Considerations For Incorporating Health Equity in Project Design_Talens_5.12.11

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Considerations For Incorporating Health Equity in Project Design_Talens_5.12.11

  1. 1. Closing the Gap by Design: Setting up a Maternal Newborn Health Program as if People Mattered.<br />The Peoples Institution Model<br />Alan Talens, MD, MPH <br />Nancy TenBroek, MA <br />Will Story , MPH<br />EmdadHoque , MD, MPH<br />CORE Group Spring Meeting<br />Baltimore MD<br />May 12,2011<br />
  2. 2. STRATEGIC THEMES<br />Of CRWRC<br />Constituent Engagement<br />Relief and Development under Justice Umbrella<br />Building Country Capacity<br />
  3. 3. Sub district performance assessed by using the “Proportions of births attended by skilled birth personnel” indicator.<br />
  4. 4. Netrokona District<br />
  5. 5. Antenatal Care (4 or more visits)<br />OR=2.06 [ns]<br />OR=Undef.<br />
  6. 6. Doer/Non-Doer for ANC<br />Male <br />Docs<br />Waste<br />Of money<br />Mothers-In law <br />approval<br />Supers-<br />tition<br />Advantage<br />Complete PE<br />Husband<br />Cooperation <br />
  7. 7. Qualitative Findings (PLA) <br />“Heavy work for pregnant women is good”<br />“Less food during pregnancy is beneficial”<br />“Less food for moms after delivery will keep them fit”<br />
  8. 8.
  9. 9. Goal of Project<br />to reduce mortality and improve health status among the most marginalized mothers and newborns<br />Study Questions: <br />Does the PImodel lead to more equitable outcomes in MNH compared to the status quo?<br />How does the Peoples Institution model reach the poor and marginalized women and children in their community?<br />
  10. 10. Community Mobilization <br />+<br />Community-IMCI<br />
  11. 11. PEOPLES’ INSTITUTION<br />
  12. 12.
  13. 13. CHV<br />Peoples<br />Institution <br />Health Sub Team<br />Health Facilities <br />TTBA<br />Community People<br />Child Survival Program<br />
  14. 14. PRIMARY GROUPS<br /><ul><li>savings- based credit
  15. 15. health promotion
  16. 16. literacy
  17. 17. agriculture.</li></li></ul><li>Emergency Health Fund<br />Monthly contribution of 2 Taka by members.<br />Emergency Treatment <br />Transportation<br />
  18. 18. Quantitative Equity Analysis<br />
  19. 19.
  20. 20. Qualitative Multi-case Study Analysis<br />Esytablishes the HOW<br />Figure 1.<br />Level of social Capital<br />Level of community mobilization<br /> Closeness of household to health provider<br />Lay providers are involved in care and referral<br />
  21. 21. Conclusion<br />1.Active Community Mobilization and C-IMCI appear to be an Effective combination for an Equity Strategy<br />2.Include equity in the design from the beginning<br />3. Incorporating Equity in our programs in the right thing to , a moral obligation . <br />Community Mobilization/<br />Governance and C-IMCI as Equity Strategies<br />
  22. 22. Thank You<br />

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