Abstract:
Between 2018 and 2022 the Liberian Government implemented the National Community Health Assistant (NCHA) program to improve provision of maternal and child health care to underserved rural areas of the country. Whereas the contributions of this and similar community health worker (CHW) based healthcare programs have been associated with improved process measures, the impact of a governmental CHW program at scale on child mortality has not been fully established. We will conduct a cluster sampled, community-based survey with landmark event calendars to retrospectively assess child births and deaths among all children born to women in the Grand Bassa District of Liberia. We will use a mixed effects Cox proportional hazards model, taking advantage of the staggered program implementation in Grand Bassa districts over a period of 4 years to compare rates of under-5 child mortality between the pre- and post-NCHA program implementation periods. This study will be the first to estimate the impact of the Liberian NCHA program on under-5 mortality.
摘要:
在2018年至2022年期间,利比里亚政府实施了国家社区卫生助理(NCHA)计划,以改善该国服务不足的农村地区的妇幼保健服务。鉴于这种和类似的社区卫生工作者(CHW)为基础的医疗保健计划的贡献与改进的过程措施有关,政府大规模CHW计划对儿童死亡率的影响尚未完全确定。我们将进行集群抽样,以社区为基础的具有里程碑事件日历的调查,以回顾性地评估利比里亚大巴萨区妇女所生的所有儿童中的儿童出生和死亡。我们将使用混合效应Cox比例风险模型,利用大巴萨地区在4年期间的交错实施计划,比较NCHA计划实施前后的5岁以下儿童死亡率。这项研究将首次评估利比里亚NCHA计划对5岁以下儿童死亡率的影响。