Qualitative Review

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Barriers and facilitators to the implementation of lay health worker programmes to improve access to maternal and child health: qualitative evidence synthesis

  1. Claire Glenton1,*,
  2. Christopher J Colvin2,
  3. Benedicte Carlsen3,
  4. Alison Swartz4,
  5. Simon Lewin1,5,
  6. Jane Noyes6,
  7. Arash Rashidian7

Editorial Group: Cochrane Effective Practice and Organisation of Care Group

Published Online: 8 OCT 2013

Assessed as up-to-date: 21 DEC 2012

DOI: 10.1002/14651858.CD010414.pub2

How to Cite

Glenton C, Colvin CJ, Carlsen B, Swartz A, Lewin S, Noyes J, Rashidian A. Barriers and facilitators to the implementation of lay health worker programmes to improve access to maternal and child health: qualitative evidence synthesis. Cochrane Database of Systematic Reviews 2013, Issue 10. Art. No.: CD010414. DOI: 10.1002/14651858.CD010414.pub2.

Author Information

  1. 1

    Norwegian Knowledge Centre for the Health Services, Global Health Unit, Oslo, Norway

  2. 2

    School of Public Health and Family Medicine, University of Cape Town, Centre for Infectious Disease Epidemiology and Research (CIDER), Cape Town, South Africa

  3. 3

    Uni Rokkan Centre, Bergen, Norway

  4. 4

    University of Cape Town Health Sciences, Primary Health Care Directorate, Cape Town, South Africa

  5. 5

    Medical Research Council of South Africa, Health Systems Research Unit, Tygerberg, South Africa

  6. 6

    Bangor University, Centre for Health-Related Research, Fron Heulog, Bangor, Wales, UK

  7. 7

    Tehran University of Medical Sciences, Department of Health Management and Economics, School of Public Health, Tehran, Iran

*Claire Glenton, Global Health Unit, Norwegian Knowledge Centre for the Health Services, PO Box 7004 St Olavs plass, Oslo, N-0130, Norway. claire.glenton@kunnskapssenteret.no.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 8 OCT 2013



References to studies included in this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. Additional references
Alcock 2009 {published data only}
  • Alcock GA, More NS, Patil S, Porel M, Vaidya L, Osrin D. Community-based health programmes: role perceptions and experiences of female peer facilitators in Mumbai's urban slums. Health Education Research 2009;24:957-66.
Ashwell 2009 {published data only}
  • Ashwell HE, Barclay L. Outcome evaluation of community health promotion intervention within a donor funded project climate in Papua New Guinea. Rural and Remote Health 2009;9(4):1219.
Beake 2005 {published data only}
Behnke 2002 {published data only}
  • Behnke EF, Hans SL. Becoming a Doula. Zero to Three 2002;November:9-13.
Bettiol 2004 {published data only}
  • Bettiol L, Griffin E, Hogan C, Heard S. Village birth attendants in Papua New Guinea. Australian Family Physician 2004;33:764-5.
bij de Vaate 2002 {published data only}
  • bij de Vaate A, Coleman R, Manneh H, Walraven G. Knowledge, attitudes and practices of trained traditional birth attendants in the Gambia in the prevention, recognition and management of postpartum haemorrhage. Midwifery 2002;18:3-11.
Bisika 2008 {published data only}
  • Bisika T. The effectiveness of the TBA programme in reducing maternal mortality and morbidity in Malawi. East African Journal of Public Health 2008;5:103-10.
Chinbuah 2006 {published data only}
Curtis 2007 {published data only}
Daniels 2010 {published data only}
  • Daniels K, Nor B, Jackson D, Ekstrom EC, Doherty T. Supervision of community peer counsellors for infant feeding in South Africa: an exploratory qualitative study. Human Resources for Health 2010;8:6.
  • Nkonki LL, Daniels KL. Selling a service: experiences of peer supporters while promoting exclusive infant feeding in three sites in South Africa. International Breastfeeding Journal 2010;5:17.
Downie 2004 {published data only}
  • Downie J, Clark K, Clemenston K. Volunteerism: 'community mothers' in action. Contemporary Nurse 2004;18:188-98.
Dynes 2011 {published data only}
  • Dynes M, Rahman A, Beck D, Moran A, Rahman A, Pervin J, et al. Home-based life saving skills in Matlab, Bangladesh: a process evaluation of a community-based maternal child health programme. Midwifery 2011;27:15-22.
George 2009 {published data only}
  • George A, Menotti EP, Rivera D, Montes I, Reyes CM, Marsh DR. Community case management of childhood illness in Nicaragua: transforming health systems in underserved rural areas. Journal of Health Care for the Poor & Underserved 2009;20:99-115.
  • George A, Menotti EP, Rivera S, Marsh DR. Community case management in Nicaragua: lessons in fostering adoption and expanding implementation. Health Policy and Planning 2011;26:327-37.
Glenton 2010 {published data only}
  • Glenton C, Scheel IB, Pradhan S, Lewin S, Hodgins S, Shrestha V. The female community health volunteer programme in Nepal: Decision makers’perceptions of volunteerism, payment and other incentives. Social Science and Medicine 2010;70(12):1920-7.
Haq 2009 {published data only}
Hazard 2009 {published data only}
Heaman 2006 {published data only}
Hendrickson 2002 {published data only}
  • Hendrickson JL, Dearden K, Pachon H, An NH, Schroeder DG, Marsh DR. Empowerment in rural Viet Nam: exploring changes in mothers and health volunteers in the context of an integrated nutrition project. Food & Nutrition Bulletin 2002;23:86-94.
Hinojosa 2004 {published data only}
Islam 2001 {published data only}
  • Islam A, Malik FA. Role of traditional birth attendants in improving reproductive health: lessons from the family health project, Sindh. Journal of the Pakistan Medical Association 2001;51:218-22.
Javanparast 2009 {published data only}
  • Javanparast S, Coveney J, Saikia U. Exploring health stakeholders' perceptions on moving towards comprehensive primary health care to address childhood malnutrition in Iran: a qualitative study. BMC Health Services Research 2009;9:36.
Kaler 2001 {published data only}
Kaufmann 1997 {published data only}
  • Kaufmann KS, Meyers H. The changing role of village health volunteers in Northeast Thailand: an ethnographic field study. International Journal of Nursing Studies 1997;34(4):249-55.
Khan 1998 {published data only}
  • Khan SH, Chowdhury AMR, Karim F, Barua MK. Training and retraining Shastyo Shebika. Reasons for turnover. The Health Care Supervisor 1998;17(1):37-47.
Korfmacher 2002 {published data only}
  • Korfmacher J, Marchi I. The helping Relationship in a Teen Parenting Program. Zero to Three 2002;November:21-26.
Lancman 2009 {published data only}
Low 2006 {published data only}
Low 2006b {published data only}
  • Low LK, Moffat A, Brennan P. Doulas as Community Health Workers: Lessons Learned from a Volunteer Program. Journal of Perinatal Education 2006;15(3):25-33.
Malema 2010 {published data only}
  • Malema RN, Malaka DW, Mothiba TM. Experiences of lay counsellors who provide VCT for PMTCT of HIV and AIDS in the Capricorn District, Limpopo Province. Curationis 2010;33(15-33):15-23.
Mathews 1994 {published data only}
  • Mathews C, Van der WH, Barron P. A shotgun marriage--community health workers and government health services. Qualitative evaluation of a community health worker project in Khayelitsha. South African Medical Journal 1994;84:659-63.
Mathole 2005 {published data only}
  • Mathole T, Lindmark G, Ahlberg BM. Competing knowledge claims in the provision of antenatal care: a qualitative study of traditional birth attendants in rural Zimbabwe. Health Care for Women International 2005;26:937-56.
Maupin 2008 {published data only}
McQuestion 2010 {published data only}
  • McQuestion MJ, Quijano CA, Drasbek C, Harkins T, Sagastume LJ. Social integration and health behavioral change in San Luis, Honduras. Health Education & Behavior 2010;37:694-708.
Meier 2007 {published data only}
Mekonnen 2008 {published data only}
  • Mekonnen A, Sophie A, Dramaix-Willmet M, Bantayehu A. Factors affecting continuity and success of community-based reproductive health service programme in rural community of Northeast Ethiopia. East African Medical Journal 2008;85:487-99.
Mkandawire 2005 {published data only}
  • Mkandawire WC, Muula AS. Motivation of community care givers in a peri-urban area of Blantyre, Malawi. African Journal of Health Sciences 2005;12:21-5.
Murphy 2008 {published data only}
  • Murphy CA, Cupples ME, Percy A, Halliday HL, Stewart MC. Peer-mentoring for first-time mothers from areas of socio-economic disadvantage: a qualitative study within a randomised controlled trial. BMC Health Services Research 2008;8:46.
Nankunda 2006 {published data only}
  • Nankunda J, Tumwine JK, Soltvedt Å, Semiyaga N, Ndeezi G, Tylleskär T. Community based peer counsellors for support of exclusive breastfeeding experiences from rural Uganda. International Breastfeeding Journal 2006;1:19.
Ngoma 2009 {published data only}
  • Ngoma CM, Himwiila L. Community perceptions of trained traditional birth attendants. African Journal of Midwifery and Women’s Health 2009;3(3):142-5.
Perkins 2001 {published data only}
  • Perkins ER, MacFarlane J. Family support by lay workers: a health visiting initiative. British Journal of Community Nursing 2001;6:26-32.
Raine 2003 {published data only}
Ramirez-Valles 2003 {published data only}
  • Ramirez-Valles J. Translocal and gender dimensions of frame alignment: community mobilization and recruitment processes among women community health workers in Mexico. Critical Public Health 2003;13(3):207-30.
Rashid 2001 {published data only}
Sheppard 2004 {published data only}
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Sibley 2006 {published data only}
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Siu 2009 {published data only}
  • Siu G, Whyte S. Increasing access to health education in eastern Uganda: rethinking the role and preparation of volunteers. Health Education Journal 2009;68(2):83-93.
Smith 2007 {published data only}
  • Smith C, Prosser M, Joomun L. A research evaluation of health support workers in a Sure Start project. Community Practitioner 2007;80:32-5.
Suchdev 2010 {published data only}
  • Suchdev PS, Ruth L, Obure A, Were V, Ochieng C, Ogange L, et al. Monitoring the marketing, distribution, and use of Sprinkles micronutrient powders in rural western Kenya. Food & Nutrition Bulletin 2010;31:168-78.
Taggart 2000 {published data only}
Warrick 1992 {published data only}
  • Warrick LH, Wood AH, Meister JS, de Zapian JG. Evaluation of a peer health worker prenatal outreach and education program for Hispanic farmworker families. Journal of Community Health 1992;17(1):13-26.
Wayland 2002 {published data only}
  • Wayland C. Acceptable and appropriate: program priorities vs. felt needs in a CHW program. Critical Public Health 2002;12(4):335-50.
Woodgate 2007 {published data only}
  • Woodgate R, Heaman M, Chalmers K, Brown J. Issues related to delivering an early childhood home-visiting program. American Journal of Maternal Child Nursing 2007;March:95-101.

References to studies excluded from this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. Additional references
Ahmed 2006 {published data only}
  • Ahmed S, Macfariane A, Naylor J, Hastings J. Evaluating bilingual peer support for breastfeeding in a local Sure Start. British Journal of Midwifery  2006;14(8):467-70.
Ainbinder 1998 {published data only}
  • Ainbinder JG, Blanchard LW, Singer GH, Sullivan ME, Powers LK, Marquis JG, et al. A qualitative study of Parent to Parent support for parents of children with special needs. Consortium to evaluate Parent to Parent. Journal of Pediatric Psychology 1998;23:99-109.
Attree 2004 {published data only}
Carr 2005 {published data only}
  • Carr S. Peer educators--contributing to child accident prevention. Community Practitioner 2005;78:174-7.
Cupples 2011 {published data only}
  • Cupples ME, Stewart MC, Percy A, Hepper P, Murphy C, Halliday HL. A RCT of peer-mentoring for first-time mothers in socially disadvantaged areas (the MOMENTS Study). Archives of Disease in Childhood 2011;96:252-8.
Farquhar 2006 {published data only}
  • Farquhar SA, Parker EA, Schulz AJ, Israel BA. Application of qualitative methods in program planning for health promotion interventions. Health Promotion Practice 2006;7:234-42.
Hoddinott 2006 {published data only}
Ingram 2005 {published data only}
Lagendyk 2005 {published data only}
  • Lagendyk LE, Thurston WE. A case study of volunteers providing labour and childbirth support in hospitals in Canada. Midwifery 2005 2005;21:14-22.
Lavender 2005 {published data only}
  • Lavender T, Thompson S, Wood L. Supporting teenage mothers with breastfeeding guardians. British Journal of Midwifery 2005;13(6):354-9.
Locklin 1995 {published data only}
  • Locklin MP. Telling the world: low income women and their breastfeeding experiences. Journal of Human Lactation 1995;11:285-91.
Martens 2002 {published data only}
  • Martens PJ. Increasing breastfeeding initiation and duration at a community level: an evaluation of Sagkeeng First Nation's community health nurse and peer counselor programs. Journal of Human Lactation 2002;18:236-46.
Moran 2006 {published data only}
  • Moran VH, Dykes F, Burt S, Shuck C. Breastfeeding support for adolescent mothers: similarities and differences in the approach of midwives and qualified breastfeeding supporters. International Breastfeeding Journal 2006;1:23.
Paris 2008 {published data only}
Raine 2003b {published data only}
  • Raine P, Woodward P. Promoting breastfeeding: A peer support initiative. Community Practitioner 2003;76(6):211-3.
Schroeder 2005 {published data only}
Scott 2003 {published data only}
  • Scott JA, Mostyn T. Women's experiences of breastfeeding in a bottle-feeding culture. Journal of Human Lactation 2003;19(3):270-7.
Smith 2004 {published data only}
  • Smith S, Randhawa G. Extending the role of the linkworker in weaning support. Community Practitioner 2004;77(4):146-9.
Suppiah 1994 {published data only}
  • Suppiah C. Working in partnership with community mothers. Health Visitor 1994;67(2):51-3.
Wade 2009 {published data only}
  • Wade D, Haining S, Day A. Breastfeeding peer support: are there additional benefits?. Community Practitioner 2009;82:30-3.
Zadoroznyj 2006 {published data only}
  • Zadoroznyj M. Postnatal care in the community: report of an evaluation of birthing women's assessments of a postnatal home-care programme. Health & Social Care in the Community 2006;15(1):35-44.

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  • Bhutta ZA, Lassi ZS, Pariyo G, Huicho L. Global Experience of Community Health Workers for Delivery of Health Related Millennium Development Goals: A Systematic Review, Country Case Studies, and Recommendations for Integration into National Health Systems. Global Health Workforce Alliance/World Health Organization 2010.
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