Assessing the Performance and Challenges of Community Health Workers in Improving Neonatal Health Outcomes in India: A Systematic Review and Meta-Analysis

Sukriti Chawla, TERI University
Chandan Kumar, TERI School of Advanced Studies
Montu Bose, Tata Institute of Social Sciences
Shikha Shrivastav, Benett University

Introduction: Adverse neonatal outcomes represent a significant global health challenge. India has reported one of the highest figures in 2022, with 3.73 million adverse neonatal outcomes. Community health workers (CHWs) play a significant role in improving neonatal health. However, these outcomes show a sluggish decline, highlighting challenges in CHWs' performance. This study provides a systematic review and meta-analysis of the performance and Challenges of CHW in India in improving neonatal outcomes. Methodology: Bibliographic databases were screened. Of the 9,223 studies identified, 34 were chosen for systematic review and 30 for meta-analysis. Further, a random effects model was applied to the shortlisted studies to calculate the pooled effect size of CHWs to assess their performance. Results: The meta-analyses observed a positive impact of CHWs on neonatal health, while the systematic review identified factors that enable or hinder CHW performance. Conclusions: This study emphasizes the necessity of a comprehensive evaluation framework to assess the performance of CHWs. If implemented, this framework could provide a nuanced understanding of CHWs' Challenges. Further, this could facilitate targeted interventions and policy reforms, improving neonatal health outcomes across India. Keywords: Community health worker, neonatal mortality, stillbirth, low birth weight, adverse neonatal outcomes, and India.

Keywords: Children, Adolescents, and Youth, Health and Morbidity, Mortality and Longevity, Sexual and Reproductive Health and Rights

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