Figures & Tables
Figures
- FIGURE.
Hypothesized Mechanisms Through Which Community Health Workers Could Affect Neonatal Care Practices and the Contexts that May Influence the Mechanisms in Ethiopia and Nigeria
Abbreviation: CHW, community health worker.
Tables
Nigerian CHWs Ethiopian HEWs Ethiopian HDA leaders Training 5–6 days 1 year 15 days Payment Incentives for taking women to facilities and for referrals Approximately $100/month None Selection criteria Existing TBAs or FOMWAMs, no literacy requirement Resident in the community, speaks local language, educated to 10th grade or above, willing to remain in the village and serve the community Model family, trusted, able to mobilize communities; no literacy requirement Scope of work Specific to maternal and newborn health including delivering key behavior change messages, detection of and referral for maternal and newborn danger signs Broad, including disease prevention and treatment Broad, including assisting families in adopting behaviors, engaging in community mobilization, and leading participatory action cycles Abbreviations: CHW, community health worker; HDA, Health Development Army; HEW, health extension worker; FOMWAM, Federation of Muslim Women’s Associations in Nigeria; TBA, traditional birth attendant.
Region Study area Ethnicity Main Religions Access to Health Care Terrain Main Economic Activities Amhara, Ethiopia Kebele A Amhara Orthodox Christian Moderate Hilly Subsistence farming Kebele B Amhara Orthodox Christian Good Hilly Subsistence farming SNNPR, Ethiopia Kebele C Gamo/Wolaita Protestant/Orthodox Christian Good Flat with some hills Subsistence farming Kebele D Silte Muslim Moderate Flat Subsistence farming Gombe, Nigeria LGA A: urban Tangle Christian Excellent Flat Traders, farmers LGA B: rural Tangle Christian Good Flat Traders, farmers LGA C: urban and close to capital Tera, Bolewa, Fulani Muslim Excellent Flat Traders, civil servants, farmers LGA D: rural and close to capital Fulani, Kanuri Muslim Excellent Flat Traders, civil servants, farmers Abbreviations: LGA, local government area; SNNPR, Southern Nations, Nationalities and Peoples Region.
- TABLE 3.
Data Collection Method, Sample Size per Country, and Content in Ethiopia and Nigeria
Method Sample Content Narrative interviews with recent mothers 12 Labor and delivery story
How was the newborn cared for, by whom, what influenced care, who made decisions
Perceived newborn care knowledge and skills compared with others
Contacts with, and advice from, health workers and CHWs, was advice new, did they agree with it, did it influence their behavior
Other advice received, agreement with the advice
Importance of what family and friends think of the care they give
In-depth interviews with recent mothers 12–13 Newborn care practices in the community and what influences these
Influence and importance of family and friends on care
CHW roles and their suitability for the role
Most significant newborn health changes in last 2 years
FGD with recent mothers 4 Pile sort of feeding and thermal care cards into practiced/not practiced and promoted/not promoted by CHW
Completion of a story of conflicting advice about delayed bathing
Most significant newborn health changes in last 2 years
Reaction to statements that CHWs work does not bring change, and that grandmothers are responsible for newborn care
FGD with grandmothers 4 Reaction to pictures of feeding and bathing practices
Role of grandmothers in newborn care and in decision making
Ranking of people who influence newborn care
Completion of a story of conflicting advice about delayed bathing
Most significant newborn health changes in last 2 years
Reaction to statements that grandmothers’ role is to support traditional practices, that CHWs know everything about newborn care and that mothers do not listen to grandmothers
FGDs with fathers 4 Reaction to pictures of feeding and bathing practices
Role of fathers in newborn care and in decision making
Completion of a story of conflicting advice about delayed bathing
CHW roles and their suitability for the role
Fathers’ knowledge of CHWs’ advice, and the advice they trust most
Most significant newborn health changes in last 2 years
Reaction to statements that mothers and fathers should decide on newborn care, that CHW visits involve fathers, that CHWs do not bring change, and that grandmothers’ role is to support traditional practices
FGD with CHWs 4 Pile sort of feeding and thermal care behaviors practiced/not practiced and important/not important by CHW
Most significant newborn health and work changes in the last 2 years
Successes and challenges in their work
Community reaction to them and their work
Reaction to statements that families are always happy to see the CHW, that CHWs do not bring change, and that families agree with delayed bathing advice
Abbreviations: CHW, community health worker; FGD, focus group discussion.
- TABLE 4.
Sample Characteristics of Mothers in Narrative and In-Depth Interviews in Ethiopia and Nigeria
Characteristic Ethiopia (N=25) Nigeria (N=24) Age, years ≤24 10 8 25–34 10 12 ≥35 5 4 Education None 10 12 Primary 12 4 Secondary and above 3 8 Religion Muslim 8 15 Christian 17 9 Parity 1 7 3 >1 18 21 Place of last delivery Home 6 4 Facility 19 20 Residence Urban 0 12 Rural 25 12
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