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Integrating Community-Based Strategies into Existing Health Systems_David Shankin_5.6.14


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Integrating Community-Based Strategies into Existing Health Systems_David Shankin_5.6.14

  1. 1. Senegal Case Study: Scaling Up Community Health Services to the National Level through INGO Partnerships Presentation: David Shanklin, MS Integrating Community-Based Strategies into Existing Health Systems: The Unique Role of INGOs May 5 – 9, 2014 Silver Spring, MD
  2. 2. Original Purpose of the Program • Health huts in Senegal have been in existence since 1978, inspired by the spirit of the Alma Ata Declaration and the promise of universal primary health care. • Health juts were intended to provide basic health promotion and selected curative services in areas without immediately available public health facilities. • Public support for health huts was abandoned by the mid- 1980s, and almost all were closed by the end of the decade. • A new health hut initiative was begun in 1998 as a pilot project by ChildFund (then known as Christian Children’s Fund) in order to resuscitate health huts at a local level.
  3. 3. Scaling Up Senegal’s Community Health Services Project Characteristics USAID Projects CANAH CANAH II CAMAT PSSC PSSC II Dates 1998-02 2002-06 2003-06 2006-11 2011-16 USAID Funding Source CSHGP CSHGP Mission Mission Mission (Sector Focus) (MCH) (MCH) (TB/Malaria) (Integrated) (Integrated) USAID Funding Levels $992,218 $1.25 Million $870,846 $26 Million $40 Million Geographic Coverage 2 Districts 3 Districts 4 Districts 13 Regions 14 Regions 65 Districts 71 Districts Target MCH Population 137,000 163,393 502,035 3,369,633 9,098,014 (>25% of Nat'l Pop) (>70% of Nat'l Pop) Health Huts/ 60 HH 154 HH N/A 1,620 HH/ 2,245 HH/ Outreach Sites 703 Sites 1,969 Sites
  4. 4. Scaling Up: Project’s Learning Transitions CANAH: • Formative research identifying and working with key community stakeholders • Organizing & training health committees and HVs • Organizing HH and later, Outreach Sites CANAH II: • Extending community health services • Liaising with local MOH • Formulating unified vision of health PSSC: • Standardizing basic CB MCH • Coordinating CB MCH with multiple implementing partners • Nationwide scale-up PSSC II: • Urban extension • Additional service components • Transfer of HH/OS to community and MOH CAMAT: • Additional services, such as TB, Malaria and Nutrition • Increased service area coverage
  5. 5. Health Promotion/Communication Health Systems Strengthening FacilityServices Community Health HIV/AIDS/TB USAID/Senegal's Conceptual Pirogue: Improved Health Status of the Senegalese Population
  6. 6. Community-Based Strategy Community mobilization using multiple local groups with consistent health messages and practices (based on early formative research) – • Project’s community mobilizers • Community health workers and volunteers (TTBA, health volunteers, community educators, health committee members) • TB cells • Youth
  7. 7. Community-Based Strategy (cont’d) • Pregnant women’s solidarity groups • Grandmothers and godmothers • Community leaders
  8. 8. Rural and urban populations dependent primarily on the health huts and outreach sites for health services.  Estimated total population – 9,098,014  Infants and children 0–5 years – 1,771,968  Children of school age – 2,544,364  Pregnant/lactating women – 354,394  Women of reproductive age – 2,090,013 Target Population
  9. 9. Intervention Areas 14 Regions 71 Districts out of 75 4,214 Health Huts/Outreach Sites
  10. 10. Strengths of INGO Participation • Geographic expansion and population coverage • Expansion in the number of services provided • Standardization of services and systems • Engagement of MOH at the local, regional and national levels Most Recent Results • October 2013 national Community Health Policy • April 2014 Five Year Strategic Plan for Community Health
  11. 11. Thank You