Bibliographic Info
Recommendation
Recommended
Certainty of evidence
Moderate
We recommend the use of LAY HEALTH WORKERS to deliver the following interventions:
- The following promotional interventions for maternal and
newborn health: » Promotion of appropriate care-seeking behaviour and antenatal care during pregnancy » Promotion of companionship during labour » Promotion of sleeping under insecticide-treated nets during pregnancy » Promotion of birth preparedness » Promotion of skilled care for childbirth » Promotion of adequate nutrition and iron and folate supplements during pregnancy » Promotion of reproductive health and family planning » Promotion of HIV testing during pregnancy » Promotion of exclusive breastfeeding » Promotion of postpartum care » Promotion of immunization according to national guidelines » Promotion of kangaroo mother care for low birth weight infants » Promotion of basic newborn care and care of low birth weight infants
Notes and Remarks
- 1.Planners need to consider a number of issues related to task sharing and the expansion of LHW responsibilities. These include the distribution of roles among cadres, stakeholder involvement, training and supervision, systems for referral, supply chains, and possible changes to payments or other incentives (see Box 1 in full guideline document).
- 2.Promotional activities, like other services, need to be perceived by both LHWs and recipients as relevant and meaningful. LHWs may be more motivated if they are able to perform curative tasks in addition to promotional ones.
- 3.Promotional services should be designed so that they are not perceived as offensive by recipients.
- 4.LHWs, trainers and supervisors need initial and ongoing training, not only in terms of information content but also in terms of counselling and communication skills. Tools and techniques that may be helpful when communicating with community members might include the use of visual tools, the use of a variety of venues and opportunities to deliver promotional information, and mass media campaigns in which the promotional messages of LHWs can be repeated. Promotional programmes should also consider whether and how to involve husbands/partners and other family members in the activities.
- 5.Recipients may find LHWs from their own community particularly acceptable. Certain topics such as sexual and reproductive health, however, may be culturally sensitive. If providers do come from the same local communities as recipients, particular concerns related to confidentiality may be raised. This issue therefore needs to be emphasized and addressed during health worker selection and training.
Also Featured In
This recommendation also appears in the following guidelines:
WHO recommendations on maternal and newborn care for a positive postnatal experience.