Community based model on use of Community Health Workers (CHWs) 2nd World Breastfeeding conference Hlamalani Mabasa PATH South Africa 14 December 2016

Presentation outline Introduction Community Based Organization Model Process of engaging CBOs Capacity Building of CHWs Community based MNCHN Interventions CBO Model management tools Success factors for CBO model Lessons Learnt 1/17/2019

Intrapartum & Neonatal Periods Introduction Funded by BHP Billiton Sustainable Communities to implement “Window of Opportunity” project Goal: To improve health and development of children aged 0-2 years in four districts (UThungulu, Nkangala, Sedibeng and John Taole Gaetsewe) Antenatal Period Intrapartum & Neonatal Periods Infancy Early Childhood

Community Based Organization Model One of the objectives: To increase positive behaviors among caregivers that impact the health and development of children aged 0-2. (community based activities) Aimed at engaging the community through community based organizations (CBOs) to create awareness and advocate on: Early antenatal care booking Use of postnatal care services Exclusive breastfeeding and Early Childhood Development messages 1/17/2019

Process of engaging CBOs Identification of CBOs to be funded by PATH was done through collaboration and recommendation with Department of Health (DOH) in the districts Providing CBO sub-grants CBO capacity building Conducting household, facility and community-based health education and promotion Sub-contract community based organizations and build their capacity on MCHN-ECD program Conducting household-based health education and Health promotion Conducting facility-based health education and health promotion Conducting community based health education and health promotion

Capacity Building of CHWs Focused on MNCHN Continuum of Care Antenatal Period Intrapartum & Neonatal Periods Infancy Early Childhood

Community based MNCHN Interventions Community Mapping Home visits Household registrations and classification Red Household (High Risk) Orange Household (Moderate Risk) Green Household There are sick children (0-2 years in household) Members of child bearing age has missed her last menstrual period. Member has not yet reported/booked to the clinic (unconfirmed pregnancy) ANC client missed ANC clinic appointment PNC client missed clinic appointment There are children between 0-2 years in household Members are within the child bearing age but have not missed last menstrual cycle Pregnant members have an ANC card and are well PNC client has been for clinic appointment   There are no children between 0-2 years in the household Adults are not within the child bearing age (15-49 years) CHWs had to register and classify household, based on who lived there and the state of their health.

Community based MNCHN Interventions Facility based education Group education Single encounter sessions Community based education Learning groups - Single encounter Learning groups -Triple Encounter Community dialogues Mass education Other rcommunity education activities Triple encounter e.g. breastfeeding Session 1: Benefits Session 2: How to breastfeed Session 3: Dealing with challenges e.g. going back to work

CBO Model management tools CBO grants management guidelines Data collection and reporting tools Content reminder tools (MCHN flipchart, ECD poster) Monthly refresher sessions and mentoring on MCHN and ECD content for CHWs Quarterly review sessions on financial & organizational management Community mapping procedures and tools Household registration tools Household visit data collection tools Household visit tracking tool Facility health education materials Community health education materials Monthly reporting tools and guides

Success factors for CBO model Customized project tools based on community needs at household level Data capturing-Home visits Activity tracking-Home visits Reporting tools –Weekly & Monthly Monitoring- Monthly & Quarterly Financial accountability (tracking good and poor performance) Continuous skills transfer and strengthening Computer skills Financial management skills Presentation skills Evidence of upward trends on MNCHN indicators in facilities linked to PATH funded CBOs Model designed to support multi-sectoral approach in communities CBO link with DOH public health facilities and performance of facility based health education Model is MNCHN & ECD focused producing knowledgeable CHWs who end up teaching their peers from other CBOs It’s a replicable model which is easy to learn and implement to improve MCHN coverage

Lessons Learnt Communities learn better when taught by peers within their own settings Collaboration with CBO`s assists in improving coverage of MCHN messaging at community level Partnership with key department(DOH, DSD, LG) and referral loop is critical in strengthening community and health facility interventions Continuous funding is necessary to keep CHWs with current information and support their activities in the communities

Acknowledgement BHP Sustainable communities PATH Window of Opportunity project team Community Based Organizations DOH for support and good collaboration 1/17/2019

Thank you   1/17/2019