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- Key Findings -

Complementary Evaluation for EIP and Documentation of scale of Integrated Community Case Management in Rwanda. - Key Findings -. Presentation Outline. Background Objectives Methodology Results Lessons Learned Next Steps. Background. EIP CSHGP Program :

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- Key Findings -

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  1. Complementary Evaluation for EIP and Documentation of scale of Integrated Community Case Management inRwanda - Key Findings -

  2. Presentation Outline • Background • Objectives • Methodology • Results • Lessons Learned • Next Steps

  3. Background EIP CSHGP Program: • Focused on iCCM, CHW training, supervision and supply chain • Encouraging peer support through CHW Care Groups Contributions to Scale: • What was Rwanda’s planned versus actual pathway to scale for iCCM? • How did EIP contribute to pathway? Cross-District Comparisons: • How does the Care Group model compare with the existing default model of C-IMCI in Rwanda? And what lessons can be learned from its experience?

  4. Objectives of Complementary Study Scale Study: To test the following Hypotheses • NGO supported actions around HBM (2004) and iCCM (2007) were essential in leveraging MOH support for scale • Strong leadership and political will in Rwanda were key in moving CCM to scale Comparative Study: • To assess Care Group attribution to CCM status

  5. Methodology The Complementary Study comprised of 3 different tasks. • Document Review (2001-2011) • Qualitative elicitation of narratives by key informants (central level stakeholders) to “tell the story” of iCCM in Rwanda over time (2001-2011) • Qualitative assessment of CCM status in one non-EIP district (Ruhango)

  6. Interviews and FGDs Conducted Interviews Focus Group

  7. RESULTS 1: CCM Timeline in Rwanda

  8. Rwanda CCM Timeline PHC HBM TWG HBM Strategic Plan CHW CCM Cadre mooted IMCITWG CH Policy + Community Health Desk C-PBF to incentivize CHWs MCH CH TWG takes over from IMCI TWG. POLICY Home-based fluid, ORS & Zinc in Kirehe DIARRHEA Pilot AQ at village level in 6 districts Oct 07: Bukora HC 1st ACT Tx by CHW RDT Policy Change MALARIA Feb 08: 1st Pneumonia case treated by a CHW in Kirehe PNEUMONIA HBM in 6 Districts HBM in all 19 endemic Districts Expansion of iCCM to 16 Districts 2008 (Phase 1) Expansion of iCCM to 30 Districts 2009-2010 EXPANSION 1990’s 2003 2004 2005 2006 2007 2008 2009 2010

  9. Other Important Critical Events for CCM in Rwanda • Vision 2020 Umurenge of 2000 and Decentralization Policy of 2001 • Global Fund Round 3, 5, 8, RCC • WHO TA for HBM 2004 • HBM NGO pilot - CORE/PMI support 2004 • Senegal Visit - 2006 • BASICS TA for ICCM 2007 • CHW Recognition by the Presidency - 2008 • New Staff Cadre for CHW Supervision - 2010

  10. RESULTS 2: CHWs and Care Groups • The EIP intervened at critical points in the pathway to iCCM scale. • CHW Services are appreciated by both users and MOH. • Care Groups at the CHW level provide a natural peer support group and help with Community mobilization and BCC.

  11. Potential CCM Challenges that Care Groups could help alleviate

  12. Lessons Learned: MCHIP’s Considerations MCHIP validated the hypotheses it was testing. Now to consider • - co-opting peer support group formation and networking module in CHW training; • - testing different CHW restocking models/ supervision models

  13. Next Steps • Compare DHS clusters from EIP and non-EIP areas from the recent DHS (2010) • Convene a face to face meeting for mutual agreement of CCM events timeline

  14. ANY QUESTIONS? Thank you! wwww.mchip.net Follow us on:

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