1 Yitbarek K, et al. BMJ Open 2019;9:e025937. doi:10.1136/bmjopen-2018-025937 Open access Contribution of women’s development army to maternal and child health in Ethiopia: a systematic review of evidence Kiddus Yitbarek,  1 Gelila Abraham, 1 Sudhakar Morankar 2,3 To cite: Yitbarek K, Abraham G, Morankar S. Contribution of women’s development army to maternal and child health in Ethiopia: a systematic review of evidence. BMJ Open 2019;9:e025937. doi:10.1136/ bmjopen-2018-025937 ► Prepublication history and additional material for this paper are available online. To view these fles, please visit the journal online (http://dx.doi. org/10.1136/bmjopen-2018- 025937). Received 12 August 2018 Revised 26 February 2019 Accepted 29 March 2019 1 Department of Health Policy and Management, Jimma University, Jimma, Ethiopia 2 Department of Health Behaviors and Society, Jimma University, Jimma, Ethiopia 3 Jimma University Rapid Review Response Center: AHPSR/WHO Center of Excellence, Jimma University, Jimma, Ethiopia Correspondence to Mr Kiddus Yitbarek; kiddus.yitbarek@yahoo.com Research © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. ABSTRACT Objective The aim of this review was to identify, appraise and synthesise studies that reported on the contribution of women’s development army (WDA) to maternal and child health development. Setting Studies conducted in Ethiopia 2010 onwards and published in English were considered. Data sources Evidence were searched in MEDLINE, CINAHL and EBSCOhost from 25 March to 10 April 2018. Eligibility criteria Both quantitative and qualitative studies assessing the contribution of WDA to maternal and child health were considered. Data extraction and synthesis Two independent reviewers have extracted data using pre-planned data extraction tool separately for each study design. Findings were synthesised using tables and narrative summary. Outcome Maternal and child health services; maternal and child mortality. Results Nine studies met the inclusion criteria and were used for synthesis. The results revealed that participation and membership in women’s development teams (WDTs) have a positive effect on minimising maternal death and improving child immunisation service use. Skilled delivery and antenatal care service use were higher in WDTs located within a radius of 2 km from health facilities. Women's development teams were also the main sources of information for mothers to prepare themselves for birth and related complications. Moreover, well-established groups have strengthened the linkage of the health facility to the community so that delays in maternal health service use were minimised; health extension workers could effectively refer women to a health facility for birth and utilisation of skilled birth service was improved. Conclusion Voluntary health service intervention in Ethiopia has improved maternal and child health services’ outcome. A decrease in maternal deaths, increase in antenatal and delivery service use and improved child immunisation service uptake are attributable to this intervention. The linkage between community members and the primary healthcare system served as an effective and effcient mechanism to share information. INTRODUCTION Evidence from various countries in the world disclosed that community volunteers’ health service intervention has shown significant health impact. 1 2 They accomplish various functions related to health service delivery. In fact, usually, they do not have formal profes- sional or paraprofessional education and can be involved in voluntary care. They intervene in healthcare after attending job-related pieces training. These community health volunteers have different names in different settings, for example, lay health workers, community health workers and unpaid community volunteers. 3 4 Community health volunteers have great importance, especially in less developed countries, so as to overcome the increasing demand for healthcare services and the shortage of formal healthcare providers. 5 After the Alma Ata declaration of Primary Healthcare (PHC) in 1978, community involvement in the healthcare was given due attention in order to improve the wide access and acceptance of the services by service users and the community at large. It is believed that problems cannot be solved from only the side of service providers and programmers. More- over, it is a good strategy to mobilise resources relevant to health services. 6–8 Strengths and limitations of this study ► The review has used two independent reviewers who rigorously searched and reviewed the pub- lished materials. Furthermore, a third reviewer par- ticipated when disagreements arose between the two reviewers. ► The review has used structured procedure during literature search, appraisal, data collection and synthesis ► Despite the strengths described above, we have not conducted meta-analysis due to the heterogeneous nature of the study design and population included in this review. ► We have included only full-text articles found free online.