Assessing & Improving  CHW Programs<br />Donna Bjerregaard<br />Initiatives Inc.  for USAID Health Care Improvement Projec...
PEPFAR II: HSS and increase of health workers<br />GHI: HSS, integration and sustainability<br />WHO/Global Health Workfor...
Maturity of health systems, especially at primary level<br />Diversity of CHW cadres/typology<br />Differences in communit...
CHW AIM Tool & Process<br />CHW AIM Operations Research Zambia<br />CHW Central: CoP<br />2011-2012: CHW Improvement Colla...
Respond to global needs to strengthen systems to support CHW programs<br />Contribute to a more strategic approach to CHW ...
Assess program functionality: <br />identify strengths & challenges, <br />guide improvement using a simple process and cl...
A tool and process that guides self-directed assessments of CHW programs and action planning <br />CHW AIM: What is it?<br />
Introduction<br />CHW Program Functionality Matrix <br />Intervention Matrices<br />HIV/AIDS, MNCH, TB<br />Soon: WASH & F...
Functionality Model <br />Process<br />Step 1: Adapt Matrices to the Country Context <br />Step 2: Plan the Assessment Wor...
CHW AIM Example Section<br />Definition of component<br />Scoring is done by individuals, then by group consensus. Scores ...
Workshop participants select appropriate boxes according to their experience<br />
12<br />   SAMPLE ACTION PLAN<br />
Field visits, either before or after workshops, validate scoring and refine action plans<br />13<br />Validating Workshop ...
Cost Effective<br />Quantitative & Qualitative <br />Can be applied at country or individual program level<br />thru works...
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CHWs on the Move_Bjerregaard_5.10.11

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  • Context and reason for request to develop tool:FY2008 USAID MCH PriorityIncrease functional CHWs by 100,000 (original request)PEPFAR IIHealth systems strengthening Specific target to increase health workers by 140,000Global Health InitiativeHealth systems strengthening Although original request was to measure and count functional community health workers, objectives changed when tool was seen as an effective way to strengthen CHW programs and to develop common and crosscutting criteria for functional programs.
  • A tool and process that guide self-directed assessments of CHW programs and an action planning processContext and reason for request to develop tool:FY2008 USAID MCH PriorityIncrease functional CHWs by 100,000 (original request)PEPFAR IIHealth systems strengthening Specific target to increase health workers by 140,000Global Health InitiativeHealth systems strengthening Although original request was to measure and count functional community health workers, objectives changed when tool was seen as an effective way to strengthen CHW programs and to develop common and crosscutting criteria for functional programs.
  • Context and reason for request to develop tool:FY2008 USAID MCH PriorityIncrease functional CHWs by 100,000 (original request)PEPFAR IIHealth systems strengthening Specific target to increase health workers by 140,000Global Health InitiativeHealth systems strengthening Although original request was to measure and count functional community health workers, objectives changed when tool was seen as an effective way to strengthen CHW programs and to develop common and crosscutting criteria for functional programs.
  • Context and reason for request to develop tool:FY2008 USAID MCH PriorityIncrease functional CHWs by 100,000 (original request)PEPFAR IIHealth systems strengthening Specific target to increase health workers by 140,000Global Health InitiativeHealth systems strengthening Although original request was to measure and count functional community health workers, objectives changed when tool was seen as an effective way to strengthen CHW programs and to develop common and crosscutting criteria for functional programs.
  • Each of these 15 components sets out clear and simple criteria based on a review of best practices for successful and not so successful programs. Components originally numbered 8 but have increased after field tests made it clear that these were all critical for sustainability and long-term functionality.
  • CHWs on the Move_Bjerregaard_5.10.11

    1. 1. Assessing & Improving CHW Programs<br />Donna Bjerregaard<br />Initiatives Inc. for USAID Health Care Improvement Project<br />CORE Group Meeting 5-10-2011<br />1<br />
    2. 2. PEPFAR II: HSS and increase of health workers<br />GHI: HSS, integration and sustainability<br />WHO/Global Health Workforce Alliance: country-level support and expansion of CHW programs<br />Key Messages<br />GHWA: Bangkok<br />1 Million Community Health Workers Campaign (UN initiative)<br />USAID Review for evidence based practices<br />2<br />Global Pressure to Increase Community Services<br />
    3. 3. Maturity of health systems, especially at primary level<br />Diversity of CHW cadres/typology<br />Differences in community systems: readiness and ability to support workers<br />Scarcity of resources<br />Paucity of practical tools and examples of success<br />3<br />Current Challenges to Widespread Improvement<br />
    4. 4. CHW AIM Tool & Process<br />CHW AIM Operations Research Zambia<br />CHW Central: CoP<br />2011-2012: CHW Improvement Collaboratives in Ethiopia and Mali<br />4<br />HCI’s CHW Program Improvement Work<br />
    5. 5. Respond to global needs to strengthen systems to support CHW programs<br />Contribute to a more strategic approach to CHW program implementation <br />Provide practical tools to disseminate and reinforce best practices<br />Build local capacity to assess and improve CHW programs in relationship to best practices<br />5<br />CHW AIM Strategy<br />
    6. 6. Assess program functionality: <br />identify strengths & challenges, <br />guide improvement using a simple process and clear criteria that can be applied across projects/programs<br />Assess health service interventions<br />Facilitate action planning to guide short-term and continuous improvement<br />6<br />CHW AIM Objectives<br />
    7. 7. A tool and process that guides self-directed assessments of CHW programs and action planning <br />CHW AIM: What is it?<br />
    8. 8. Introduction<br />CHW Program Functionality Matrix <br />Intervention Matrices<br />HIV/AIDS, MNCH, TB<br />Soon: WASH & FP<br />Facilitator’s Guide<br />Training Guide<br />Appendices<br />Participant Selection Form for Workshop<br />Comprehensive Document Review Guide and Checklist for CHW Programs <br />CHW AIM Validation Questionnaire<br />Score and Score Rationale Documentation Worksheet<br />CHW AIM Program Functionality Score Sheet<br />CHW AIM Action Planning Framework<br />Resources and Field Examples<br />8<br />CHW AIM Toolkit<br />
    9. 9. Functionality Model <br />Process<br />Step 1: Adapt Matrices to the Country Context <br />Step 2: Plan the Assessment Workshop<br />Step 3: Conduct the Assessment Workshop <br />Step 4: Provide Follow-Up Support<br />9<br />
    10. 10. CHW AIM Example Section<br />Definition of component<br />Scoring is done by individuals, then by group consensus. Scores are validated by field visit interviews<br />10<br />
    11. 11. Workshop participants select appropriate boxes according to their experience<br />
    12. 12. 12<br /> SAMPLE ACTION PLAN<br />
    13. 13. Field visits, either before or after workshops, validate scoring and refine action plans<br />13<br />Validating Workshop Scoring<br />
    14. 14. Cost Effective<br />Quantitative & Qualitative <br />Can be applied at country or individual program level<br />thru workshop or document review/interviews<br />Allows cross department sharing<br />Action plan: clear deliverables /indicators<br />14<br />Facilitating Factors <br />

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