Community health worker interventions are key to optimal infant immunization coverage, evidence from a pretest-posttest experiment in Mwingi, Kenya

Pan Afr Med J. 2017 Sep 13:28:21. doi: 10.11604/pamj.2017.28.21.11255. eCollection 2017.


Introduction: Immunization is a powerful and cost-effective health intervention which averts an estimated 2 to 3 million deaths every year. Kenya has a high infant and under five mortality and morbidity rates. Increasing routine child immunization coverage is one way of reducing child morbidity and mortality rates in Kenya. Community Health Workers (CHWs) have emerged as critical human resources for health in developing countries. The Community Strategy (CS) is one of the CHW led interventions promoting Maternal and Child Health (MCH) in Kenya. This study sought to establish the effect of CS on infant vaccination Coverage (IVC) in Mwingi west sub-county; Kenya.

Methods: This was a pretest - posttest experimental study design with 1 pretest and 2 post-test surveys conducted in intervention and control sites. Mwingi west and Mwingi north sub-counties where intervention and control sites respectively. Sample size in each survey was 422 households. Women with a child aged 9-12 months were main respondents.

Results: Intervention site end-term evaluation indicated that; the CS increased IVC by 10.1% (Z =6.0241, P <0.0001), from a suboptimal level of 88.7% at baseline survey to optimal level of 98.8% at end term survey. Infants in intervention site were 2.5 times more likely to receive all recommended immunizations within their first year of life [(crude OR= 2.475, P<0.0001; 95%CI: 1.794-3.414) (adj. OR=2.516, P<0.0001; 95%CI: 1.796-3.5240)].

Conclusion: CS increased IVC in intervention site to optimal level (98.8%). To improve child health outcomes through immunization coverage, Kenya needs to fast-track nationwide implementation of the CS intervention.

Keywords: Community health workers; maternal and child health; vaccination coverage.

Publication types

  • Validation Study

MeSH terms

  • Adolescent
  • Adult
  • Child Health*
  • Community Health Workers / organization & administration*
  • Developing Countries
  • Female
  • Humans
  • Infant
  • Kenya
  • Maternal Health
  • Middle Aged
  • Pilot Projects
  • Prospective Studies
  • Reproducibility of Results
  • Surveys and Questionnaires
  • Vaccination / statistics & numerical data*
  • Vaccination Coverage / statistics & numerical data*
  • Young Adult