Evidence map›Paper›PMID 30922341›Full record

Trial reportHuman resources for health2019

The effect of a community health worker intervention on public satisfaction: evidence from an unregistered outcome in a cluster-randomized controlled trial in Dar es Salaam, Tanzania.

Elysia Larson, Pascal Geldsetzer, Eric Mboggo, Irene Andrew Lema, David Sando, Anna Mia Ekström, Wafaie Fawzi, Dawn W Foster, Charles Kilewo, Nan Li and 10 more

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in Human resources for health, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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

2 citing papers in PubMed.

  1. Article
  2. Article
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

20 authors.

Elysia LarsonDepartment of Global Health and Population, Harvard T.H. Chan School of Public Health, 665 Huntington Ave., Building 1, 11th floor, Boston, MA, 02115, United States of America. elarson@mail.harvard.edu.ORCID 0000-0002-4099-536X
Pascal GeldsetzerDepartment of Global Health and Population, Harvard T.H. Chan School of Public Health, 665 Huntington Ave., Building 1, 11th floor, Boston, MA, 02115, United States of America.
Eric MboggoManagement and Development for Health, Dar es Salaam, Tanzania.
Irene Andrew LemaManagement and Development for Health, Dar es Salaam, Tanzania.
David SandoDepartment of Global Health and Population, Harvard T.H. Chan School of Public Health, 665 Huntington Ave., Building 1, 11th floor, Boston, MA, 02115, United States of America.
Anna Mia EkströmDepartment of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
Wafaie FawziDepartment of Global Health and Population, Harvard T.H. Chan School of Public Health, 665 Huntington Ave., Building 1, 11th floor, Boston, MA, 02115, United States of America.
Dawn W FosterDepartment of Psychiatry, Yale School of Medicine, New Haven, United States of America.
Charles KilewoMuhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
Nan LiJanssen Research & Development, LLC, Raritan, United States of America.
Lameck MachumiManagement and Development for Health, Dar es Salaam, Tanzania.
Lucy MagesaManagement and Development for Health, Dar es Salaam, Tanzania.
Phares MujinjaMuhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
Ester MungureManagement and Development for Health, Dar es Salaam, Tanzania.
Mary Mwanyika-SandoAfrica Academy for Public Health, Dar es Salaam, Tanzania.
Helga NaburiMuhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
Hellen SirilManagement and Development for Health, Dar es Salaam, Tanzania.
Donna SpiegelmanDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, United States of America.
Nzovu UlengaManagement and Development for Health, Dar es Salaam, Tanzania.
Till BärnighausenHeidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany.

Funding

BIOSTATISTICS/EPIDEMIOLOGY TRAINING GRANTS IN AIDST32AI007358 · NIAID · HARVARD UNIVERSITY (SCH OF PUBLIC HLTH) · PI Michael David Hughes · 1989 to 2026
$12.4M
6 · The paper itself

Abstract

backgroundThere 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.

methodsFrom 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.

resultsIn 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).

conclusionsA 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 registrationClinicalTrials.gov, EJF22802.

Indexed as

Community Health WorkersConsumer BehaviorMaternal Health ServicesAdolescentAdultCommunity Health ServicesFemaleHumansMiddle AgedPregnancySurveys and QuestionnairesTanzaniaYoung AdultCommunity health workersMaternal and child healthSatisfactionSub-Saharan AfricaTask shifting

Identifiers

PMID30922341
PMCPMC6440091

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.