Utilization of maternal health services provided by community health workers among pregnant women, in Mkuranga district, Tanzania

Abstract

Background: The burden of maternal mortality in higher in developing Countries which is approximated to harbor 99% of the global burden; the Sub Saharan Africa harbors an enormous portion of this burden, Tanzania inclusive. Efforts in improving maternal health are being hampered by number of factors which include Shortage of human resource for health (HRH) and poor access to care by pregnant women. To bridge this gap a Community health worker model is being implemented in a number of countries and has shown to be effective. Community health workers are community members who are given short course training, intended to enable them provide health services especially in remote and underserved areas. However little is known about utilization of the services offered by CHW and factors that influences the utilization of the services they provide in the community. Objectives: The aim of the study was to determine utilization of maternal health services provided by CHWs among pregnant women in Mkuranga district Tanzania Materials and Method: This Analytical cross sectional study was conducted among pregnant women attending antenatal clinic in Mkuranga district. Semi structured questionnaire and Reproductive and Child Health Card number 4 (RCH Card No 4) were used to collect data. Data was entered in SPSS version 20 statistical package. Descriptive statistics was used to describe the data, chi square was used to check evidence of association of variable at population level and logistic regression was used to check the relationship of factors with utilization. STATA version 12 was also used in constructing the wealth index.

Results: Total of 612 pregnant women aged between 18 to 48 years, with median age of 28 were recruited in the study. Among the respondents 48 (8.5%) were HIV positive. More than a quarter (27.5%) of pregnant women reported to have utilized services provided by CHW’s in their current pregnancy.Marital status, respondent education, partner education and occupation influenced utilization of maternal health services provided by community health workers.

Conclusion: Significant number of pregnant women in Mkuranga district utilizes CHWs services. The study suggested different relationship of some factors known to influence utilization of health services provided by CHWs as compared to when provided by modern health care system.

Recommendations: Deployment of more CHWs to improve their access by pregnant women, improving supportive supervision to CHWs as well as reviewing CHW scope of work and workload should be considered. Studying community acceptability of CHWs program and exploring CHW competency and effectiveness in executing the tasks assigned to them is of paramount importance.