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Chang collaborative approach

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CORE Group Fall Meeting 2010. Collaborative Approach to Community-based Malaria Prevention in Benin. - Judy Chang, Plan International USA

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Chang collaborative approach

  1. 1. Collaborative Approach to Community-based Malaria Prevention in Benin Judy Chang | Plan International USA CORE Group Fall Meeting September 15, 2010
  2. 2. Plan International <ul><li>A child-centered, community development organization with over 70 years of experience </li></ul><ul><li>Benefits approximately 15 million people in 48 developing countries in Asia, Africa and the Americas </li></ul><ul><li>Began operating in Benin in 1994 </li></ul><ul><li>Works in 754 villages in Benin, covering the domains of health, water and sanitation, education, household food security, and child rights </li></ul>
  3. 3. Background – Malaria in Benin <ul><li>A principle cause of morbidity and mortality among infants and pregnant women </li></ul><ul><li>Utilization of ITNs is low (34%) </li></ul><ul><li>Very few mothers (~14%) seek care and treatment from health facilities for their children </li></ul><ul><li>Limited human resources for health – average of one health agent per village </li></ul>
  4. 4. Plan’s Improvement Collaborative <ul><li>Dates: April 2007-June 2009 </li></ul><ul><li>Coverage: 50 villages in the communes of Aplahoué and Djakotomey in the Couffo department of Benin </li></ul><ul><li>Improvement topics: Malaria—LLINs, malaria case management, malaria treatment in children and pregnant women, IPTp </li></ul>
  5. 5. Goal and objectives <ul><li>Goal: To contribute to the reduction of child and maternal mortality rates by improving behaviors related to the prevention and treatment of malaria by the community itself </li></ul><ul><li>Objectives: </li></ul><ul><ul><li>Increase from 34% to 60% the use of LLIN </li></ul></ul><ul><ul><li>Promote appropriate management of malaria in households and communities </li></ul></ul><ul><ul><li>Increase by 40% timely care seeking for complicated malaria among children under five and pregnant women </li></ul></ul><ul><ul><li>Strengthen collaboration between health structures and communities through home visits and support to community groups. </li></ul></ul>
  6. 6. Implementation package <ul><ul><li>Establishment and training of Quality Improvement Teams (QITs) </li></ul></ul><ul><ul><li>Information, education, and communication on malaria prevention and treatment (LLIN utilization, identification of signs of serious malaria) </li></ul></ul><ul><ul><li>Home visits and night visits to reinforce good behaviors </li></ul></ul><ul><ul><li>Home-based treatment of malaria with ACTs </li></ul></ul><ul><ul><li>Establishment of a referral and counter-referral system between CHWs and health facility staff </li></ul></ul>
  7. 7. Measurement <ul><li>Key indicators monitored by QITs: </li></ul><ul><ul><li>% of children under 5 who slept under a mosquito net the previous night </li></ul></ul><ul><ul><li>% of children under 5 who had a fever within the last 2 weeks and who were treated according to the guidelines </li></ul></ul><ul><ul><li>Number of children under 5 who were referred to a health center through the community referral system </li></ul></ul><ul><ul><li>% of pregnant women who slept under a mosquito net the previous night </li></ul></ul><ul><ul><li>% of children with serious malaria who were brought to a health center within 24 hours </li></ul></ul>
  8. 8. Coaching, learning, and communication among teams Activity Purpose Frequency QIT meetings <ul><li>Report monitoring data and project progress </li></ul>Bimonthly Inter-village learning sessions for QITs <ul><li>Share innovative methods developed </li></ul><ul><li>Assess each QIT’s effectiveness relative to one another </li></ul>Quarterly Coaching by animators from partner NGOs <ul><li>Improve QITs’ teamwork, problem solving, and monitoring of progress </li></ul>Monthly Advisory Committee supervision and meetings <ul><li>Monitor project activities </li></ul><ul><li>Make recommendations to project implementation team </li></ul>Quarterly
  9. 9. Results – LLIN utilization Target: 60%
  10. 10. Results – Home care and management of fever Target: 40%
  11. 11. Results – Early referral of serious malaria Target: 40%
  12. 12. Results – IPTp <ul><li>40% of pregnant women received IPTp </li></ul><ul><li>Malaria consultations among pregnant women at health centers decreased from 92 to 66 per year </li></ul><ul><li>No malaria-related deaths were recorded among pregnant women </li></ul>
  13. 13. Best practices <ul><li>Conducting home visits and night visits </li></ul><ul><li>Creating local responses to identified barriers </li></ul><ul><li>Establishing accountability of QIT members </li></ul><ul><li>Increasing collaboration between communities and health facilities </li></ul>
  14. 14. Challenges <ul><li>Engaging health facility staff in supervision and coaching of QITs </li></ul><ul><li>Counter-referrals </li></ul><ul><li>IPTp </li></ul><ul><li>Sustained support and scale up </li></ul>
  15. 15. Conclusions <ul><li>The project was successful in creating a favorable environment for sustained behavior changes </li></ul><ul><ul><li>Development of entrepreneurial spirit and shared learning among QIT members </li></ul></ul><ul><ul><li>Increased ownership of community health </li></ul></ul>
  16. 16. 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

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