PSI’s experience in Community Case Management programs

PSI’s experience in Community Case Management programs Megan Wilson, Child Survival Program Manager CoreGroup Spring Meeting, April 2010

PSI’s work
To improve health of low-income population through behavior change communication and increased access to health-related products;
Traditional delivery models are:
(i) social marketing
(ii) franchised clinic and
(iii) free distribution campaign;
Recently, focus on accelerating Child Survival by integrating life-saving interventions through community case management of common childhood illnesses.
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PSI’s Role in Preventing Child Deaths
3 rd cause (8%): Malaria prevention / treatment
2 nd cause (17%): Diarrhea prevention / treatment
1 st cause (19%): Pneumonia treatment

Promotion of household water treatment and hand washing
Early treatment of diarrhea at home / community
Diarrhea prevention & treatment

Improved nutrition of infants through Sprinkles promotion
Treatment of pneumonia at the community level through antibiotics
Pneumonia Management & Nutrition

Communications + Product = Healthy Behavior

So what does PSI do around CCM?
Training and equiping Community Health workers in rural area to assess fever, cough with fast-breathing and diarrhea in children and determine treatment or whether a referral to a health facility is needed;
Regular supervision in partnership with local health authorities and partners
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Experience in Myanmar
« Village-based Community Health Workers » from the Sun Primary Health network identify, assess and refer cases of pneumonia to Sun Quality Health franchised clinic network where pre-packaged ATB treatment is provided.
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Madagascar
Children under five with:
non-severe pneumonia
diarrheal diseases and
non-severe malaria:
in rural settings are managed by Community Health Workers using respectively pre-packaged treatment.
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Uganda
Public « Village Health Teams » will receive training and supervision to identify and refer sick child to private health providers
These private health providers are part of PSI’s franchised clinic network ProFam . The patient will be referred and receive adequate treatment developed by PSI.
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CIDA CCM Program
To learn how best to scale-up delivery of ACTs, antibiotics and ORS/ZN to ensure maximum impact on overall child mortality,
Hope to avert 27,800 deaths overall
Through Integrated management of childhood illnesses by « Health Security Agents » in Malawi and Community Health Volunteers in DRC ,
And Home Management of Malaria in under five by « Community Volunteers » in Mali and « Community Relay Agents » in Cameroun
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Cameroun
Target Group : 2.1 M
What : Scale-up delivery of ACTs, Pilot delivery of antibiotics and ORS/ZN
How: Community Outreach Agents
Goal: Avert an estimated 4,114 deaths
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Democratic Republic of Congo
Target Group: 1.5 million people
What : To learn how best to scale-up delivery of ACTs, antibiotics and ORS/ZN to ensure maximum impact on overall child mortality,
How: Through Integrated management of childhood illnesses by Community Health Volunteers,
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Malawi
Target Group: 1.7 million people in 5 districts in Malawi
What: To learn how best to scale-up delivery of ACTs, antibiotics and ORS/ZN to ensure maximum impact on overall child mortality,
How: Through Integrated management of childhood illnesses by « Health Security Agents »
page District Population Hospitals H/ Centres HSAs Villages households Machinga 488996 1 21 370 897 115136 Zomba Rural 583167 5 28 640 1539 142394 Thyolo 514138 3 39 580 456 142039 Mwanza 94476 1 4 269 156 47433 Neno 108897 1 9 Total 1789674 11 101 1859 3048 447002

Mali
Target Group : Over a population 2.22 M in Segou
What : S cale-up delivery of Home Management of Malaria (HMM)
How: Delivering 1,655,000 ACTs by « Community Volunteers »
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Progress to date
Reduction in:
Severe dehydration
Severe malaria cases,
Reduction in transfusions
have been reported by health facilities staff in settings PSI’ CCM interventions are implemented
On going health impact research will tell us much more over the couple of years
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Challenges and Lessons learned
On-going communications about CHW services needed with target groups
Drug Stock-out could be avoided by ensuring health center staff which are responsible for CHW supervision and replenishment are supportive,
CHW Training & Refreshers needs to be rigourous so that case management algorithm can be done correctly,
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Challenges and Lessons learned continued
Monitoring & evaluation is essential for programmatic improvements
Partnership is critical and roles need to be clearly defined throughout the management system
CHW need to be empowered to highlight when they more commodities, support and training
Communication channels / means need to be established and maintained
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PSI’s experience in Community Case Management programs

by jehill3 on May 03, 2010

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PSI’s experience in Community Case Management programs — Presentation Transcript