| dc.description.abstract | Background: Achievement of the SDG 3.1target for maternal mortality reduction requires a threshold of at least 4.45 skilled health professionals per 1000 people. However, acute shortages and inequitable distribution of skilled health workers are still existent, especially in developing countries. That has led to the continued adoption and expansion of the community-based approaches in health systems. In doing so, the CHW program has been strengthened in many countries. Community health workers are said to be an effective part of the workforce for delivering essential maternal and child health and nutrition services and linking women to maternal health providing facilities for maximum service utilization. CHWs are mandated to increase maternal health service utilization because poor utilization of maternal health services is frequently associated with maternal deaths and morbidity, and yet, most maternal deaths could be prevented if all women successfully utilized maternal health-
care services.
Objective: The purpose of this study was to investigate the effectiveness of community health workers‟ activities on the utilization of maternal health services among women in Butaleja district
Methods: This study used a cross-sectional survey design, based in Butaleja district, among 384 mothers with children under 1 year. Butaleja district was purposively sampled and it was then stratified by Sub-county. In each strata, simple random sampling was used to sample a cross-section of parishes (50%) using the lottery method. Simple random sampling was used to sample the villages.
In each sampled village, convenience sampling was made to sample the households. The study used structured interviews and structured questionnaires as data collection methods and tools respectively.
Data was analyzed in SPSS 21.0 using descriptive statistics, Chi-Square tests of independence and binary logistic regression.
Results: Majority of the women interviewed in Butaleja district had adequately utilized maternal health services 65% (249/384).Most of the women interviewed had attended antenatal care 66.7% (256/384). More than three quarters of the women interviewed reported that they had delivered their most recent pregnancy in a health facility 87.5% (336/384). Less than half of the women who were interviewed had sought PNC adequately 40.1% (154/384).
No community health worker ANC activity had a statistically significant relationship with ANC attendance, but had with SBA. Women who had been visited at least twice by a community health
worker (AOR = 4.111, 95%CI = 2.529 - 6.333), those for whom CHWs had assessed previous ANC attendance and frequency during pregnancy and those who had been advised to attend Health Centre
ANC visit at least 4 times were twice as likely to adequately attend SBA (AOR = 2.582, 95%CI =1.295 - 4.148). Women who had been visited for the purpose of identifying danger signs (AOR =0.565, CI = .369 - .867), and those who had been visited and asked about any health challenges were less likely to adequately attend PNC (AOR = .589, 95%CI = .386 - .901).
Conclusion: About 6 of every 10 mothers in Butaleja district adequately utilize maternal health services; with the most utilized being skilled birth attendance (9 out of every 10 of the mothers),
followed by ANC (6 of every 10 mothers). Postnatal care is the least utilized maternal health service among mothers in Butaleja district; only 4 of every 10 mothers seek PNC. In the context of Butaleja
district, CHW activities done during the ANC period have no significant effect on ANC attendance, but influence SBA. CHW activities done during the PNC period influence PNC attendance. | en_US |
