Table 3 Impact of training community health workers on stillbirths and perinatal mortality

Hodnett et al. 2003 [55]

USA, South Africa, England, Rosario, Argentina; Pelotas, Brazil; Havana, Cuba; and Mexico City.

Meta-analysis (Cochrane). 5 RCTs included (N = 9507 poor women)

Assessed the effects of additional antenatal support (intervention) vs. usual care (controls) during pregnancies at risk of low birth weight.

SBR/NMR: RR = 1.15 (95% CI: 0.89, 1.51) [NS].

[112/4778 vs. 96/4729 in intervention and control groups, respectively].

Intervention studies

Bhutta et al. 2008 [56]

Pakistan (Sindh). Rural community (8 village clusters).

Pilot study. Before-after intervention data in both intervention and control villages. N = 3747 pregnant women (N = 2056 in the intervention villages, N = 1691 in the controls).

Compared the impact of an intervention where Lady Health Workers (LHWs) and TBAs (Dais) received enhanced training in newborn care and established close liaisons with each other as well as community mobilization activities (intervention) vs. control villages where the regular LHW training programme was continued, but no attempt was made to link LHWs with the Dais.

SBR: RR = 0.66 (95% CI: 0.53–0.83); P < 0.001.

[65.9/1000 vs. 43.1/1000 births before and after the intervention in intervention villages, respectively].

SBR: RR = 1.04 (95% CI: 0.84–1.30); P = 0.23 [NS].

[58.1/1000 vs. 60.5/1000 births before and after the intervention period in the control villages, respectively].

PMR: 110.8/1000 vs. 72.5/1000 before and after the intervention in intervention villages, respectively.

PMR: 94.64/1000 vs. 101.2/1000 before and after the intervention period in the control villages, respectively.

Mercer et al. 2004 [57]

Bangladesh. Rural community.

Before-after study design. N = 27 partner NGOs from 1996–2002 funded by the Bangladesh Population and Health Consortium.

To assess the effectiveness of a non-governmental organization (NGO) primary health care programme utilising female Family Health Visitors (FHV) who were responsible for basic health and family planning counseling, doorstep delivery of contraceptives and oral rehydration salts, and mobilization of women to use satellite clinics and higher level facilities.

NMR: 39.0/1000 in 1996 (baseline). From 1999–2002, decreased consistently from 36.8 to 15.1/1000 live births among the poorest, and from 30.6 to 16.5/1000 among the remainder of women.