The Role of Community Health Practitioners in Reducing Maternal and Child Mortality in Nigeria: A Comprehensive Review
Chapter One
OBJECTIVE OF THE STUDY
The objective of this study is to examine the role of Community Health Practitioners (CHPs) in reducing maternal and child mortality in Nigeria. The specific objectives are to:
- Assess the extent of involvement of Community Health Practitioners in providing maternal and child healthcare services in Nigeria.
- Identify the specific strategies employed by Community Health Practitioners to reduce maternal and child mortality.
- Examine the challenges faced by Community Health Practitioners in delivering maternal and child health services.
- Evaluate the effectiveness of government initiatives in supporting Community Health Practitioners to reduce maternal and child mortality.
CHAPTER TWO
REVIEW OF RELATED LITERATURE
Community Health Practitioners
Community Health Practitioners (CHPs) are trained healthcare professionals who provide essential health services at the grassroots or community level. They serve as the first point of contact between the community and the formal healthcare system, particularly in areas where access to hospitals and specialized care is limited (Ogunyemi et al., 2020). CHPs include Community Health Extension Workers (CHEWs), Community Health Officers (CHOs), midwives, and other frontline health workers trained to deliver preventive, promotive, and basic curative services (Adejumo & Oladimeji, 2019).
The role of CHPs is multifaceted. They are responsible for health education, disease prevention, immunization campaigns, maternal and child healthcare, treatment of minor illnesses, and referral services to higher-level facilities when necessary (Glenton et al., 2019). By being embedded in communities, CHPs are uniquely positioned to understand local health needs, cultural practices, and barriers to healthcare utilization, enabling them to deliver context-specific interventions that improve health outcomes (Banerjee et al., 2021).
In the context of maternal and child health, CHPs play a critical role in reducing mortality rates by providing antenatal and postnatal care, promoting institutional deliveries, supporting exclusive breastfeeding, and monitoring child growth and immunization (Okonofua et al., 2019). Community-based programs that utilize CHPs, such as the Midwives Service Scheme (MSS) and the Abiye (Safe Motherhood) Project, have demonstrated that deploying trained practitioners to rural and underserved areas significantly improves access to maternal and child health services (Aregbeshola & Khan, 2018).
However, the effectiveness of CHPs depends on adequate training, provision of resources, proper supervision, and integration into the formal healthcare system. Challenges such as inadequate remuneration, insufficient supplies, unclear scope of practice, and weak policy support can limit their impact (Onasoga et al., 2020; Ibrahim & Olorunfemi, 2018). Despite these challenges, CHPs remain an essential component of Nigeria’s primary healthcare strategy and are pivotal to achieving Sustainable Development Goal 3, which aims to reduce maternal and child mortality globally (WHO, 2021).
CHAPTER THREE
METHODOLOGY
Research Design
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This study adopts a descriptive and analytical research design through a comprehensive review of existing literature on the role of Community Health Practitioners (CHPs) in reducing maternal and child mortality in Nigeria. The descriptive approach allows for systematic documentation of CHPs’ functions, strategies, and challenges in maternal and child healthcare, while the analytical component critically examines the effectiveness of government initiatives and community interventions. This design is appropriate because the study relies on secondary data obtained from peer-reviewed journals, government reports, program evaluations, and relevant publications.
Population of the Study
The population of this study comprises previous empirical studies, policy documents, and official reports on maternal and child health programs in Nigeria. These sources focus on the activities, impact, and challenges of CHPs in delivering maternal and child health services across different regions of the country. The study population is not human subjects but rather documented evidence on CHPs’ roles and interventions.
CHAPTER FOUR
DATA PRESENTATION, ANALYSIS, AND INTERPRETATION
This chapter presents, analyzes, and interprets the findings from the reviewed literature concerning the role of Community Health Practitioners (CHPs) in reducing maternal and child mortality in Nigeria. The analysis is structured around the study’s research questions.
CHAPTER FIVE
SUMMARY, CONCLUSION, AND RECOMMENDATIONS
Summary of Findings
This study examined the role of Community Health Practitioners (CHPs) in reducing maternal and child mortality in Nigeria through a comprehensive review of literature. The findings from the review of empirical studies, government reports, and scholarly publications are summarized as follows:
- Extent of Involvement of CHPs: Community Health Practitioners are significantly involved in maternal and child healthcare services across Nigeria, particularly in rural and underserved communities. Their roles include providing antenatal and postnatal care, conducting immunization programs, delivering health education, facilitating referrals, and conducting home visits to monitor maternal and child health (Adejumo & Oladimeji, 2019; Okonofua et al., 2019). CHPs serve as vital links between formal health facilities and communities, improving accessibility and uptake of essential health services.
- Strategies Employed by CHPs: CHPs employ a combination of clinical, educational, and community-based strategies to reduce maternal and child mortality. Key strategies include promoting skilled birth attendance, conducting immunization and growth monitoring, providing nutritional counseling, conducting home visits, and mobilizing communities to overcome socio-cultural barriers to health service utilization (Aregbeshola & Khan, 2018; Banerjee et al., 2021; Glenton et al., 2019). These strategies contribute to improved maternal and child health outcomes and increased health-seeking behavior among community members.
- Challenges Faced by CHPs: Despite their critical role, CHPs face numerous challenges, including inadequate training, insufficient medical supplies and equipment, high workload, socio-cultural resistance, poor remuneration, and weak policy support (Onasoga et al., 2020; Ibrahim & Olorunfemi, 2018). These challenges limit their capacity to deliver optimal maternal and child healthcare services, highlighting the need for targeted interventions to strengthen their effectiveness.
- Effectiveness of Government Initiatives: Government programs such as the Midwives Service Scheme (MSS) and the Abiye Project have shown significant effectiveness in supporting CHPs to reduce maternal and child mortality. These initiatives improve access to skilled health personnel, provide essential resources, and enhance CHPs’ capacity to deliver quality care (Okonofua et al., 2019; Aregbeshola & Khan, 2018). However, gaps such as irregular funding, poor supervision, and logistical challenges persist.
Conclusion
The study concludes that Community Health Practitioners are indispensable in Nigeria’s efforts to reduce maternal and child mortality. They provide essential preventive, promotive, and basic curative services, particularly in hard-to-reach areas. Their involvement increases access to antenatal and postnatal care, improves immunization coverage, and promotes maternal and child health-seeking behaviors.
However, the effectiveness of CHPs is constrained by systemic, infrastructural, and socio-cultural challenges. Government initiatives such as MSS and the Abiye Project have positively impacted CHPs’ roles, but sustained support, capacity-building, and strategic resource allocation are necessary to optimize their contributions. Strengthening CHPs’ operational environment is critical for achieving significant reductions in maternal and child mortality in Nigeria.
Recommendations
Based on the findings and conclusions of this study, the following recommendations are proposed:
- Regular in-service training and refresher courses should be provided to CHPs to enhance their skills, particularly in maternal and neonatal emergency care.
- The government and relevant health authorities should ensure the provision of essential medical supplies, vaccines, delivery kits, and functional equipment to PHC centers where CHPs operate.
- Policies should clearly define CHPs’ roles and responsibilities, and effective supervision mechanisms should be implemented to monitor service delivery and performance.
- CHPs should be supported in implementing community-based health education and advocacy programs to address socio-cultural barriers and improve health-seeking behaviors among women and caregivers.
- To motivate and retain CHPs, appropriate remuneration, incentives, and career progression opportunities should be provided.
- Programs such as the Midwives Service Scheme and Abiye Project should be expanded and adequately funded to ensure the continued effectiveness of CHPs in reducing maternal and child mortality.
REFERENCES
- Adejumo, P., & Oladimeji, O. (2019). Community Health Workers and Maternal Health: A Nigerian Perspective. African Journal of Primary Health Care & Family Medicine, 11(1), e1–e9.
- Aregbeshola, B. S., & Khan, S. M. (2018). Improving Maternal Health in Nigeria: The Abiye Project Experience. International Journal of Health Planning and Management, 33(2), e591–e602.
- Banerjee, A., Duflo, E., & Glennerster, R. (2021). Community-Based Health Interventions in Northern Nigeria: Evidence from a Randomized Controlled Trial. Journal of Development Economics, 150, 102622.
- Glenton, C., Colvin, C. J., Carlsen, B., Swartz, A., Lewin, S., & Noyes, J. (2019). Barriers and Facilitators to the Implementation of Community Health Worker Programs in Low- and Middle-Income Countries. Cochrane Database of Systematic Reviews, 10, CD008122.
- Ibrahim, H., & Olorunfemi, O. (2018). Scope of Practice and Role Clarity of Community Health Practitioners in Nigeria. Nigerian Journal of Clinical Practice, 21(8), 1030–1036.
- Okonofua, F. E., et al. (2019). Midwives Service Scheme in Nigeria: Lessons Learned and Way Forward. Reproductive Health Matters, 27(54), 1–8.
