Are populations of postpartum women differentially served by community health worker programs: an observational cohort study from Zanzibar, Tanzania

Autor: Michelle Olakkengil, Samira Said, Omar Abdalla, Rachel Hofmann, Bethany Hedt-Gauthier, Isabel Fulcher
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: BMC Pregnancy and Childbirth, Vol 24, Iss 1, Pp 1-22 (2024)
Druh dokumentu: article
ISSN: 1471-2393
DOI: 10.1186/s12884-024-06356-8
Popis: Abstract Background Although community health worker (CHW) programs focus on improving access to healthcare, some individuals may not receive the intended quality or quantity of an intervention. The objective of this research was to examine if certain populations of pregnant women differentially experience the implementation of a community health worker-led maternal health intervention in Zanzibar. Methods We included pregnant women enrolled in the Safer Deliveries (Uzazi Salama) program, which operated in 10 of 11 districts in Zanzibar, Tanzania between January 1, 2017, and June 19, 2019 (N = 33,914). The outcomes of interest were receipt of the entire postpartum intervention (three CHW visits) and time to first postpartum CHW visit (days). Visits by CHWs were done at the women’s home, however, a telehealth option existed for women who were unable to be reached in-person. We conducted statistical tests to investigate the bivariate associations between our outcomes and each demographic and health characteristic. We used multivariate logistic regression to estimate the relationships between covariates and the outcomes and multivariate linear regression to estimate the association between covariates and the average time until first postpartum visit. Results Higher parity (OR = 0.85; P = 0.014; 95%CI: 0.75–0.97), unknown or unreported HIV status (OR = 0.64; p
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