Over half of the deaths in African children under 5
years of age are due to malaria, diarrhea and pneumonia. Community or lay
health workers (CHWs) are lay people trained in specific health care tasks,
including distribution of anti-malarials, antibiotics, oral rehydration
solution and insecticide-treated bednets.  As such, they are an important part of
interventional healthcare. However, to date there is limited evidence on the
impact of CHW programs on child mortality in Africa. Evidence from non-randomized
studies, in particular, had not been reviewed systematically.

A systematic review
published in ‘Human Resources for Health’ evaluated randomized and non-randomized
studies of CHW programs delivering curative treatments for malaria, diarrhea
or pneumonia in children in sub-Saharan Africa. The review identified 7 studies
from Ghana, Benin and The Gambia evaluating community health workers. These
studies showed large reductions in child mortality rates with CHWs in national
programs providing interventional healthcare. The review provides policymakers
with an up-to-date understanding of the evidence on this key public health
issue. However, surprisingly few studies were identified, suggesting that
further research in this area is needed.

The lead author,
Jason Christopher, noted that ‘The review shows that community health worker
programs can reduce childhood mortality in Africa through the delivery of
simple interventions such as antimalarial drugs. More efforts are now needed to
implement and rigorously evaluate these programs.’