The effect of community nurses and health volunteers on child mortality: the Navrongo Community Health and Family Planning Project.

Journal Article (Journal Article)

BACKGROUND: Despite effective treatments and preventive measures for the major causes of child illness and death in less wealthy nations, child mortality remains high in resource-poor settings due in part to ineffective health service delivery models. METHODS: The Navrongo Community Health and Family Planning Project is a longitudinal community trial of alternative organizational strategies for health service delivery in a rural, impoverished area of Ghana. In one area, nurses are placed in communities with doorstep visitation and service responsibilities. A second area includes training of a local health volunteer and community involvement in health delivery. A third area combines both strategies. Under-five mortality rates were calculated and Poisson regression was used to adjust for potential confounding characteristics. RESULTS: In areas with village-based community nurse services, under-five child mortality fell by 14% during five years of program implementation compared with before the intervention, with reductions in infant (5%), early child (18%), and late child (39%) mortality. The volunteer intervention was associated with a 14% increase in mortality, primarily driven by a 135% increase in early child mortality. Areas with both nurses and volunteers saw an 8% increase, with small increases in all age groups. Mortality in a comparison area with standard Ministry of Health services fell by 4% during the same time period. CONCLUSIONS: These results suggest that convenient, accessible professional nursing care can reduce child mortality in impoverished African settings. However, they do not demonstrate a beneficial effect of community volunteers and suggest a possible negative impact on children's survival.

Full Text

Duke Authors

Cited Authors

  • Pence, BW; Nyarko, P; Phillips, JF; Debpuur, C

Published Date

  • 2007

Published In

Volume / Issue

  • 35 / 6

Start / End Page

  • 599 - 608

PubMed ID

  • 17852975

International Standard Serial Number (ISSN)

  • 1403-4948

Digital Object Identifier (DOI)

  • 10.1080/14034940701349225


  • eng

Conference Location

  • Sweden