Skip Navigation

Strengthen the Evidence for Maternal and Child Health Programs

Sign up for MCHalert eNewsletter

Evidence Tools
MCHbest. Postpartum Visit.

MCHbest Logo

Strategy. Community Health Workers

Approach. Train Community Health Workers to serve as a liaison between patients and healthcare providers to improve access to postpartum care

Return to main MCHbest page >>

Overview. Community Health Workers (CHWs) have a close understanding of the communities they serve and can help residents communicate effectively with healthcare providers and social workers. They can improve access to perinatal health services, including postpartum checkups, and help link new mothers to community resources and support services.[1,2] CHWs can also be trained and credentialed to serve as home visitors throughout the postpartum period.[3]

Evidence. Emerging Evidence. Strategies with this rating typically trend positive and have good potential to work. They often have a growing body of recent, but limited research that documents effects. However, further study is needed to confirm effects, determine which types of health behaviors and conditions these interventions address, and gauge effectiveness across different population groups. (Clarifying Note: The WWFH database calls this "mixed evidence").

Access the peer-reviewed evidence through the MCH Digital Library or related evidence source. (Read more about understanding evidence ratings). This strategy is also supported as "Community Health Workers" in the What Works for Health database.

Source. Peer-Reviewed Literature and What Works for Health (WWFH) Database (County Health Rankings and Roadmaps)

Outcome Components. This strategy has shown to have impact on the following outcomes (Read more about these categories):

  • Access to/Receipt of Care. This strategy increases the ability for individuals to obtain healthcare services when needed, including preventive, diagnostic, and treatment services.
  • Utilization. This strategy improves the extent to which individuals and communities use available healthcare services.
  • Morbidity Reduction. This strategy addresses factors that can decrease the incidence or prevalence of diseases and illnesses.

Detailed Outcomes. For specific outcomes related to each study supporting this strategy, access the peer-reviewed evidence and read the Intervention Results for each study.

Intervention Type. Outreach (Read more about intervention types and levels as defined by the Public Health Intervention Wheel).

Intervention Level. Community-Focused

Examples from the Field. There are currently no ESMs that use this strategy. As Title V agencies begin to incorporate this strategy into ESMs, examples will be available here. Until then, you can search for ESMs that have similar intervention components in the ESM database.

Sample ESMs. Here are sample ESMs to use as models for your own measures using the Results-Based Accountability framework (for suggestions on how to develop programs to support this strategy, see The Role of Title V in Adapting Strategies).

Quadrant 1:
Measuring Quantity of Effort ("What/how much did we do?")

PROCESS MEASURES:

  • Number of community health workers (CHWs) recruited, trained, and deployed to support postpartum care access and coordination. (Indicates the implementation and scale of the strategy)
  • Number of healthcare providers and social service agencies partnered with CHWs to facilitate seamless postpartum care coordination and referrals. (Shows the multi-sector collaboration and integration efforts)

Quadrant 2:
Measuring Quality of Effort ("How well did we do it?")

PROCESS MEASURES:

  • Percent of community health workers (CHWs) recruited, trained, and deployed to support postpartum care access and coordination. (Indicates the implementation and scale of the strategy)
  • Percent of healthcare providers and social service agencies partnered with CHWs to facilitate seamless postpartum care coordination and referrals. (Shows the multi-sector collaboration and integration efforts)
  • PROCESS MEASURES:

Quadrant 3:
Measuring Quantity of Effect ("Is anyone better off?")

PROCESS MEASURES:

  • Number of CHWs who complete comprehensive training and demonstrate core competencies in perinatal health, postpartum care, and community engagement. (Indicates the workforce development and capacity building efforts)
  • Number of postpartum care plans and interventions co-created and implemented by CHWs in collaboration with individuals, families, providers, and community partners that result in satisfaction among users. (Shows the participatory and integrated approach of the strategy)

OUTCOME MEASURES:

  • Number of healthcare systems, payers, and policymakers that recognize and value the contributions of CHWs in improving postpartum care access, quality, and outcomes. (Indicates the broad partner buy-in and support for the strategy)
  • Number of communities and populations that experience sustained improvements in postpartum health and well-being through the long-term embedding of CHWs in the perinatal care continuum. (Shows the population-level and generational impact of the strategy)

Quadrant 4:
Measuring Quality of Effect ("How are they better off?")

PROCESS MEASURES:

  • Percent of CHWs who complete comprehensive training and demonstrate core competencies in perinatal health, postpartum care, and community engagement. (Indicates the workforce development and capacity building efforts)
  • Percent of postpartum care plans and interventions co-created and implemented by CHWs in collaboration with individuals, families, providers, and community partners that result in satisfaction among users. (Shows the participatory and integrated approach of the strategy)

OUTCOME MEASURES:

  • Percent of healthcare systems, payers, and policymakers that recognize and value the contributions of CHWs in improving postpartum care access, quality, and outcomes. (Indicates the broad partner buy-in and support for the strategy)
  • Percent of communities and populations that experience sustained improvements in postpartum health and well-being through the long-term embedding of CHWs in the perinatal care continuum. (Shows the population-level and generational impact of the strategy)

Note. When looking at your ESMs, SPMs, or other strategies:

  1. Move from measuring quantity to quality.
  2. Move from measuring effort to effect.
  3. Quadrant 1 strategies should be used sparingly, when no other data exists.
  4. The most effective measurement combines strategies in all levels, with most in Quadrants 2 and 4.

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.

References

[1] Association of Public Health Professionals. Community Health Workers, https://www.apha.org/apha-communities/member-sections/community-health-workers.
[2] Nelson, D. B., Martin, R., Duryea, E. L., Lafferty, A. K., McIntire, D. D., Pruszynski, J., Rochin, E., & Spong, C. Y. (2023). Extending Maternal Care After Pregnancy: An Initiative to Address Health Care Disparities and Enhance Access to Care After Delivery. Joint Commission journal on quality and patient safety, 49(5), 274–279. https://doi.org/10.1016/j.jcjq.2023.02.003.
[3] Pan, Z., Veazie, P., Sandler, M., Dozier, A., Molongo, M., Pulcino, T., Parisi, W., & Eisenberg, K. W. (2020). Perinatal Health Outcomes Following a Community Health Worker-Supported Home-Visiting Program in Rochester, New York, 2015-2018. American journal of public health, 110(7), 1031–1033. https://doi.org/ 10.2105/AJPH.2020.305655.

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.