The role of community health workers in improving uptake of institutional delivery service in Jimma zone, Ethiopia

Abstract

Background: Many women lose their lives in the process of giving life. Reducing maternal morbidity and mortality is a global priority which is particularly relevant to developing countries. One of the key strategies for reducing maternal morbidity and mortality is increasing institutional delivery service utilization of mothers under the care of skilled birth attendants. The crucial role that Community Health Workers (CHWs) can play in delivering these interventions is not clearly understood. Objectives; The aim of this study was to explore the role of community health workers in improving utilization of institutional delivery service in Jimma zone south west Ethiopia. Methods:-A community based descriptive cross sectional study was conducted in Jimma zone Oromia regional state south west Ethiopia. The source population for this study was all women of reproductive age group, CHWs, other health workers, health managers and community members. Three woredas were selected using lottery method and two kebeles selected from each woredas then mothers of reproductive age groups, kebeles leaders, health extension supervisors, health extension workers and health managers were purposively selected. Qualitative data were collected using FGD (focus group discussion) and in-depth interview to get deep insight into the role of CHWs to institutional birth service utilization. Data were analyzed manually by thematic analysis and narration. Results: The findings of the study showed that community health workers played a role of delivering key health education and information, referrals, and provision of services like immunization and acted as advocators (speaking, acting, and writing with minimal conflict of interest on behalf of the community). Their contribution to institutional delivery is affected by several factors like access to health facility, commitments and approaches of health workers, the skill of health care providers, resource constraints, and factors related to the community, health facilities and healthcare providers. Conclusion: CHWs contribution to the uptake of institutional delivery is changing positively in recent times but it is very slight. A continuous support from different stake holders to community health workers, with increased service quality and commitment of health workers will help to improve uptake of facility delivery services.