Getting more children into treatment: Improving CMAM referral uptake with systematic referral tracking and follow-up Meredith Dyson, MSPH CRS / Sierra Leone

Background CRS project in support of Ministry of Health and Sanitation with funding from UNICEF 450 CHWs covering 712 communities Supporting MOHS to scale up CMAM coverage

Referral Tracking System Two-part referral booklets used by CHWs – Referral slips detached and issued to caregivers – Matching ‘stubs’ remain with CHW Community-based records  Improved follow up with caregivers and facilities

How it works CHWs verify referrals against slips received at treatment center CHWs follow up with caregivers of referred children Barriers to referral uptake addressed with individual caregivers Distance / transport Opportunity cost Stock-out of RUTF Distance / transport Project staff assist when necessary Provide additional counseling Emphasize importance of referral Identify barriers

Conclusions Improved referral uptake: 69%  93% Credibility behind CHW- initiated referral Active monitoring Individualized support to overcome barriers, go the final mile Simple, low-tech solution can make a big difference

Next Steps Sustainability and Scale Review of system by MOHS, UNICEF, other implementing partners for feedback Integration between project-specific and national monitoring systems and tools Further Improvements mHealth for data reporting?? Stock-out alert system??