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MABAYI CHILD SURVIVAL
  PROJECT CIBITOKE
 PROVINCE, 
           BURUNDI
A Promising Approach to Care Groups
• Objective & Key Research
  Questions

• What are the two models

• What are the main difference
  between the models

• OR Study design

• Discussion of Preliminary
  Results
To test the effectiveness and sustainability of an
   Integrated Care Group Model to improve both
  knowledge and practice of key child health and
nutrition behaviors as compared to the Traditional
                 Care Group Model
   Does the Integrated Care Group Model achieve the same
    improvement in the knowledge of key child health and
    nutrition behaviors among caregivers of children 0-23 months
    as the Traditional Care Group Model?

   Does the Integrated Care Group Model achieve the same
    improvement in the practice of key child health and nutrition
    behaviors among caregivers of children 0-23 months as the
    Traditional Care Group Model?

   Does the Integrated Care Group Model achieve the same
    level of Care Group functionality as the Traditional Care
    Group Model?

   Does the Integrated Care Group Model achieve the same
    level of Care Group sustainability as the Traditional Care
    Group Model?
Traditional Model                     Integrated Model

Supervision                           • MOH Staff: support the CHWs
• Animators (Supervisors)-paid, NGO   • Animators (paid NGO staff): provide
  staff: supervise Promoters            oversight, supervision and follow-up
                                        at all levels
• Health Promoters-paid, NGO staff:
  motivate and supervise Care Group   • Each Community Health Worker
  Volunteers which includes CHWs        (CHW): motivates and supervises 2
                                        Care Groups

Training                              CHWs responsible for training Care
Care Group Volunteers and CHWs        Group volunteers and facilitating Care
trained by Health Promoters           Groups

                                      CHWs are trained by MOH staff
Traditional model




Integrated model
Janvier Niandwi-
Community Health Worker
Joseline
Akimana, Care Group
Volunteer
Traditional Care   Integrated Care          Comparisons
                         Group Model        Group Model

Collines of         13 Collines            16 Collines       Knowledge & practices of
comparable          5,344 HH               5,134 HH          key child health & nutrition
population          51 Care Groups         59 Care Groups    behaviors among caregivers
                                                             of children 0-23 months.

Support&            1    Animator          1 Animator/TPS    Functionality
Supervision              (Supervisor)      (MOH Staff)
                    6    Promoters
                         (1 per 9 CG)

Frequency of Care   Twice per month        Twice per month   Functionality
Group Training
                    Trained by Promoter    CHWs trained by
                                           MOH

CHW roles with CG   Participants           Trainers          Sustainability
                                           (1 or 2 per CG)
   13 out of 14 Titulaires interviewed commented on the
    strong working relationship with CHWs that has
    developed as a direct result of the MCSP

   CHWs and CGVs commented on how easily information
    is spread throughout their communities as a result of the
    Care Group network of volunteers

   Health center staff stated that information between the
    health center team and the communities now passes
    quickly and directly to those concerned
   Both models achieving high levels of efficiency
   In general traditional group performing more efficiently
   Not unexpected due to presence of Promoters
   Greatest difference in percentage of households
    receiving at least one visit per month
   Possible trade off between efficiency and potential
    sustainability
   Husbands
   Local
    administration
   Problems with
    CHWs
   Pressure for
    financial motivation
Anticipating an endline survey will be conducted in February
2013

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Improving Child Health in Burundi with Care Group Models

  • 1. MABAYI CHILD SURVIVAL PROJECT CIBITOKE PROVINCE,   BURUNDI A Promising Approach to Care Groups
  • 2. • Objective & Key Research Questions • What are the two models • What are the main difference between the models • OR Study design • Discussion of Preliminary Results
  • 3. To test the effectiveness and sustainability of an Integrated Care Group Model to improve both knowledge and practice of key child health and nutrition behaviors as compared to the Traditional Care Group Model
  • 4. Does the Integrated Care Group Model achieve the same improvement in the knowledge of key child health and nutrition behaviors among caregivers of children 0-23 months as the Traditional Care Group Model?  Does the Integrated Care Group Model achieve the same improvement in the practice of key child health and nutrition behaviors among caregivers of children 0-23 months as the Traditional Care Group Model?  Does the Integrated Care Group Model achieve the same level of Care Group functionality as the Traditional Care Group Model?  Does the Integrated Care Group Model achieve the same level of Care Group sustainability as the Traditional Care Group Model?
  • 5.
  • 6.
  • 7. Traditional Model Integrated Model Supervision • MOH Staff: support the CHWs • Animators (Supervisors)-paid, NGO • Animators (paid NGO staff): provide staff: supervise Promoters oversight, supervision and follow-up at all levels • Health Promoters-paid, NGO staff: motivate and supervise Care Group • Each Community Health Worker Volunteers which includes CHWs (CHW): motivates and supervises 2 Care Groups Training CHWs responsible for training Care Care Group Volunteers and CHWs Group volunteers and facilitating Care trained by Health Promoters Groups CHWs are trained by MOH staff
  • 11. Traditional Care Integrated Care Comparisons Group Model Group Model Collines of 13 Collines 16 Collines Knowledge & practices of comparable 5,344 HH 5,134 HH key child health & nutrition population 51 Care Groups 59 Care Groups behaviors among caregivers of children 0-23 months. Support& 1 Animator 1 Animator/TPS Functionality Supervision (Supervisor) (MOH Staff) 6 Promoters (1 per 9 CG) Frequency of Care Twice per month Twice per month Functionality Group Training Trained by Promoter CHWs trained by MOH CHW roles with CG Participants Trainers Sustainability (1 or 2 per CG)
  • 12. 13 out of 14 Titulaires interviewed commented on the strong working relationship with CHWs that has developed as a direct result of the MCSP  CHWs and CGVs commented on how easily information is spread throughout their communities as a result of the Care Group network of volunteers  Health center staff stated that information between the health center team and the communities now passes quickly and directly to those concerned
  • 13.
  • 14.
  • 15.
  • 16.
  • 17.
  • 18.
  • 19. Both models achieving high levels of efficiency  In general traditional group performing more efficiently  Not unexpected due to presence of Promoters  Greatest difference in percentage of households receiving at least one visit per month  Possible trade off between efficiency and potential sustainability
  • 20. Husbands  Local administration  Problems with CHWs  Pressure for financial motivation
  • 21. Anticipating an endline survey will be conducted in February 2013

Notas do Editor

  1. 2008 CSP Innovations Award
  2. reduce the dependence of Care Group implementation on full-time, paid NGO staff increasing integration with the local Ministry of Health (MOH) structure
  3. Groups of 10-15 women volunteers-elected by communityMeeting twice per months to be trained on health education/promotion topicsCollect information on vital events at the hhVolunteer is responsible for 10-15 HHs
  4. Streamlined into the MoHSystemAccomplished via task shiftingCHV serve as relays for CHWsincrease the feasibility of the Care Group Model to be scaled up and sustained, particularly by national Ministries of Health
  5. The aim is at the end of the program TPS will continue the role played by AnimatorsTask shifting element introduced in the integrated model
  6. Traditional care group members very keen to continue after project finished.
  7. Building relationshipsEase of information sharingImproved linkage between health center and communities