Assessment of the outcome of tasking shifting some maternal and child health services to community extension workers in a rural hospital in Ebonyi State

Abstract

Background: The dearth of skilled birth attendants in Nigeria's health sector has never been more critical than now because of the massive brain drain in the country’s health sector. The task-shifting policy of the Federal Government of Nigeria has been in effect since August 2014; if properly implemented, this policy can be the antidote to the shrinking health workforce.

Objectives: To implement and assess the outcome of task shifting some maternal and child health services to community extension workers.

Methodology: This was a randomized controlled trial conducted at Sudan United Mission hospitals in Izzi, Ebonyi State, utilizing both purposive and convenience sampling methods, and mixed data collection methods were used. Collected data were analyzed with the Statistical Package for Social Sciences (SPSS) version 20 using descriptive and inferential statistics.

Result: The study recorded a significant increase in both knowledge and clinical skills of the 10 CHEWs at the intervention site (Onuenyim) (p<0.00), a statistically significant decline in neonatal death (P< 0.014), and a reduction in expulsion of the intrauterine contraceptive device (IUCD) (P <0.015). The study established a knowledge and clinical skills gap in the control site (Onuenyim). There were no significant differences in the outcome of other maternal and neonatal services after the intervention.

Conclusion: This study revealed improved neonatal and IUCD retention outcomes due to an increase in the knowledge and skills of the CHEWs. It demonstrated the huge potential of CHEWs as the newest member of skilled birth attendants in Nigeria, and holds a very good promise for reproductive, maternal, neonatal and child health if fully maximized through the task-shifting policy