Community health workers’ involvement in mother-child care during the postpartum period in the Missed Opportunities in Mother and Infant Health (MOMI) project in the Kaya health district: a contribution analysis

Abstract Maternal and infant morbidity and mortality remain high in the world and particularly in sub-Saharan Africa. However, actions to strengthen postpartum care remain weak and are mainly limited to health facilities (HFs). The MOMI project implemented in the Kaya health district included community-based health workers (CHWs) in the care of women and children during the first postpartum year through home visits, accompanying mothers to HFs and outreach sessions. The aim of this study was to assess the contribution of CHWs to postpartum women’s HF attendance.Methods We conducted an effect assessment using Mayne and Lemire's contribution analysis framework. This was a mixed-case study. Qualitative and quantitative data were collected through project document review and interviews.Results Out of 6633 women, 3768 (56.8%) were visited by CHWs before the 10th day following childbirth, 34.3% between the sixth and eighth week and 9% between the ninth and twelfth months; during the same home visit periods, the CHWs accompanied 57.3%, 51.4% and 32.5% of women, respectively, to HFs for postpartum consultations. Postpartum consultation rates within the first week postpartum increased from 29% in 2011 to 80% in 2015 and from 19% to 50% within 6 weeks.Conclusions Community-based health workers involvement in the care of women improved their adherence to postpartum consultations.