Community case management to accelerate access to healthcare in Mali: a realist process evaluation nested within a cluster randomized trial.

ABSTRACT: The Proactive Community Case Management (ProCCM) trial in Mali reinforced the health system across both arms with user fee removal, professional community health workers (CHWs) and upgraded primary health centres (PHCs)-and randomized village-clusters to receive proactive home visits by CHWs (intervention) or fixed site-based services by passive CHWs (control). Across both arms, sick children's 24-hour treatment and pregnant women's four or more antenatal visits doubled, and under-5 mortality halved, over 3 years compared with baseline. In the intervention arm, proactive CHW home visits had modest effects on children's curative and women's antenatal care utilization, but no effect on under-5 mortality, compared with the control arm. We aimed to explain these results by examining implementa

SUBMITTER: Whidden C 

PROVIDER: S-EPMC11384120 | biostudies-literature | 2024 Sep

REPOSITORIES: biostudies-literature