Care Groups: The Essential Ingredients

Care Groups: The Essential Ingredients April 2010 Carolyn Wetzel, MPH Senior Coordinator for Health Programs Food for the Hungry Melanie Morrow, MPH Director of MCH Programs World Relief Thomas P. Davis Jr., MPH Senior Director of Health Programs Food for the Hungry

Description of a Care Group
They are different from typical mother’s groups in that each volunteer is responsible for regularly visiting 10-15 of her neighbors, sharing what she has learned and facilitating behavior change at the household level .
A Care Group is a group of 10-15 volunteer, community-based health educators who regularly meet together with project staff for training and supervision.

Description of a Care Group
Care Groups create a multiplying effect to equitably reach every beneficiary household with interpersonal behavior change communication.
They also provide the structure for a community health information system that reports on new pregnancies, births and deaths detected during home visits

Results: KPC and Anthropometry All of these changes were statistically significant (p<0.05). Indicator FY97 (Baseline) FY 2000 Percentage of children with diarrhea receiving appropriate oral rehydration liquids 26% 95% Percentage of children 0-4m exclusively breastfeeding 46% 83% Percentage of children 12-23m who received a vitamin A capsule in the last six months 1% 97% Percentage of children with diarrhea in the last two weeks 44% 28% Severe stunting, children 6-23m of age 25% 13%

42% decrease in underweight from Feb/06 to Sept/08 in a 2.5 year time period in Sofala, Mozambique (LOP Target was 18%) Sept 07 Feb 06 Sept 08

Differences in Health Service Utilization: Care Group vs. Non-Care Group Districts (Sofala, Mozambique)

Results: Mortality Rate Changes (CMR) 94% decrease in CMR

Reduction in Under-five Mortality Rate: Seven Care Group Projects

Why Criteria for Care Groups
14 PVO’s using the model since 1995
Increased attention to the model and its repeated association with decreases in mortality .
Wide variations in what is called a “Care Group” can lead to the use of less effective strategies that do not fit within the model.
Fewer opportunities to advocate for the Care Group Model and it’s role in child survival if the name is applied to less effective strategies.

Why Criteria for Care Groups
Criteria formed by the two organizations that are recognized as having a history of using and promoting Care Groups extensively (WR being the original developer)
We hope that by informing donors and others about these criteria, they will use the criteria to decide to what degree a proposed implementation strategy is really based on the Care Group model.

Establishment of Criteria
During meetings between World Relief and Food for the Hungry staff members on April 23, 2009, the Care Group criteria were agreed upon.
The list is divided into those that we feel should be required to be present when using the term, “Care Group,” and other criteria that we feel have been helpful when included in the model, but that should not be considered required.
Edits to this list were then made by the two founders of the model, Dr. Pieter Ernst and Dr. Muriel Elmer.

The Care Group Criteria Essential characteristics for a model of community based health promotion to be considered the "Care Group" Model. 1 The model is based on peer-to-peer health promotion (Mother-to-mother for MCH and nutrition behaviors.) CG Volunteers should be chosen by the mothers within the group of households that they will serve or by the leadership in the village. 2 The workload of CG volunteers is limited: No more than 15 HH per CG volunteer. 3 The Care Group size is limited to 16 members and the project attains at least 70% monthly attendance. Coverage is monitored.

4 CG volunteer contact with her assigned beneficiary mothers is monitored and should be at a minimum once a month, preferably twice monthly. 5 The plan is to reach 100% of households in the targeted group on at least a monthly basis, and the project attains at least 80% monthly coverage of households within the target group. Coverage is monitored. 6 Care Group Volunteers (e.k.a. “Leader Mothers”) collect vital events data on pregnancies, births, and death. 7 The majority of what is promoted through the Care Groups is directed towards reduction of mortality and malnutrition (e.g., Essential Nutrition Actions, Essential Hygiene Actions).

8 The Care Group volunteers use some sort of visual teaching tool (e.g., flipcharts) to do health promotion at the household level. 9 Participatory methods of BCC are used in the Care Group with the CG Volunteers, and by the volunteers when doing health promotion at the household or small-group level. 10 The Care Group instructional time (when a Promoter teaches CG Volunteers) is no more than two hours per meeting. 11 Supervision of Promoters and at least one of the Care Group Volunteers (e.g., data collection, observation of skills) occurs at least monthly.

Answer the questions on your handout for the Care Group Criteria assigned to your group. 30 people Small Group 1 2 3 4 Care Group Criteria to Cover 1 4 6 8 2 5 7 9 3 11 10

Answer the questions on your handout for the Care Group Criteria assigned to your group. 35+ people Small Group 1 2 3 4 5 Care Group Criteria to Cover 1 2 4 5 8 7 3 11 6 9 10

Care Groups: The Essential Ingredients

by jehill3 on May 04, 2010

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Care Groups: The Essential Ingredients — Presentation Transcript