The KIDCARE (2004-2009) project seeks to sustainably reduce child mortality and morbidity in Kilifi. KIDCARE was implemented by the Kilifi community, Plan, MOH, AMKENI, Aga Khan Health Services, KEMRI Welcome Trust and PSI. AMKENI and PSI are projects funded by the local USAID mission in Kenya. The project prioritized six interventions malaria control, prevention of malnutrition, improved immunization coverage, pneumonia case management, control of diarrhea, and HIV/AIDS prevention.
KID-CARE’s definition for sustainability was “To identify and work with existing structures to strengthen and help our children to live until their fifth birthday “= Strengthening the health system They envisioned the healthy child at the center, and graded necessary stakeholders. They also identified actions that need to be taking place in the future if the vision is to be realized.
In Kilifi which is rural Kenya, households are clustered around homesteads. The is a definite Head of Homestead who is recognized as a leader. Some Homesteads are large and may comprise upto 20 households. Others are small and may have only 5 households
Each of those CHWs passed on the health messages to at least 10 Care Group Volunteers every two weeks. The Care Group Volunteers ensured that the health messages reached each household in their area. Each CHW also ensured they visited and taught health lessons to each and every eligible mother within the ten homesteads under her/his care. When they started working, each SuperCHW met with 10-15 CHWs once every month. The SuperCHW also held quarterly review meetings with the MoH staff and project frontline staff Drivers for the acceptance of the care groups at the village model: traditional household arrangement into homesteads, male migration to urban settings leaving women behind, stakeholder involvement and support (MOH staff viewed it as a less burdensome strategy for expanding preventive activities) One CHW could cover between 30-80 households in the denser areas and about 10-50 households in the less dense areas. Likewise a CHW had anywhere between 3 and 10 Care Group Volunteers under their care.
Plan kenya care_groups
Local Lessons on Care Groups Core Fall Meeting September 14, 2010 Plan Kenya
Outline <ul><li>Plan Kenya- Standard CS in Kilifi (2004-2009) </li></ul><ul><li>Adoption of the Care Group Strategy </li></ul><ul><li>Lessons learned </li></ul><ul><li>Conclusions </li></ul>
Plan Kenya KIDCARE Vision for Sustainability Fathers as active caretakers of sick children Extension of the health system to where the communities live Re-organization of the community from the village level to the household level to ensure more active engagement with health benefits and communication INFLUENCERS (CENTRAL MOH) LOCAL MOH CHILD CORPS PARENTS GUARDIANS VHCs/DHCs/CBOs PARTNERS
Plan Kenya KIDCARE Project 2 <ul><li>The project to adopt a ten-cell (Miji kumi) model akin to one that had been used for political mobilization in the period before Kenya re-adopted multiparty democracy. Only much later was it realized that in the Miji kumi model the project had unwittingly adopted the care-group model with all it core elements of multiplication of volunteer effort, peer support and community mobilization for health action. </li></ul><ul><li>. </li></ul><ul><li>8 frontline staff (Promoters) reached all the 357 villages’ population of 257,000 persons . This was made possible because each Promoter got in touch with upto 100 CHWs every two weeks (through 10 SuperCHWs who are unpaid volunteers) </li></ul>
Plan Kenya KIDCARE Org. Structure CGV HH HH HH HH HH HH CGV HH HH HH HH HH HH HH HH HH HH CGV PROMOTER CHW CHW SUPER CHW SUPER CHW SUPER CHW CHW CHW CHW CHW HH HH HH HH CGV HH Each homestead (nominates a care group volunteer 10 care group volunteers form a care group and nominates a CHW. A SuperCHW was nominated from each group of 10 CHWs. This was an unpaid volunteer A promoter who is a paid project staff was responsible for 10-15 SuperCHW The social unit targeted for interventions is the household. These are usually found clustered in homesteads
Indicators Baseline Coverage % Endline Coverage % Target % % Children (0-23mths) underweight 26.6 14.4 21.6 % Children (0-23mths) births attended by SBA 12.9 35.4 % Mothers of children (0-23mths)who received 2TT 24.0 66.7 60 % Infants (0-5mths) exclusively breastfed in last 24 hrs 21.1 54.9 31 % Children (0-23mths) fully vaccinated by 12mnths 62.2 76.5 74 % Children (0-23mths) who slept under ITN last night 20.7 76.7 60 % Mothers of children (0-23mths) who know 2 ways of preventing HIV 41.4 66.0 70
Lessons Learned <ul><li>Born out of shared vision </li></ul><ul><li>Project catalyzed not project led </li></ul><ul><li>Took time to set up </li></ul><ul><li>Care Group Volunteers represented homesteads instead of “10 households” </li></ul><ul><li>Rapid BCC: solidarity, endorsement by HH </li></ul><ul><li>Spin-offs: VSL/Microenterprise, CLTS </li></ul><ul><li>Did not work well in peri-urban centers </li></ul>
The preceding slides were presented at the CORE Group 2010 Fall Meeting Washington, DC To see similar presentations, please visit: www.coregroup.org/resources/meetingreports