31st January-2nd February 2007 CHF best practice WS, Golden Tulip Hotel, DSM0 CHF best practices workshop Muheza District Community Participation in CHF Dr Shaaban Sheuya, CRTOP, TNCHF

31st January-2nd February 2007 CHF best practice WS, Golden Tulip Hotel, DSM1 CHF Muheza - “Community Participation” In its effort to innovate and make CHF more community-owned, Muheza District has introduced the concept of CHF Agents and Promoters This way it is no longer health workers collecting CHF funds and government officials informing on CHF membership - but it is staff selected by the community They are based at the health facility Their work is exclusively dedicated to CHF

31st January-2nd February 2007 CHF best practice WS, Golden Tulip Hotel, DSM2 Muheza District: CHF Agents and Promoters CHF Agents are the actual collectors and administrators of CHF funds Responsible for enrolment of new members and for giving further CHF information They also promote CHF at facility level Agents are full-time staff at facility level and remunerated on bases of their collected CHF funds (a District-wide agreed proportion) CHF agents are self employed and remunerated according to performance and workload They are accountable to the HFGC and to the CHF management CHF Agents work in close collaboration with the CHF Promoters

31st January-2nd February 2007 CHF best practice WS, Golden Tulip Hotel, DSM3 Muheza District: CHF Agents and Promoters CHF Promoters are community based - responsible to create awareness of the CHF concept among local communities at village level Work on voluntary commitment and together with other influential people in the villages, such as: village leaders, religious leaders and any active NGOs in the locality of their duty. They refer interested people to the CHF agents at health facility level for enrolment and membership fee payment. In Muheza, 175 CHF promoters would cover 175 villages

31st January-2nd February 2007 CHF best practice WS, Golden Tulip Hotel, DSM4 Muheza District: CHF Agents and Promoters CHF Agents and Promoters need to collaborate with each other The promoters market the idea of CHF to the community and once these want to join CHF the agents register them and collect their membership fees The success of the agent depends on the work done by the promoter The idea behind those roles: reduce the workload of health workers and allow them to focus on their actual activities Have workers in place specifically accountable to CHF issues, rendering the process of fund collection and promotion more efficient

31st January-2nd February 2007 CHF best practice WS, Golden Tulip Hotel, DSM5 CHF Muheza - Challenges of CHF Agent and Promoter System Keep agents and promoters motivated to do their work District needs to ensure that agents are remunerated on time Give appropriate non-financial incentives to the promoters Train them appropriately so they understand the CHF concept well and their duties

31st January-2nd February 2007 CHF best practice WS, Golden Tulip Hotel, DSM6 CHF Muheza - Recent Study Findings on CHF Promoters (opinions from Mihinduro Village) Best Promoters Religious leaders, influential people, Youth, Drama Groups, teachers, CHF members, MASKANI YA KAHAWA (people attending popular meeting places) Qualities of a good promoter hard working and committed, able to convince others, accepted by the community, known by many people educated to at least primary level Acceptable Non-Financial Incentives Free CHF membership card, promotion materials, transport, uniforms, media material, gum boots etc

31st January-2nd February 2007 CHF best practice WS, Golden Tulip Hotel, DSM7 CHF Muheza - Recent Study Findings on CHF Promoters (opinions from Mihinduro Village) Community Based Distributors as CHF Promoters? 11 CBDs operating in Muheza District Promotion activities relate to reproductive health Promotion via mass meetings, house to house visits, social gatherings, religious buildings and schools All CBDs are trained in respective areas of promotion Incentives are non-financial: fast-track access to health services, transport, rain boots, umbrella, promotion materials, uniforms and identity card, stationary etc.

31st January-2nd February 2007 CHF best practice WS, Golden Tulip Hotel, DSM8 CHF Muheza - Recent Study Findings on CHF Promoters (opinions from Mihinduro Village) Community Based Distributors as CHF Promoters Could CBDs also take over the task of CHF Promotion? Can their experience be used for CHF? Generally 11 interviewed CBDs are willing to take on the additional CHF promotion duty

31st January-2nd February 2007 CHF best practice WS, Golden Tulip Hotel, DSM9 CHF Muheza - Recommendations Mihinduro study shows that besides local leaders also other persons and groups of people in local communities would make good promoters It is a good idea to involve the local community closely in the selection of CHF Promoters The kind of non-financial incentives for such promoters could be the same as for interviewed CBDs An additional incentive for promoters should be free CHF membership cards

31st January-2nd February 2007 CHF best practice WS, Golden Tulip Hotel, DSM10 CHF Muheza Envisaged Way Forward Select two villages in Muheza District to test the involvement of CBDs in CHF promotion activities Implement the recommended non-financial incentives to motivate promotion activity Monitor this approach and evaluate its effectiveness