Role of Community Health Extension Workers in Reducing Maternal Mortality in Kebbi State

Background: Community health extension workers represent a critical human resource strategy for extending primary care reach and reducing maternal mortality in underserved areas of the North West geopolitical zone. This study examines the role and effectiveness of community health extension workers in maternal mortality reduction in Kebbi State. Methods: A mixed-methods programme evaluation was conducted. Retrospective maternal mortality data from 2019 to 2023 were reviewed for health facilities with and without CHEW-led community outreach. Twelve in-depth interviews with CHEWs, supervisors, and community leaders provided qualitative context. Results: Facilities in communities served by active CHEW programmes showed lower rates of unattended deliveries and skilled birth attendance rates were correspondingly higher. CHEWs identified obstetric danger signs and facilitated timely referrals in a significant proportion of cases. Barriers included irregular supervision, transportation gaps, and commodity stockouts. Conclusion: Community health extension workers play a demonstrable role in maternal mortality reduction in Kebbi State when adequately supported. Family medicine departments should strengthen CHEW supervision systems and integrate community outreach data into routine maternal health monitoring frameworks. Keywords: community health extension workers, maternal mortality, Kebbi State, skilled birth attendance, primary care