%0 Journal Article
%@ 1478-4491
%A Larson, Elysia
%A Geldsetzer, Pascal
%A Mboggo, Eric
%A Lema, Irene Andrew
%A Sando, David
%A Ekström, Anna Mia
%A Fawzi, Wafaie
%A Foster, Dawn W.
%A Kilewo, Charles
%A Li, Nan
%A Machumi, Lameck
%A Magesa, Lucy
%A Mujinja, Phares
%A Mungure, Ester
%A Mwanyika-Sando, Mary
%A Naburi, Helga
%A Siril, Hellen
%A Spiegelman, Donna
%A Ulenga, Nzovu
%A Bärnighausen, Till
%C London
%D 2019
%F heidok:26243
%I Biomed Central
%J Human Resources for Health
%K Community health workers, Satisfaction, Sub-Saharan Africa, Maternal and child health, Task shifting
%N 23
%P 1-8
%T The effect of a community health worker intervention on public satisfaction: evidence from an unregistered outcome in a cluster-randomized controlled trial in Dar es Salaam, Tanzania
%U https://archiv.ub.uni-heidelberg.de/volltextserver/26243/
%V 17
%X Background: There is a dearth of evidence on the causal effects of different care delivery approaches on health system satisfaction. A better understanding of public satisfaction with the health system is particularly important within the context of task shifting to community health workers (CHWs). This paper determines the effects of a CHW program focused on maternal health services on public satisfaction with the health system among women who are pregnant or have recently delivered.    Methods: From January 2013 to April 2014, we carried out a cluster-randomized controlled health system implementation trial of a CHW program. Sixty wards in Dar es Salaam, Tanzania, were randomly allocated to either a maternal health CHW program (36 wards) or the standard of care (24 wards). From May to August 2014, we interviewed a random sample of women who were either currently pregnant or had recently delivered a child. We used five-level Likert scales to assess women’s satisfaction with the CHW program and with the public-sector health system in Dar es Salaam.    Results: In total, 2329 women participated in the survey (response rate 90.2%). Households in intervention areas were 2.3 times as likely as households in control areas to have ever received a CHW visit (95% CI 1.8, 3.0). The intervention led to a 16-percentage-point increase in women reporting they were satisfied or very satisfied with the CHW program (95% CI 3, 30) and a 15-percentage-point increase in satisfaction with the public-sector health system (95% CI 3, 27).    Conclusions: A CHW program for maternal and child health in Tanzania achieved better public satisfaction than the standard CHW program. Policy-makers and implementers who are involved in designing and organizing CHW programs should consider the potential positive impact of the program on public satisfaction.    Trial registration: ClinicalTrials.gov, EJF22802