The role of community health workers in covid 19
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This power point outlines key roles of community health workers also referred to as village health teams in the fight against covid-19. We share practical experiences from ACCESS Uganda (accessuganda.org).
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The role of community health workers in covid 19
- 1. The Role of Community Health workers in Covid-19 Robert Kalyesubula, MD President, ACCESS Uganda Senior Lecturer, Makerere University Email: rkalyesubula@gmail.com Website: http://accessuganda.org/
- 2. Talk outline • Covid-19 pandemic • Health care system of Uganda • Ugandan response • CHW matrix • ACCESS Uganda-case study
- 3. Covid-19 Global Pandemic- Sept 2020 • Cases by Country/Region/Sovereignty • 7,032,595 US • 5,818,570 India • 4,689,613 Brazil • 1,131,088 Russia • 798,317 Colombia • 794,584 Peru • 720,858 Mexico • 716,481 Spain • 691,235 Argentina • 668,529 South Africa • 552,421 France Global Cases 32,476,713
- 4. Uganda the Pearl of Africa • Land Locked country-EA • Has Lake Victoria and source of the Nile • Equator • Popn. of 45,741,007 • 78% of popn are below 30yrs • 74.6% live in rural areas • Warm and welcoming people World Population Specs, 2019, World Bank, GeoNames
- 5. Health care system organization in Uganda Target Population (administrative)
- 6. Covid-19 Uganda - Sept 2020
- 8. The challenge • Africa has 3% of the world’s health workforce but 25% of world’s burden of disease • Shortages more pronounced in rural areas • The pandemic is world wide devastating donors too • Inequalities aggravated by PPE global shortages • CHWs/VHTs well recognized by Uganda MoH but not renumerated • Medical care is mainly hospital centered rather than community centered • Initial response of government excluded many players-NGOs & private sector • Rural areas will not be spared Maddison AR, 2010; Ballard M et al 2020,
- 9. Projected model spread from urban to rural areas Ballard M et al, BMJ Glob Health. 2020; 5(6): e002550.
- 10. How can we address this challenge?
- 11. Community Health Worker Assessment and Improvement Matrix (CHW AIM) WHO, 2011, Crigler L, 2011, Ballard M et al 2018 1. Role and Recruitment 6. Incentives 2. Training 7. Community Involvement 3. Accreditation 8. Opportunity for Career Advancement 4. Equipment and Supplies 9. Data (flow) 5. Supervision 10. Linkages to National Health System
- 12. Framework for CHWs for Covid-19 PROTECT Health Workers INTERRUPT the Virus MAINTAIN health services while surging their capacity SHIELD the vulnerable Ballard M et al, 2020
- 13. ACCESS Uganda Case- Study Who is a CHW ? A Community Health Worker (CHW) is a frontline public health worker who is a trusted member of and has an unusually close understanding of the community served.
- 14. ACCESS Mission Our mission is to work with vulnerable people in resource-limited settings through the provision of medical care, education, and economic empowerment to create long-lasting change that is owned by the entire community. Our target population is women and children OVCs and elderly people
- 15. What we do • Health care -Lifecare center -Health training -CHW and outreaches • Education -Preschool -Primary to University -Nurses and midwifery school -Out of school programs • Economic empowerment - IGAs - Nano-finance
- 16. Leadership & Community Engagement
- 17. Health care- covid-19 adjustments • Engaged District leadership • Adopted MOH policies • Trained all Health workers • Developed SOPs • Procured required protective equipment • Reached out to partners • Established covid-19 task force • Trained CHWs • Bulk purchases of medicines • MoH screening tool with referrals
- 18. CHW in Health care • Trained 40 out of 125 CHWs • Comprehensive training involving covid-19 distancing • Provided covid-19 guidelines • PPE provided to CHWs • CHWs facilitated to carry out their work • Liaison and linkage with district • Communication through phones and weekly calls • Support supervision and responding to suspects identified. • Provision of supplies • 866 screened with 30 suspects referred
- 19. Effects of Covid-19 on health service provision
- 20. Education in Covid-19 • CHWs help distribute food • CHWs identify teachers and support home learning • Small Radios procured for learners and parents • Radio talks for families and beneficiaries • Demonstrations for staying safe • Supervisory visits with feedback
- 22. Approaches during covid-19 Up to 12% (13) of beneficiary businesses closed down 10% (10 nanofinance) repurposed Booster support for covid-19 activities Regular monitoring and visits by CHWs Rescue support for vulnerable families Attention to increased domestic violence and teenage pregnancy
- 23. Community Health workers- Home visits
- 24. Access to meals before and after covid-19
- 25. Refocus Local and International Resources Current Plans Future Plans • Train more CHWs • Center for training CHWs • Monitoring and evaluation • Leveraging ACCESS resources • Using Technology for covid-19 care SWOT analysis priority setting at all levels with revised strategic plan to address covid- 19 ACCESS plan to fight covid-19 • CHW outreaches • Community engagement • Support supervision • Local leadership • Resource mobilization
- 26. THANK YOU
Notas do Editor
- In Uganda this is exactly what is happening following the restriction and later release of travel by the MOH, president of Uganda
- 15 steps initially suggested by Crigler L in 2011 and Later modified by Ballard et al in 2018
- Our organization was founded in 2003 by 2 individuals with a goal of making a big difference in a community that was devasted by HIV-AIDS.
- Our organization was founded in 2003 by 2 individuals with a goal of making a big difference in a community that was devasted by HIV-AIDS.
- Preschool, Nursing and Midwifery, Dream girls Tailoring and Hair broidery training
- Raring animals, Jewelry and micro nano finance project
- Raring animals, Jewelry and micro nano finance project
- We will focus on setting up a maternal child health program enhanced by a diagnostic laboratory.
- We will focus on setting up a maternal child health program enhanced by a diagnostic laboratory.