestos City, Liberia. Tamba Boima is with the Liberia Ministry of Health, Community Health Services Division, Monrovia. Raj Panjabi is with Last Mile Health, Boston, and the Division of Global Health Equity, Brigham and Women's Hospital. Mark J. Siedner is with Massachusetts General Hospital, Boston. John D. Kraemer is with the Department of Health Systems Administration, Georgetown University, Washington, DC.
Vidiya SathananthanEmily E. White is with Last Mile Health, Boston, MA. Jordan Downey, Vidiya Sathananthan, Avi Kenny, Ami Waters, Jenny Rabinowich, Mallika Raghavan, Lorenzo Dorr, Amal Halder, and Joseph Nyumah are with Last Mile Health, Monrovia, Liberia. Zahir Kanjee is with the Division of Global Health Equity, Brigham and Women's Hospital, Boston, and the Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston. Derry Duokie is with the Rivercess County Health Team, Cestos City, Liberia. Tamba Boima is with the Liberia Ministry of Health, Community Health Services Division, Monrovia. Raj Panjabi is with Last Mile Health, Boston, and the Division of Global Health Equity, Brigham and Women's Hospital. Mark J. Siedner is with Massachusetts General Hospital, Boston. John D. Kraemer is with the Department of Health Systems Administration, Georgetown University, Washington, DC.
Zahir KanjeeEmily E. White is with Last Mile Health, Boston, MA. Jordan Downey, Vidiya Sathananthan, Avi Kenny, Ami Waters, Jenny Rabinowich, Mallika Raghavan, Lorenzo Dorr, Amal Halder, and Joseph Nyumah are with Last Mile Health, Monrovia, Liberia. Zahir Kanjee is with the Division of Global Health Equity, Brigham and Women's Hospital, Boston, and the Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston. Derry Duokie is with the Rivercess County Health Team, Cestos City, Liberia. Tamba Boima is with the Liberia Ministry of Health, Community Health Services Division, Monrovia. Raj Panjabi is with Last Mile Health, Boston, and the Division of Global Health Equity, Brigham and Women's Hospital. Mark J. Siedner is with Massachusetts General Hospital, Boston. John D. Kraemer is with the Department of Health Systems Administration, Georgetown University, Washington, DC.
Avi KennyEmily E. White is with Last Mile Health, Boston, MA. Jordan Downey, Vidiya Sathananthan, Avi Kenny, Ami Waters, Jenny Rabinowich, Mallika Raghavan, Lorenzo Dorr, Amal Halder, and Joseph Nyumah are with Last Mile Health, Monrovia, Liberia. Zahir Kanjee is with the Division of Global Health Equity, Brigham and Women's Hospital, Boston, and the Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston. Derry Duokie is with the Rivercess County Health Team, Cestos City, Liberia. Tamba Boima is with the Liberia Ministry of Health, Community Health Services Division, Monrovia. Raj Panjabi is with Last Mile Health, Boston, and the Division of Global Health Equity, Brigham and Women's Hospital. Mark J. Siedner is with Massachusetts General Hospital, Boston. John D. Kraemer is with the Department of Health Systems Administration, Georgetown University, Washington, DC.
Ami WatersEmily E. White is with Last Mile Health, Boston, MA. Jordan Downey, Vidiya Sathananthan, Avi Kenny, Ami Waters, Jenny Rabinowich, Mallika Raghavan, Lorenzo Dorr, Amal Halder, and Joseph Nyumah are with Last Mile Health, Monrovia, Liberia. Zahir Kanjee is with the Division of Global Health Equity, Brigham and Women's Hospital, Boston, and the Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston. Derry Duokie is with the Rivercess County Health Team, Cestos City, Liberia. Tamba Boima is with the Liberia Ministry of Health, Community Health Services Division, Monrovia. Raj Panjabi is with Last Mile Health, Boston, and the Division of Global Health Equity, Brigham and Women's Hospital. Mark J. Siedner is with Massachusetts General Hospital, Boston. John D. Kraemer is with the Department of Health Systems Administration, Georgetown University, Washington, DC.
Jenny RabinowichEmily E. White is with Last Mile Health, Boston, MA. Jordan Downey, Vidiya Sathananthan, Avi Kenny, Ami Waters, Jenny Rabinowich, Mallika Raghavan, Lorenzo Dorr, Amal Halder, and Joseph Nyumah are with Last Mile Health, Monrovia, Liberia. Zahir Kanjee is with the Division of Global Health Equity, Brigham and Women's Hospital, Boston, and the Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston. Derry Duokie is with the Rivercess County Health Team, Cestos City, Liberia. Tamba Boima is with the Liberia Ministry of Health, Community Health Services Division, Monrovia. Raj Panjabi is with Last Mile Health, Boston, and the Division of Global Health Equity, Brigham and Women's Hospital. Mark J. Siedner is with Massachusetts General Hospital, Boston. John D. Kraemer is with the Department of Health Systems Administration, Georgetown University, Washington, DC.
Mallika RaghavanEmily E. White is with Last Mile Health, Boston, MA. Jordan Downey, Vidiya Sathananthan, Avi Kenny, Ami Waters, Jenny Rabinowich, Mallika Raghavan, Lorenzo Dorr, Amal Halder, and Joseph Nyumah are with Last Mile Health, Monrovia, Liberia. Zahir Kanjee is with the Division of Global Health Equity, Brigham and Women's Hospital, Boston, and the Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston. Derry Duokie is with the Rivercess County Health Team, Cestos City, Liberia. Tamba Boima is with the Liberia Ministry of Health, Community Health Services Division, Monrovia. Raj Panjabi is with Last Mile Health, Boston, and the Division of Global Health Equity, Brigham and Women's Hospital. Mark J. Siedner is with Massachusetts General Hospital, Boston. John D. Kraemer is with the Department of Health Systems Administration, Georgetown University, Washington, DC.
Lorenzo DorrEmily E. White is with Last Mile Health, Boston, MA. Jordan Downey, Vidiya Sathananthan, Avi Kenny, Ami Waters, Jenny Rabinowich, Mallika Raghavan, Lorenzo Dorr, Amal Halder, and Joseph Nyumah are with Last Mile Health, Monrovia, Liberia. Zahir Kanjee is with the Division of Global Health Equity, Brigham and Women's Hospital, Boston, and the Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston. Derry Duokie is with the Rivercess County Health Team, Cestos City, Liberia. Tamba Boima is with the Liberia Ministry of Health, Community Health Services Division, Monrovia. Raj Panjabi is with Last Mile Health, Boston, and the Division of Global Health Equity, Brigham and Women's Hospital. Mark J. Siedner is with Massachusetts General Hospital, Boston. John D. Kraemer is with the Department of Health Systems Administration, Georgetown University, Washington, DC.
Amal HalderEmily E. White is with Last Mile Health, Boston, MA. Jordan Downey, Vidiya Sathananthan, Avi Kenny, Ami Waters, Jenny Rabinowich, Mallika Raghavan, Lorenzo Dorr, Amal Halder, and Joseph Nyumah are with Last Mile Health, Monrovia, Liberia. Zahir Kanjee is with the Division of Global Health Equity, Brigham and Women's Hospital, Boston, and the Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston. Derry Duokie is with the Rivercess County Health Team, Cestos City, Liberia. Tamba Boima is with the Liberia Ministry of Health, Community Health Services Division, Monrovia. Raj Panjabi is with Last Mile Health, Boston, and the Division of Global Health Equity, Brigham and Women's Hospital. Mark J. Siedner is with Massachusetts General Hospital, Boston. John D. Kraemer is with the Department of Health Systems Administration, Georgetown University, Washington, DC.
Joseph NyumahEmily E. White is with Last Mile Health, Boston, MA. Jordan Downey, Vidiya Sathananthan, Avi Kenny, Ami Waters, Jenny Rabinowich, Mallika Raghavan, Lorenzo Dorr, Amal Halder, and Joseph Nyumah are with Last Mile Health, Monrovia, Liberia. Zahir Kanjee is with the Division of Global Health Equity, Brigham and Women's Hospital, Boston, and the Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston. Derry Duokie is with the Rivercess County Health Team, Cestos City, Liberia. Tamba Boima is with the Liberia Ministry of Health, Community Health Services Division, Monrovia. Raj Panjabi is with Last Mile Health, Boston, and the Division of Global Health Equity, Brigham and Women's Hospital. Mark J. Siedner is with Massachusetts General Hospital, Boston. John D. Kraemer is with the Department of Health Systems Administration, Georgetown University, Washington, DC.
Derry DuokieEmily E. White is with Last Mile Health, Boston, MA. Jordan Downey, Vidiya Sathananthan, Avi Kenny, Ami Waters, Jenny Rabinowich, Mallika Raghavan, Lorenzo Dorr, Amal Halder, and Joseph Nyumah are with Last Mile Health, Monrovia, Liberia. Zahir Kanjee is with the Division of Global Health Equity, Brigham and Women's Hospital, Boston, and the Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston. Derry Duokie is with the Rivercess County Health Team, Cestos City, Liberia. Tamba Boima is with the Liberia Ministry of Health, Community Health Services Division, Monrovia. Raj Panjabi is with Last Mile Health, Boston, and the Division of Global Health Equity, Brigham and Women's Hospital. Mark J. Siedner is with Massachusetts General Hospital, Boston. John D. Kraemer is with the Department of Health Systems Administration, Georgetown University, Washington, DC.
Tamba BoimaEmily E. White is with Last Mile Health, Boston, MA. Jordan Downey, Vidiya Sathananthan, Avi Kenny, Ami Waters, Jenny Rabinowich, Mallika Raghavan, Lorenzo Dorr, Amal Halder, and Joseph Nyumah are with Last Mile Health, Monrovia, Liberia. Zahir Kanjee is with the Division of Global Health Equity, Brigham and Women's Hospital, Boston, and the Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston. Derry Duokie is with the Rivercess County Health Team, Cestos City, Liberia. Tamba Boima is with the Liberia Ministry of Health, Community Health Services Division, Monrovia. Raj Panjabi is with Last Mile Health, Boston, and the Division of Global Health Equity, Brigham and Women's Hospital. Mark J. Siedner is with Massachusetts General Hospital, Boston. John D. Kraemer is with the Department of Health Systems Administration, Georgetown University, Washington, DC.
Raj PanjabiEmily E. White is with Last Mile Health, Boston, MA. Jordan Downey, Vidiya Sathananthan, Avi Kenny, Ami Waters, Jenny Rabinowich, Mallika Raghavan, Lorenzo Dorr, Amal Halder, and Joseph Nyumah are with Last Mile Health, Monrovia, Liberia. Zahir Kanjee is with the Division of Global Health Equity, Brigham and Women's Hospital, Boston, and the Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston. Derry Duokie is with the Rivercess County Health Team, Cestos City, Liberia. Tamba Boima is with the Liberia Ministry of Health, Community Health Services Division, Monrovia. Raj Panjabi is with Last Mile Health, Boston, and the Division of Global Health Equity, Brigham and Women's Hospital. Mark J. Siedner is with Massachusetts General Hospital, Boston. John D. Kraemer is with the Department of Health Systems Administration, Georgetown University, Washington, DC.
Mark J SiednerEmily E. White is with Last Mile Health, Boston, MA. Jordan Downey, Vidiya Sathananthan, Avi Kenny, Ami Waters, Jenny Rabinowich, Mallika Raghavan, Lorenzo Dorr, Amal Halder, and Joseph Nyumah are with Last Mile Health, Monrovia, Liberia. Zahir Kanjee is with the Division of Global Health Equity, Brigham and Women's Hospital, Boston, and the Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston. Derry Duokie is with the Rivercess County Health Team, Cestos City, Liberia. Tamba Boima is with the Liberia Ministry of Health, Community Health Services Division, Monrovia. Raj Panjabi is with Last Mile Health, Boston, and the Division of Global Health Equity, Brigham and Women's Hospital. Mark J. Siedner is with Massachusetts General Hospital, Boston. John D. Kraemer is with the Department of Health Systems Administration, Georgetown University, Washington, DC.
John D KraemerEmily E. White is with Last Mile Health, Boston, MA. Jordan Downey, Vidiya Sathananthan, Avi Kenny, Ami Waters, Jenny Rabinowich, Mallika Raghavan, Lorenzo Dorr, Amal Halder, and Joseph Nyumah are with Last Mile Health, Monrovia, Liberia. Zahir Kanjee is with the Division of Global Health Equity, Brigham and Women's Hospital, Boston, and the Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston. Derry Duokie is with the Rivercess County Health Team, Cestos City, Liberia. Tamba Boima is with the Liberia Ministry of Health, Community Health Services Division, Monrovia. Raj Panjabi is with Last Mile Health, Boston, and the Division of Global Health Equity, Brigham and Women's Hospital. Mark J. Siedner is with Massachusetts General Hospital, Boston. John D. Kraemer is with the Department of Health Systems Administration, Georgetown University, Washington, DC.
Funding
Behavioral Aspects of Low-cost Medical Devices to Improve HIV CareK23MH099916 · NIMH · MASSACHUSETTS GENERAL HOSPITAL · PI SIEDNER, MARK J · 2013 to 2017
$917kNIMH NIH HHS K23 MH099916
Abstract
objectivesTo assess a community health worker (CHW) program's impact on childhood illness treatment in rural Liberia.
methodsWe deployed CHWs in half of Rivercess County in August 2015 with the other half constituting a comparison group until July 2016. All CHWs were provided cash incentives, supply chain support, and monthly clinical supervision. We conducted stratified cluster-sample population-based surveys at baseline (March-April 2015) and follow-up (April-June 2016) and performed a difference-in-differences analysis, adjusted by inverse probability of treatment weighting, to assess changes in treatment of fever, diarrhea, and acute respiratory infection by a qualified provider.
resultsWe estimated a childhood treatment difference-in-differences of 56.4 percentage points (95% confidence interval [CI] = 36.4, 76.3). At follow-up, CHWs provided 57.6% (95% CI = 42.8, 71.2) of treatment in the intervention group. The difference-in-differences diarrhea oral rehydration therapy was 22.4 percentage points (95% CI = -0.7, 45.5).
conclusionsImplementation of a CHW program in Rivercess County, Liberia, was associated with large, statistically significant improvements treatment by a qualified provider; however, improvements in correct diarrhea treatment were lower than improvements in coverage. Findings from this study offer support for expansion of Liberia's new National Community Health Assistant Program.
Indexed as
Child HealthCommunity Health WorkersHealth Services AccessibilityProfessional RoleRural PopulationChild, PreschoolCommunity Health ServicesDiarrheaFemaleFeverHealth Care SurveysHumansInfantLiberiaProgram EvaluationRespiratory Tract Infections
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