Introducing Community Health Agentsto accelerate achievement of MDGs 4 and 5                in Tanzania:          The Conn...
Core Aspects of the CHA Role1) Improve household and community practices and   capacity to support maternal and child heal...
Household and Community PracticesRoutine household distribution of key household health “technologies” that prevent illnes...
Household and Community PracticesEducation and counseling regarding key aspects of reproductive and child health  • Child ...
Household and Community PracticesPregnancy monitoring visits during antenatal period   • Promotion of antenatal care and f...
Household and Community PracticesPostnatal/partum visits for both mother and newborn   • Counseling on essential newborn c...
Community Case ManagementTraining in CHAs in Integrated Case Management  • Ability integrate disease specific guidelines i...
Community Case ManagementRoutine Household Visits to Assess U5 Children for  Major Symptoms   • Cough or difficulty breath...
Community Case ManagementProvision of complete treatment and follow up to children  with uncomplicated illnesses:   • Mala...
Local Health System StrengtheningFacilitate Access to Additional Support and Financing  Mechanisms:   • Community mobiliza...
Local Health System StrengtheningLinking district-level and village planning and  organization:   • Provide organizational...
Local Health System StrengtheningImprove quality of data on community health information  and reporting mechanisms:   • Tr...
Enabling                                                         CHA intervention                                       …g...
Upcoming SlideShare
Loading in …5
×

The Role of CHAs

230 views

Published on

Published in: Health & Medicine, Business
0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total views
230
On SlideShare
0
From Embeds
0
Number of Embeds
18
Actions
Shares
0
Downloads
5
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide
  • We should make handouts of the interventions…
  • Key aspects of RCH: Child growth, development and recognition and management of illness;NutritionWater, sanitation and hygieneReproductive health, including family planning and STI preventionTuberculosis and malaria preventionPregnancy monitoring visits during antenatal period:Promotion of antenatal care and facility-based delivery Counseling on danger signs of complications, nutrition and post-partum family planning Birth planning and emergency preparations Monitoring and reminders for net use and IPTp, TT and PMTCT adherence Identification and referral for complications
  • Introduce a community health agent (CHA) with necessary system supports:To improve access to MNCH services through community-based care and referral systems with a focus on equity To extend the range of MNCH services available, particularly as relates to promotive and preventive servicesTo improve the quality of services through contextually appropriate and people-centered care and improved information on community health status and needsTo increase efficiency of the health system through task-shifting to CHAs
  • The Role of CHAs

    1. 1. Introducing Community Health Agentsto accelerate achievement of MDGs 4 and 5 in Tanzania: The Connect Project The Role of the CHA intervention in Community-based Primary Health Care
    2. 2. Core Aspects of the CHA Role1) Improve household and community practices and capacity to support maternal and child health and child development.2) Enhance community-based case management of childhood illnesses when illness/injury does not require facility attendance.3) Strengthen the health system by way of facilitating accessibility of drugs and supplies where needed, improving organization of work from the community- level up, including monitoring, supervision and referral. Training Module on IMCI and Community IMCI Implementation, MoH Tanzania, 2004 2
    3. 3. Household and Community PracticesRoutine household distribution of key household health “technologies” that prevent illness • Insecticide treated bednets • Condoms • Oral contraceptives (use of DMPA-Uniject under negotiation with PATH) • Soap and hygienic supplies
    4. 4. Household and Community PracticesEducation and counseling regarding key aspects of reproductive and child health • Child growth, development and management of illness • Nutrition (including micronutrient and complementary feeding) • Water, sanitation and hygiene • Reproductive health • HIV/AIDS and STI Prevention • Tuberculosis and malaria prevention 4
    5. 5. Household and Community PracticesPregnancy monitoring visits during antenatal period • Promotion of antenatal care and facility-based delivery • Counseling on danger signs of complications, nutrition and post-partum family planning • Birth planning and emergency preparations • Monitoring and reminders for net use and IPTp, TT and PMTCT adherence • Identification and referral for complications • Promote male active participation and child care and Reproductive Health
    6. 6. Household and Community PracticesPostnatal/partum visits for both mother and newborn • Counseling on essential newborn care • Identification and referral for complications • Promotion of postpartum/natal care • Identification of LBWs using foot size • Family planning • Monitoring/reminders for early diagnosis of HIV 6
    7. 7. Community Case ManagementTraining in CHAs in Integrated Case Management • Ability integrate disease specific guidelines into a comprehensive and efficient process for attending sick children. • Understanding of protocols for assessment for symptoms, and danger signs in sick children. • Recognition of less common illnesses or chronic problems that may require clinical care or be managed in community (routine injuries, etc.) 7
    8. 8. Community Case ManagementRoutine Household Visits to Assess U5 Children for Major Symptoms • Cough or difficulty breathing, diarrhea, fever, ear problems, bacterial infection, nutritional, immunization and Vitamin A status, etc. • Identification of select clinical signs for classification (not diagnosis): • Urgent Referral to clinical level of care • Initiation of specific treatment using limited number of essential drugs • Home treatment, counseling/education of caretakers, including active participation in treatment of children. 8
    9. 9. Community Case ManagementProvision of complete treatment and follow up to children with uncomplicated illnesses: • Malaria – dependent on national supply and scale up of Rapid Diagnostic Tests (RDT); treat with SP and Paracetamol • Pneumonia: using ARI timers (detection) and Cotrimoxazole • Diarrhea: Oral Rehydration Therapy with zinc and extra fluids. • Malnutrition: Increased breasfeeding, extra feeds (if on complementary feeding. • Referral to facility when appropriate. 9
    10. 10. Local Health System StrengtheningFacilitate Access to Additional Support and Financing Mechanisms: • Community mobilization for enrollment in National Health Insurance/Community Health Funds • Education and identification of households eligible for fee exemptions, facilitate their acquisition of CHF cards and care- seeking support. • Identification of vulnerable households and facilitate access to additional support services (e.g. families affected by disability, aging household members, chronic illness, poor water and sanitation, etc.) 10
    11. 11. Local Health System StrengtheningLinking district-level and village planning and organization: • Provide organizational support with facility management and village health committees. • Represent and encourage involvement of village health committees for immunization, Vitamin A, ANC, and reproductive health community outreach. • Develop and sustain emergency referral mechanisms. • Communicate district and village health agenda to the community and ensure accountability • Participate in maternal and newborn death audits. 11
    12. 12. Local Health System StrengtheningImprove quality of data on community health information and reporting mechanisms: • Training and follow up support to facility-based supervisors for supportive supervision of the CHA. • Facilitate the CHA collection, management and utilization of health data for decision-making. • Identify and address bottlenecks in the supply chain of essential drugs and commodities and integrate the community into that process. • Reports summary information to village health committees, encourages communities to advocate for health rights to decision makers. 12
    13. 13. Enabling CHA intervention …generate sub-system system integrates pillars, links inputs… outcomes… inputs to impactIntegrated service components: …that alter the CHA package of services + climate of CHA emergency referral system Enhanced demand for INTRODUCTION access: services Health workforce: Community …impact on CHA training, deployment and -based services health supervision behavior, and Extended Improved …. Information: range of equityData collection + feedback tools for services: CHAs Enhanced Promotion/ prevention Health Medicines, Vaccines, etc: Service Supply chain management for Improved Utilization essential commodities for CHAs quality of services: ImproveFinancing & social protection: Reduced Improved People-Financing of programme + role of centred social wellness Child CHA in expanding protections costs and behavior Improved Leadership & governance: efficiency: maternal CHAs relationship with local Task- survival governance structures & planning shifting

    ×