Vurhonga Expanded Impact CSPLessons Learned in Gaza Province, Mozambique

CORE Group Fall Meeting September, 15, 2010

Gaza Province, MozambiqueWR Moz CSHGP Districts

Vurhonga 1 : Guija & Mabalane

Vurhonga 2: Chokwe District

Expanded Impact (V4): Massangena, Chicualacuala, Chigubu, Massingir, & Chibuto Districts

Original Care Group Structure

World Relief MozambiqueVurhonga 1 CSP

1995-1999 • Each block of 10 HH had a volunteer

• Volunteers in Care Groups of 8-12 members• Full time, paid promoters (called animators) each

responsible for 8 Care Groups

• One supervisor for every 5 promoters

Expanded Impact Districts

• Lower population density

• Villages small in size and far apart

• Lower levels of literacy and education

• Stronger traditional beliefs

• Much longer distances to access treatment

• Limited public transportation

Changes in Promoter Role

• Recruited locally

• Not WR staff

• Paid a stipend per CG supervised

• Promoters responsible for limited number of

groups reachable by foot or by bicycle (1-3 vs

8)

Promoters in Expanded Impact

• Less formal education (limited

primary school)

• More entrenched in traditional

beliefs re: illness• Required more training to internalize and accurately transmit new health messages• Trained in Chokwe in all interventions up front; refresher training in respective districts

TradeoffsUpside• Cost savings - Stipend per Care Group vs. fulltime salaries - Reduced transport costs for promoter level• Promoters remain in village post-project

Downside• Overall increase in the number of promoters who need to be trained and supervised.

• Promoter performance reduced

 

Estimated Cost per Life Saved using the LiST Tool 

Vurhonga 1 $2600

Vurhonga 2 $2000

Expanded Impact $1640

Lessons Learned

1.Less “control” over part-time promoters resulted in reduced activity and impact on some behavior change indicators, though the inmpact (as estimated by the Lives Saved Calculator) was greater due to economies of scale.

Lessons Learned

2. Improved promoter selection could have taken place by engaging potential promoters in census and other preliminary activities prior to making a final decision on who to invest in promoter training.

Lessons Learned

3.Close, supportive supervision is essential.

2/3 of supervisor’s time was spent in the communities to enhance this.

Supervision was maximized by supervisors (all from Chokwe) spending three weeks straight in their supervision areas vs. weekly trips – needed because of distances.

Lessons Learned

4.Support from village leadership and health committees is important  for local ownership and problem resolution. 

Local data from the community and project HIS supported this further.

Thank You

The preceding slides were presented at theCORE Group 2010 Fall Meeting

Washington, DC

To see similar presentations, please visit:www.coregroup.org/resources/meetingreports