Revitalizing family planning in Christian Health Associations through community health workers and religious leaders
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Revitalizing family planning in Christian Health Associations through community health workers and religious leaders
- 1. Revitalizing family planning in Christian Health Associations through community health workers and religious leaders Lauren VanEnk, MPH Institute for Reproductive Health Georgetown University
- 2. Reach of CHAs across Africa
- 3. CHAK’s dream: • That family planning (FP) education and options will become easily accessible through a community-based distribution system • That FP will cease to be restricted to hospitals where it is offered as medical treatment but instead will be transformed into an opportunity for Family Centered Health Care • That FP will become a right for every woman and family - Dr. Samuel Mwenda, Director of CHAK and ACHA Platform
- 4. Mobilizing FBOs to expand access to and choice in FP Donor World Bank Christian Partners Christian Institute for Connections Health Reproductive for Association of Health (IRH) International Kenya (CHAK) Health (CCIH) Strengthen the capacity of Christian Health Associations to Goal improve access to FP information and services, emphasizing opportunities for regional scale-up.
- 5. Project Objectives 1. Strengthen FP service delivery – TOT for master trainers – Facility-based Trainings – Community-based Trainings 2. Sensitize Religious Leaders – Develop IEC materials for FBO context – Informational workshops for pastors 3. Strengthen reporting process – Develop CHW reporting tools – Ensure supportive supervision provided to CHWs 4. Develop capacity building strategy for regional implementation – Introduce project at regional conference in Ghana – Disseminate model at an end of project workshop
- 6. Pilot introduction of community- based FP through CHAK facilities • 67 community health workers (CHWs) trained to provide FP information and methods • CHWs distributed pills, condoms, Standard Days Method® (SDM)/ CycleBeads®, Lactational Amenorrhea Method (LAM), referrals to facility for all other methods • SDM was introduced for the first time as a new method, bringing new users to FP
- 7. Capacity Building Strategy components Establish Create a Ongoing Establish Supportive Training Reporting Supervision 5 Supply Chain Environment Mechanism of CHWs Capacity Building Strategy In order for project This capacity building strategy Project managers/ To create a CHWs attend to be relies on a training curriculum supervisors must supportive supervision visits successful, CHWs for CHWs based on the WHO ensure CHWs are able environment for FP monthly to submit must have access to flipchart for FP provision. to complete FP reports. provision at the reporting FP supplies. community level, a forms, receive Activities Supervisors are equipped to It is equally important one-day workshop resupplies of FP provide this training as well as that facilities readily with pastors is commodities (if ongoing supervision to CHWs. receive CHW reports conducted. possible), and and record them in receive support and their service statistics. Pastors create action refresher plans detailing how instruction on they will use this knowledge gaps. information with their congregations. • CHW Curriculum • Reporting forms • Bible Study guide • Supervision • Presentations, including • WHO flipchart for checklist • Knowledge Tools HTSP FP provision • WHO flipchart for FP • HTSP Improvement provision presentation Tool • Client cards
- 8. Establish Supply Chain Must Haves: • Pills, condoms, and CycleBeads at the community level • Stakeholder involvement
- 9. Training Must Haves: Tools: • Work with existing • CHW Curriculum cadre of CHWs • Presentations, including HTSP • WHO flipchart for FP provision • Client cards
- 10. Establish Reporting Mechanism Must Haves: Tools: • Tested reporting forms • Reporting forms • Facility staff understands their role • MOH buy-in
- 11. Create a Supportive Environment Must Haves: Tools: • Pastors willing to share • Bible study guide health information with • WHO flipchart for FP their congregations provision • HTSP presentation
- 12. Ongoing Supervision of CHWs Must Haves: Tools: • Stakeholder • Supervision checklist involvement • Knowledge • Incentive for CHWs Improvement Tool • Capable supervisors equipped to support CHWs
- 13. Capacity Building Strategy components Establish Create a Ongoing Establish Supportive Training Reporting Supervision 5 Supply Chain Environment Mechanism of CHWs Capacity Building Strategy In order for project This capacity building strategy Project managers/ To create a CHWs attend to be relies on a training curriculum supervisors must supportive supervision visits successful, CHWs for CHWs based on the WHO ensure CHWs are able environment for FP monthly to submit must have access to flipchart for FP provision. to complete FP reports. provision at the reporting FP supplies. community level, a forms, receive Activities Supervisors are equipped to It is equally important one-day workshop resupplies of FP provide this training as well as that facilities readily with pastors is commodities (if ongoing supervision to CHWs. receive CHW reports conducted. possible), and and record them in receive support and their service statistics. Pastors create action refresher plans detailing how instruction on they will use this knowledge gaps. information with their congregations. • CHW Curriculum • Reporting forms • Bible Study guide • Supervision • Presentations, including • WHO flipchart for checklist • Knowledge Tools HTSP FP provision • WHO flipchart for FP • HTSP Improvement provision presentation Tool • Client cards
- 14. Change in Pill Use and SDM/CycleBeads Use Pre and Post Community-based FP Provision 3500 350 3000 300 2500 250 2000 200 Jan-Feb 1500 150 2011 100 Jan-Feb 1000 2012 500 50 0 0 Pills dispersed CycleBeads dispersed Statistics from Chogoria Presbyterian Hospital
- 15. Changes in Injectable, IUD, and Implant Use Pre and Post Community-based FP Provision 1300 25 20 1250 20 15 1200 15 1150 10 10 1100 5 1050 5 0 1000 0 Implants Injectables IUDs dispersed dispersed dispersed Statistics from Chogoria Presbyterian Hospital
- 16. Lessons Learned • No Product, No Program • Lay the ground work: advocacy and stakeholder involvement is crucial • Expanding the method mix at the community level can increase method use and bring new users to FP
- 17. Thank you!
Notas do Editor
- You can see here the 5 components of the strategy which are outlined in greater detail in a forthcoming report.
- You can see here the 5 components of the strategy which are outlined in greater detail in a forthcoming report.
- No Product, No Program. This couldn’t be more applicable for community-based family planning programs. Success hinges on the availability of family planning supplies, and CHWs rely on supervisors and project managers to ensure their availability. Stockouts are a common problem in most countries and even moreso within most CHAs. Special attention must be paid to addressing stockouts before the project begins, not after/during because then it is too late. If no formal CHW training program exists in-country, special attention must be given to communicating with ALL stakeholders about the project. Emphasis the credibility of CHWs to provide FP and distribute supplies. Ensure that facilities incorporate CHW reports into facility statistics submitted to the district and national level. This is especially important if CHWs in church-based networks visit government facilities rather than CHA facilities to pick up supplies and turn in reports.Introducing SDM in project sites brought renewed interest to family planning use. Project results showed that use of pills more than tripled as compared to the previous year, and uptake of CycleBeads--which was added to the method mix for the first time--was high. Use of implants and injectables also increased, indicating that the CHWs are referring clients to health facilities for methods they are not able to provide at the community level.