Improving health facility delivery rates in Zanzibar, Tanzania through a large-scale digital community health volunteer programme

A process evaluation

Bibliographic Data

ID11490957
AuthorsIsabel R Fulcher (0000-0002-1209-824X, Harvard Medical School), Nurul Aisyah Husain (corresponding author), Allyson R Nelson (0000-0002-1910-5422, D-tree International, IRCH Building, Kidongo Chekundu, Zanzibar, Tanzania), Jalia I Tibaijuka (D-tree International, IRCH Building, Kidongo Chekundu, Zanzibar, Tanzania), Samira S Seif (D-tree International, IRCH Building, Kidongo Chekundu, Zanzibar, Tanzania), Sam Lilienfeld (D-tree International, IRCH Building, Kidongo Chekundu, Zanzibar, Tanzania), Omar A Abdalla (D-tree International, IRCH Building, Kidongo Chekundu, Zanzibar, Tanzania), Nadine Beckmann (0000-0002-2747-0833, University of Roehampton), Erica H Layer (D-tree International, IRCH Building, Kidongo Chekundu, Zanzibar, Tanzania), Bethany Hedt-Gauthier (0000-0002-9689-5413, Harvard Medical School), Rachel Lieber Hofmann (D-tree International, IRCH Building, Kidongo Chekundu, Zanzibar, Tanzania)
Year2021
Volume35
Issue10
Pages1-11
Publication date2021-02-16
Open AccessYes
TypeARTICLE
VenueHealth Policy and Planning (JOURNAL)
Journal identifiersISSN: 0268-1080 • E-ISSN: 1460-2237
PublisherOxford University Press (PUBLISHER • GB)
DOI10.1093/heapol/czaa068
OpenAlexW33263749
LanguageEN
Citations received2
References cited25

The utilization of community health worker (CHW) programmes to improve maternal and neonatal health outcomes has become widely applied in low- and middle-income countries. While current research has focused on discerning the effect of these interventions, documenting the process of implementing, scaling and sustaining these programmes has been largely ignored. Here, we focused on the implementation of the Safer Deliveries CHW programme in Zanzibar, a programme designed to address high rates of maternal and neonatal mortality by increasing rates of health facility delivery and postnatal care visits. The programme was implemented and brought to scale in 10 of 11 districts in Zanzibar over the course of 3 years by D-tree International and the Zanzibar Ministry of Health. As the programme utilized a mobile app to support CHWs during their visits, a rich data resource comprised of 133 481 pregnancy and postpartum home visits from 41 653 women and 436 CHWs was collected, enabling the evaluation of numerous measures related to intervention fidelity and health outcomes. Utilizing the framework of Steckler et al., we completed a formal process evaluation of the primary intervention, CHW home visits to women during their pregnancy and postpartum period. Our in-depth analysis and discussion will serve as a model for process evaluations of similar CHW programmes and will hopefully encourage future implementers to report analogous measures of programme performance

Biology · Botany · Bud · Cultivar · Cut flowers · Postharvest · Sucrose · Vase · Vase life · Wilting · Flowering Plant Growth and Cultivation · Food Science · Horticulture · Plant Physiology and Cultivation Studies · Postharvest Quality and Shelf Life Management