ArticleBMC public health2020
Community health workers impact on maternal and child health outcomes in rural South Africa - a non-randomized two-group comparison study.
Article in BMC public health, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 3 of them syntheses that pooled it.
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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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
33 citing papers in PubMed, 3 syntheses or guidelines pooled it, 42 citations in OpenAlex.
- How effective are community health workers in managing and preventing perinatal depression in sub-Saharan Africa? A systematic review of quantitative evidence.Health policy and planning · 2026Pooled it
- Lay health workers in primary and community health care for maternal and child health: identification and treatment of wasting in children.The Cochrane database of systematic reviews · 2023Pooled it
- What improves access to primary healthcare services in rural communities? A systematic review.BMC primary care · 2022Pooled it
- The mental health benefit of a community-based home-visiting program for prenatal women: evidence from a randomized controlled trial in China.BMC pregnancy and childbirth · 2025Trial
- Relationship of perinatal outcomes to the competence and quantity of contact with community health workers.Journal of global health · 2025Trial
- The role of a community health worker-delivered preconception and pregnancy intervention in achieving a more positive pregnancy experience: the Bukhali trial in Soweto, South Africa.BMC women's health · 2024Trial
- The effect of supervision on community health workers' effectiveness with households in rural South Africa: A cluster randomized controlled trial.PLoS medicine · 2023Trial
- Global, regional and national burden of maternal haemorrhage (2000-2021) and projections to 2050 in 204 countries and territories.BMJ open · 2026Article
- "If they were telling us to go, we will go": factors associated with effective postnatal care coverage before and after discharge - a mixed-methods study in rural western Kenya.BMJ global health · 2026Article
- Health Cadre Mentoring Model in Stunting Prevention Programs: A Systematic Literature Review.Journal of multidisciplinary healthcare · 2026Review
- Unseen and underserved: A scoping review of perinatal mental health interventions in Sub-Saharan Africa.PLOS mental health · 2026Article
- Costs and cost-effectiveness of community health worker programs on reproductive, maternal, newborn and child health in low- and middle-income countries (2015-2024): A scoping review.PLOS global public health · 2026Article
- Abortion in conflict zones: moral responsibilities of humanitarian agencies in providing safe abortion care.Frontiers in reproductive health · 2026Review
- Interventions for enhancing child survival practices among caregivers of under-five children in Sub-Saharan Africa: a scoping review.BMC public health · 2025Article
- Three decades of community health workers in primary healthcare delivery in Rwanda: evolution, impact and policy lessons.BMJ global health · 2025Article
- Accelerating community health worker programmes: a key priority of the Global Health Initiatives for the operationalisation of the Lusaka Agenda in Africa.BMJ global health · 2025Article
- Article
- Evidence-Based Behavioral Interventions to Improve the Double-Duty Actions Impacting the Dual Burden of Malnutrition: A Scoping Review.Food science & nutrition · 2025Review
- Implementation of the national community health policy in Guinea: a decision space analysis of the roles and responsibilities of community health workers.Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz · 2025Article
- Article
Corrections and comments
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Authors and funding
10 authors at 5 institutions in 3 countries.
Funding
Abstract
backgroundHome visits by paraprofessional community health workers (CHWs) has been shown to improve maternal and child health outcomes in research studies in many countries. Yet, when these are scaled or replicated, efficacy disappears. An effective CHW home visiting program in peri-urban Cape Town found maternal and child health benefits over the 5 years point but this study examines if these benefits occur in deeply rural communities.
methodsA non-randomized, two-group comparison study evaluated the impact of CHW in the rural Eastern Cape from August 2014 to May 2017, with 1310 mother-infant pairs recruited in pregnancy and 89% were reassessed at 6 months post-birth.
resultsHome visiting had limited, but important effects on child health, maternal wellbeing and health behaviors. Mothers reported fewer depressive symptoms, attended more antenatal visits and had better baby-feeding practices. Intervention mothers were significantly more likely to exclusively breastfeed for 6 months (OR: 1.8; 95% CI: 1.1, 2.9), had lower odds of mixing formula with baby porridge (regarded as detrimental) (OR: 0.4; 95% CI: 0.2, 0.8) and were less likely to consult traditional healers. Mothers living with HIV were more adherent with co-trimoxazole prophylaxis (p < 0.01). Intervention-group children were significantly less likely to be wasted (OR: 0.5; 95% CI 0.3-0.9) and had significantly fewer symptoms of common childhood illnesses in the preceding two weeks (OR: 0.8; 95% CI: 0.7,0.9).
conclusionThe impact of CHWs in a rural area was less pronounced than in peri-urban areas. CHWs are likely to need enhanced support and supervision in the challenging rural context.
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Registered trials
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.