Community-Facility Linkage Interventions: Enhancing Child Health Outcomes

By Danélia Botes

May 1, 2024


In 2021, childhood mortality claimed 5 million lives under the age of five, highlighting a significant global health challenge (UNICEF 2023). This dilemma is particularly prevalent in resource-constrained settings where child mortality rates are alarmingly high. To address this, various interventions have been implemented on multiple system levels, from facility improvements to community health education. However, a disconnect exists between these two spheres of action, often hindering the prospect of long-term, sustainable improvements.

Understanding Community-Facility Linkage

Community-facility linkage is a formalised connection between a health facility and the communities it serves, with the goal of improving health outcomes. Despite the lack of definitive evidence on the effectiveness of interventions aimed at strengthening such connections, these approaches could potentially improve healthcare provision at local health centres, reduce missed opportunities for adequate care, and improve overall health outcomes.

The Role of Community Participation

Active participation from local communities in the intervention design and delivery process can significantly enhance the effectiveness of community-facility linkage interventions. This is because local communities possess unique insights into the health challenges specific to their settings, which can help tailor interventions to the population’s actual needs. Empowering communities to take the lead in health programs is not only a powerful tool for sustainable change but also for maintaining positive outcomes post-intervention.

The Impact of Community-Facility Linkage Interventions

The study conducted a systematic literature review to identify the key features that make community-facility linkage interventions successful. The focus was on features that improve community participation, especially in rural areas of low or lower-middle-income countries. These conditions are similar to those in Jigawa, Nigeria. The results showed that effective implementation of these interventions can positively change care-seeking behaviour. They can also improve healthcare access for community members and alter healthcare providers’ practices. However, none of the studies reviewed adequately assessed the impact on child mortality rates.


The analysis reveals the need for more active inclusion of hard-to-reach populations, a preference for mixed-methods methodology, involvement of community members in programmatic decisions, and a focus on the actual context need. This highlights the importance of transformative considerations within evaluation plans and suggests a potential evaluation framework for assessing the impact of community-based and facility link interventions.

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