Community health systems strengthening in Petit-Goave, Haiti_Sankar
-
Upload
core-group -
Category
Government & Nonprofit
-
view
183 -
download
0
description
Transcript of Community health systems strengthening in Petit-Goave, Haiti_Sankar
Community health systems strengthening in Petit-Goave, Haiti
Girija Sankar
Associate Director
Global Health Action Atlanta GA, USA & Port-au-Prince, Haiti
Objectives of Panel :
• Objective 1: By the end of this session, participants will have greater appreciation for the need to engage Ministries of Health, local NGOs, and Faith-based institutions in identifying innovative ways of expanding community volunteers as links to the formal health services
• Objective 2: By the end of this session, participants will have learned about efforts to repurpose existing cadres such as Traditional Birth Attendants to achieve greater community acceptance and use of health services.
• Objective 3: By the end of this session, participants will compiled a set of critical considerations for external organizations to draw upon when developing community based health volunteers.
Presentation outline:
Background
Framework for a functioning health system
Working with Institutions
Working with community health providers
Critical considerations
Background
2004-2010, USAID-funded maternal and child health project in partnership with faith-based organization and Ministry of Health.
Petit-Goâve commune
HAITI
Source: Google Maps
Basic Indicators for Haiti Country Data
Population 10M
Birth Rate 26
NMR 25.5
Facility Birth 36%
Skilled Birth Attendants 37%
Source: UNICEF, WHO
Program Area: Petit-Goave commune
• Total population of 157,296
• 68 km west of Port-au-Prince.
• 25% of women of reproductive age
Child Survival Project, 2004-2010
MAIN OBJECTIVES:
• Improve the quality of pre- and post-natal/infant services.
• Improve access to pre- and post-natal/infant services.
• Establish a local network of referral services that provide quality maternal and neonatal care.
GOAL: Contribute to reduction of maternal and infant mortality in Petit-Goâve commune.
Interventions • Health promotion by Community Health Workers (CHWs)
• Birth attendance by trained Traditional Birth Attendants (TBAs)
• Facility-based care (HIV testing & counseling; STI counseling)
• Mobile health services
Positive Outcomes(highlights) • Trained network of community health providers
• Community health services complimented by facility-based services
• Community mobilization
Challenges
• Resource-poor institutional mechanisms
• Vertical program not sustainable without strong foundations of a community health system
• CHWs integrated into project from past MOH initiatives
Functioning Community Health System: A Framework
• Partnership between health facilities and the communities they serve
• Appropriate and accessible health care and information from community based providers
• Collaboration between state, facility, community-based providers and the communities through community associations
Ref: CORE group (http://coregroup.org)
What’s different now? 2014-
Working with Institutions
• Administration and infrastructure support for MOH
• Proactively seeking MOH input and feedback for program activities
• Working with village/community health committees
• Helping faith-based partner set up a health board to oversee and coordinate health activities
Working with community providers
Traditional Birth Attendants:
• TBAs supported by community
• Open to training and skill building
• Challenge: not recognized by health system
Working with community providers (cont.)
Community Health Workers:
• In many instances CHWs are not necessarily “chosen” by community
• Tend to be elected or nominated officials; representatives of municipal government; faith-based leaders; spiritual healers
Critical considerations for developing community based health systems & providers:
• Long term support for health systems
• Innovative ways to support CHWs
• Greater engagement with/of TBAs
• Getting the community back in community-based
• Network at all levels of MOH
Funding & Implementing Partners