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PSI’s experience in Community Case Management programs Megan Wilson, Child Survival Program Manager CoreGroup Spring Meeti...
<ul><li>PSI’s work </li></ul><ul><li>To improve health of low-income population through behavior change communication and ...
PSI’s Role in Preventing Child Deaths <ul><li>3 rd  cause (8%): Malaria prevention / treatment </li></ul><ul><li>2 nd  cau...
<ul><li>Promotion of household water treatment and hand washing </li></ul><ul><li>Early treatment of diarrhea at home / co...
<ul><li>Improved nutrition of infants through Sprinkles promotion </li></ul><ul><li>Treatment of pneumonia at the communit...
Communications + Product = Healthy Behavior
So what does PSI do around CCM? <ul><li>Training and equiping  Community Health workers in rural area to assess fever, cou...
<ul><li>Experience in Myanmar </li></ul><ul><li>«   Village-based Community Health Workers » from the Sun Primary Health n...
<ul><li>Madagascar </li></ul><ul><li>Children under five with:  </li></ul><ul><li>non-severe pneumonia </li></ul><ul><li>d...
<ul><li>Uganda </li></ul><ul><li>Public «  Village Health Teams  » will receive training and supervision to identify and r...
<ul><li>CIDA CCM Program </li></ul><ul><li>To learn how best to scale-up delivery of ACTs, antibiotics and ORS/ZN to ensur...
Cameroun <ul><li>Target Group : 2.1 M </li></ul><ul><li>What : Scale-up delivery of ACTs, Pilot delivery of antibiotics an...
Democratic Republic  of  Congo  <ul><li>Target Group:  1.5 million people  </li></ul><ul><li>What : To learn how best to s...
Malawi <ul><li>Target Group:  1.7 million people  in 5 districts in Malawi </li></ul><ul><li>What:  To learn how best to s...
Mali <ul><li>Target Group :  Over a population 2.22 M in Segou  </li></ul><ul><li>What : S cale-up delivery of Home Manage...
<ul><li>Progress to date </li></ul><ul><li>Reduction in: </li></ul><ul><ul><li>Severe dehydration  </li></ul></ul><ul><ul>...
<ul><li>Challenges and Lessons learned </li></ul><ul><li>On-going  communications  about CHW services needed with target g...
<ul><li>Challenges and Lessons learned continued </li></ul><ul><li>Monitoring & evaluation  is essential for programmatic ...
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PSI’s experience in Community Case Management programs

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PSI’s experience in Community Case Management programs

Megan Wilson, Population Services International

CORE Group Spring Meeting, April 28, 2010

Published in: Health & Medicine
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PSI’s experience in Community Case Management programs

  1. 1. PSI’s experience in Community Case Management programs Megan Wilson, Child Survival Program Manager CoreGroup Spring Meeting, April 2010
  2. 2. <ul><li>PSI’s work </li></ul><ul><li>To improve health of low-income population through behavior change communication and increased access to health-related products; </li></ul><ul><li>Traditional delivery models are: </li></ul><ul><li>(i) social marketing </li></ul><ul><li>(ii) franchised clinic and </li></ul><ul><li>(iii) free distribution campaign; </li></ul><ul><li>Recently, focus on accelerating Child Survival by integrating life-saving interventions through community case management of common childhood illnesses. </li></ul>page
  3. 3. PSI’s Role in Preventing Child Deaths <ul><li>3 rd cause (8%): Malaria prevention / treatment </li></ul><ul><li>2 nd cause (17%): Diarrhea prevention / treatment </li></ul><ul><li>1 st cause (19%): Pneumonia treatment </li></ul>
  4. 4. <ul><li>Promotion of household water treatment and hand washing </li></ul><ul><li>Early treatment of diarrhea at home / community </li></ul>Diarrhea prevention & treatment
  5. 5. <ul><li>Improved nutrition of infants through Sprinkles promotion </li></ul><ul><li>Treatment of pneumonia at the community level through antibiotics </li></ul>Pneumonia Management & Nutrition
  6. 6. Communications + Product = Healthy Behavior
  7. 7. So what does PSI do around CCM? <ul><li>Training and equiping Community Health workers in rural area to assess fever, cough with fast-breathing and diarrhea in children and determine treatment or whether a referral to a health facility is needed; </li></ul><ul><li>Regular supervision in partnership with local health authorities and partners </li></ul>page
  8. 8. <ul><li>Experience in Myanmar </li></ul><ul><li>«   Village-based Community Health Workers » from the Sun Primary Health network identify, assess and refer cases of pneumonia to Sun Quality Health franchised clinic network where pre-packaged ATB treatment is provided. </li></ul>page
  9. 9. <ul><li>Madagascar </li></ul><ul><li>Children under five with: </li></ul><ul><li>non-severe pneumonia </li></ul><ul><li>diarrheal diseases and </li></ul><ul><li>non-severe malaria: </li></ul><ul><li>in rural settings are managed by Community Health Workers using respectively pre-packaged treatment. </li></ul>page
  10. 10. <ul><li>Uganda </li></ul><ul><li>Public «  Village Health Teams  » will receive training and supervision to identify and refer sick child to private health providers </li></ul><ul><li>These private health providers are part of PSI’s franchised clinic network ProFam . The patient will be referred and receive adequate treatment developed by PSI. </li></ul>page
  11. 11. <ul><li>CIDA CCM Program </li></ul><ul><li>To learn how best to scale-up delivery of ACTs, antibiotics and ORS/ZN to ensure maximum impact on overall child mortality, </li></ul><ul><li>Hope to avert 27,800 deaths overall </li></ul><ul><li>Through Integrated management of childhood illnesses by «   Health Security Agents » in Malawi and Community Health Volunteers in DRC , </li></ul><ul><li>And Home Management of Malaria in under five by « Community Volunteers » in Mali and « Community Relay Agents » in Cameroun </li></ul>page
  12. 12. Cameroun <ul><li>Target Group : 2.1 M </li></ul><ul><li>What : Scale-up delivery of ACTs, Pilot delivery of antibiotics and ORS/ZN </li></ul><ul><li>How: Community Outreach Agents  </li></ul><ul><li>Goal: Avert an estimated 4,114 deaths </li></ul>page
  13. 13. Democratic Republic of Congo <ul><li>Target Group: 1.5 million people </li></ul><ul><li>What : To learn how best to scale-up delivery of ACTs, antibiotics and ORS/ZN to ensure maximum impact on overall child mortality, </li></ul><ul><li>How: Through Integrated management of childhood illnesses by Community Health Volunteers, </li></ul><ul><li>Goal: Avert an estimated 5,361 deaths </li></ul>page
  14. 14. Malawi <ul><li>Target Group: 1.7 million people in 5 districts in Malawi </li></ul><ul><li>What: To learn how best to scale-up delivery of ACTs, antibiotics and ORS/ZN to ensure maximum impact on overall child mortality, </li></ul><ul><li>How: Through Integrated management of childhood illnesses by «   Health Security Agents » </li></ul><ul><li>Goal: Avert an estimated 3,927 deaths </li></ul>page District Population Hospitals H/ Centres HSAs Villages households Machinga 488996 1 21 370 897 115136 Zomba Rural 583167 5 28 640 1539 142394 Thyolo 514138 3 39 580 456 142039 Mwanza 94476 1 4 269 156 47433 Neno 108897 1 9       Total 1789674 11 101 1859 3048 447002
  15. 15. Mali <ul><li>Target Group : Over a population 2.22 M in Segou </li></ul><ul><li>What : S cale-up delivery of Home Management of Malaria (HMM) </li></ul><ul><li>How: Delivering 1,655,000 ACTs by « Community Volunteers » </li></ul><ul><li>Goal: Avert an estimated 14,392 deaths </li></ul>page
  16. 16. <ul><li>Progress to date </li></ul><ul><li>Reduction in: </li></ul><ul><ul><li>Severe dehydration </li></ul></ul><ul><ul><li>Severe malaria cases, </li></ul></ul><ul><ul><li>Reduction in transfusions </li></ul></ul><ul><li>have been reported by health facilities staff in settings PSI’ CCM interventions are implemented </li></ul><ul><li>On going health impact research will tell us much more over the couple of years </li></ul>page
  17. 17. <ul><li>Challenges and Lessons learned </li></ul><ul><li>On-going communications about CHW services needed with target groups </li></ul><ul><li>Drug Stock-out could be avoided by ensuring health center staff which are responsible for CHW supervision and replenishment are supportive, </li></ul><ul><li>CHW Training & Refreshers needs to be rigourous so that case management algorithm can be done correctly, </li></ul>page
  18. 18. <ul><li>Challenges and Lessons learned continued </li></ul><ul><li>Monitoring & evaluation is essential for programmatic improvements </li></ul><ul><li>Partnership is critical and roles need to be clearly defined throughout the management system </li></ul><ul><li>CHW need to be empowered to highlight when they more commodities, support and training </li></ul><ul><li>Communication channels / means need to be established and maintained </li></ul>page

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