Infection preparedness of community health workers: implications for maternal and neonatal health services in Pakistan

Abstract

Aim: This study aimed to (i) identify community health workers’ (CHWs) perceived satisfac- tion for maternal and neonatal health services, with respect to (1) socio-demographic character- istics; (2) coronavirus preparedness; (3) coronavirus responsiveness; and (4) employee

satisfaction and (ii) investigate the interplay among study variables to identify the role of direct

effects and mediation. Background: Women CHWs are salient providers for maternal and neo- natal services at the primary level, especially in conservative regions. Service delivery is a valu- able indicator for mother and newborn wellbeing. There is need for empirical evidence to

understand how CHWs may be supported in delivering maternal and neonatal health services during pandemics. Methods: Bivariate regression was used to identify the lower odds for CHWs’ perceived satisfaction for maternal and neonatal health services. In addition, structural equation modeling was used to investigate if coronavirus responsiveness and employee satisfaction as mediating variables influence the relationship between coronavirus preparedness and maternal and neonatal health services. Data were collected telephonically from 350 CHWs. The sample was representative of 35 districts of Punjab, which is the most populated province in the

country. Findings: We found thirty predictors with respect to coronavirus preparedness, coro- navirus responsiveness and employee satisfaction which contribute to lower odds of satisfaction

for maternal and neonatal health services. We also found that coronavirus preparedness has a direct effect on maternal and neonatal health service satisfaction (β = .242, P < .001) and an indirect effect on maternal health satisfaction (β = .242, P < .001) via the mediation of employee satisfaction. We conclude with four critical recommendations to support CHWs in delivering optimal services, comprising of education and training, operational support, public acceptance, and employee support and benefits. The findings are important for the planning of primary health services and governance support for CHWs and poor women clients in Pakistan and other developing countries.