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COMMUNITY HEALTH WORKER PROGRAMME TOOL KIT

COMMUNITY HEALTH WORKER PROGRAMME TOOL KIT. ST. LUCIA NURSING HOME AND ORPHANAGE EXPERIENCE ARUSHA, TANZANIA. Winfrida Mwashala RN – Tanzania Carol Parker MPH - USA. Agenda. Background Environmental Assessment Working With Stakeholders Recruitment and Training Implementation Budget

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COMMUNITY HEALTH WORKER PROGRAMME TOOL KIT

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  1. COMMUNITY HEALTH WORKER PROGRAMME TOOL KIT ST. LUCIA NURSING HOME AND ORPHANAGE EXPERIENCE ARUSHA, TANZANIA Winfrida Mwashala RN – Tanzania Carol Parker MPH - USA

  2. Agenda • Background • Environmental Assessment • Working With Stakeholders • Recruitment and Training • Implementation • Budget • Evaluation • Case Study

  3. What is a Community Health Worker?

  4. WinfridaMwashala Arusha, Tanzania St Lucia Nursing Home

  5. Tanzania – East Africa

  6. Income - $528 Prevalence - 7.7%

  7. General Objectives • To enable participants to understand Community Health Worker Program (CHW). Or Community Based Care concept in order to create a positive attitude towards the provision of HIV/AIDS prevention, care and support services within the community, in low resource countries

  8. Definition • Community Based Care is an umbrella term use to describe several kinds of care that do not occur in a clinic or hospital setting, BUT do occur within the home community of the affected person in an effort to meet the overall needs of people suffering from prolonged/chronic illnesses and their families.

  9. Types of Community Based Care • Outreach Services • Volunteer Health Care • Community Center Services • Hospice (Nursing Home)

  10. Benefits of Community Based Care • General Benefits • Client Benefits • Family Benefits • Community Benefits

  11. General Benefits • Encourages people living with HIV/AIDS to live positively. • Decreases the impact of HIV /AIDS on families and communities. • Improves the quality of life for people with HIV/AIDS and their care providers. • Decreases the stigma of having HIV/AIDS. • Prevents the spread of HIV related illness, e.g. TB, that can also infect others.

  12. Benefits to the Client • Opportunity to live with family • Lowers chance of other infections • Reduces psychological trauma - eg. death • Confidentiality of patient maintained • Visits of friends and family • Live positively • Longer life

  13. To The Family • Reduces hospital expenses e.g. transport • Provides more time to be with family • Provides time for other duties at home • To be knowledgeable on how to care for patient

  14. To The Community • Learn to prevent infection • Enhance HIV prevention behavior • Reduce stigma • Involved in care and support • Learn to ‘own’ the program and care for their own community members

  15. ENVIRONMENTAL ASSESMENT

  16. Discussions include the following topics: • Hospital facilities are adequate or inadequate to serve the people. • Health facilities are accessible to the people. • There is a need for added strategies and approaches to provide care to the people. • Local community leaders will/will not support the approach. • Community plans and activities for meeting those plans. • If it is possible to recruit local persons in the community to be trained for the purpose, as Community Health Workers.

  17. WORKING WITH STAKEHOLDERS

  18. Community Resources • Hospitals • Clinics • Schools • Community-based organizations involved in care and support • Traditional healers • Trained resource persons • Churches and other religious centers • NGO’s of all types • Legal aid services

  19. Elements of Comprehensive Care and Support • Clinical Care • Psychological • Socio-economic • Legal

  20. Supportive Policy & Social Environment Clinical Care (medical & nursing) VCT , PMTCT Preventive therapy (Ols, TB) Management of STIs and Ols palliative care, nutritional support antiretroviral therapy Adults and Children affected by HIV/AIDS Psychosocial Support Counseling Orphan care Community support Services Spiritual support Socioeconomic Support Material support Economic security Food security Human rights & legal support Stigma & discrimination reduction succession planning PLHA participation Elements of Comprehensive Care and Support

  21. Recruitment of Community Health Workers • Community Health workers are non- professional people who must come from the community in which they will be serving. • CHW’s must be recruited by community members through their leaders. • The program must set qualities and criteria for selecting CHWs. • During community description and needs assessment, the recruitment strategies can be discussed fully by key stakeholders so that they can begin to think of suitable persons for referral.

  22. Qualities of Good CHW’s • A person with a spirit of volunteering. • A compassionate person with the ability to read and write. • A person who is touched by someone else’s problems. • A self respecting person with a good reputation in the community. • A person who is readily available and reachable. • It is important to stress the point of voluntarism to CHWs because they normally are not given any salaries, only transport allowance and a kit.

  23. Visits There are three types of visits to clients: • Routine Visits • Focused Visits • Emergency Visits

  24. Monthly Meetings Important Activities; • Reporting sheets are turned in to supervisor. • Sharing of experiences from the field in regard to effective care of clients • Reporting and discussion of activities to draw upon lessons learned • Discussion to describe and address challenges.

  25. Monthly Meetings (Cont’d) • Travel allowances and replacement supplies are distributed. • Success stories are shared and enjoyed. • Support is offered to CHW’s who have experienced the death of a patient. • Another opportunity for support is offered through the confidentiality of written reports to the supervisor.

  26. Budget

  27. Budget Cont’d

  28. EVALUATION

  29. EVALUATION: HOW DO YOU KNOW YOUR PROGRAM IS SUCCESSFUL? • The evaluation should compare the HIV/AIDS care, prevention and support activities in place at the onset and those at the time of evaluation. • Sample parameters: • How many new referrals have you had to the program? • Are patients measurably more open about their status? • Is the death rate among infected persons served diminishing? • Are served clients increasingly adherent to medication? • How is your communication with stakeholders? • Increasing number of people attending HIV test facility for being tested

  30. More about Evaluation • Depending on funding and resources, both process and impact evaluation should be done. • If desired, a team of experts from within and outside the Community Health Worker program can evaluate the service objectively. Important! • Evaluation should be done at nine months after initiation and at the end of each year thereafter

  31. Please feel free to contact us: Winfrida Mwashala, RN Executive Director St. Lucia Nursing Home and Orphanage P. O. Box 11342 Arusha, Tanzania stlucianursinghome@yahoo.com Tel: +255 784 6111892 Carol Parker, MPH Executive Director Pamoja Project US 4220 Vuelta Colorada Santa Fe, NM 87507 USA carol@pamojaproject.org IN US 505-473-0691

  32. THANK YOU FOR LISTENING

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