Table 1

Characteristics and Findings of Studies

Study

(first author, publication date, reference)

Setting

CHW programme

Intervention tested

Study design

Period when impact measured

Change in mortality (95% CIs)

Change in morbidity (95% CIs)

Gambian PHC

(Greenwood, 1988, [26])

North bank of river, Gambia.

Rural

National programme

(all villages > 400 people have a CHW)

13 CHWs delivering curative treatments, health education & malaria chemoprophylaxis

CBA

9-21 months after CHWs began delivering anti-malarial chemoprophylaxis

36% (-17, 63) reduction 1-4 yr old mortality

84% (48, 95) reduction in fever and parasitaemia

Gambian PHC

(Menon, 1990, [24])

North bank of river, Gambia.

Rural

National programme

(as above)

13 CHWs delivering curative treatments, health education & malaria chemoprophylaxis

CBA

3-4 yrs after CHWs began delivering anti-malarial chemoprophylaxis

77% (51, 89) reduction in 1-4 yr old mortality

84% (60, 94) reduction in fever and parasitaemia

Gambian PHC

(Hill, 2000, [25])

North bank of River Gambia.

Rural

National programme

(as above)

1 CHW & TBA per village (15 villages) Curative treatments & health education delivered.

CBA

Mortality measured in four successive 2-3 yr periods after programme onset in 1983, covering 14 years.

33% (10, 50) reduction in 1-4 yr old mortality, 6 to 9 yrs after programme onset.

Not assessed

Gambian PHC

(Alonso, 1991, [27])

South bank of river, Gambia.

Rural

National programme

(as above)

1 CHW & TBA per village (17 villages) delivering ITNs, curative treatments & health education

CBA

0-12 months following initiation of ITN delivery by CHWs

63% (32, 80) reduction in 1-4 yr old mortality

Not assessed

Navrongo

(Pence, 2005, [28])

North Ghana.

Rural

Initiated by research institute

CHWs delivering health education, curative treatments, making referrals

Cluster RCT

Only 4 clusters

4-5 years after CHWs rolled out

87% (27, 178) increase in 1-2 yr old mortality

Not assessed

Gomoa

(Afari, 1995, [29])

South Ghana. Rural

Initiated by research institute

Curative treatments & growth monitoring by 6 CHWs, 1 nurse & 1 physician.

Before and after study

0-3 years after programme onset.

61% (no CIs given) reduction in 0-4 yr old mortality, 36 months after programme onset

Not assessed

Pahou

(Velema, 1991, [30])

Coast of Benin.

Rural

National programme

17 CHWs. Tasks included home visits, curative treatments, anti-malarial chemoprophylaxis, health education, growth monitoring, and referrals.

Case control study

Cases (deaths) & controls were assessed for exposure to CHWs in the preceding 3-year period

OR = 0.39 (0.16, 0.97)

Not assessed

CHW: Community Health Worker; RCT: Randomized Controlled Trial

ITN: Insecticide-treated nets; NGO: Non-governmental organisation

TBA: Traditional birth attendant; CBA: Controlled before and after study

OR: Odds ratio of death in children exposed to CHW compared to those unexposed

Christopher et al. Human Resources for Health 2011 9:27   doi:10.1186/1478-4491-9-27