Roles of social workers and community health extension workers in enhancing access to maternal and child health services: reflection on a Nigerian intervention

Nigeria introduced Maternal and Child Health (MCH) programs to improve access to skilled care in response to persistently poor health outcomes among women and children. While existing assessments often emphasize the role of healthcare workers, the contributions of social workers and Community Health Extension Workers (CHEWs) remain largely overlooked. This study explores the roles played by social workers and CHEWs in enhancing access to MCH services through an intervention project in Anambra State, Nigeria. An exploratory qualitative design was employed, involving interviews with five social workers, ten healthcare workers, and three CHEWs. Thematic analysis revealed that both groups were instrumental in mobilizing pregnant women and other community members to utilize antenatal and postnatal services, facility-based deliveries, and basic noncommunicable disease care. Social workers, in particular, reported feeling undervalued despite their contributions to community health work. The findings underscore the importance of integrating social workers and CHEWs into strategies aimed at increasing demand for MCH services. This has significant implications for evidence-based policy development and health program planning in Nigeria. The study recommends the formal inclusion of social workers and CHEWs in MCH initiatives to strengthen community engagement and improve health outcomes.