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NATIONAL LEVEL MINISTRY OF HEALTH Community Health Desk

Community Health Structure. NATIONAL LEVEL MINISTRY OF HEALTH Community Health Desk. DISTRICT ADMINISTRATION District Health Supervisor. DISTRICT HOSPITAL District Hygiene and Sanitation Officer Community Health Officer. HEALTH CENTER/COOPERATIVE

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NATIONAL LEVEL MINISTRY OF HEALTH Community Health Desk

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  1. Community Health Structure NATIONAL LEVEL MINISTRY OF HEALTH Community Health Desk DISTRICT ADMINISTRATION District Health Supervisor • DISTRICT HOSPITAL • District Hygiene and Sanitation Officer • Community Health Officer HEALTH CENTER/COOPERATIVE Hygienist or Sociologue in charge of Community Health Activities CELL LEVEL Binome Supervisor (1 per cell, elected from among the binomes) UMUDUGUDU (VILLAGE) LEVEL Community Health Workers

  2. % Strengthening health systems through community health T Evolution of CHWs 1995 2005 2011 BEGINNING OF CHW • Initiated : 1995 ( after Genocide ) Objective: first level of entry to the health system • Operates at smallest administrative unit of the country (villages) • Includes a minimum package of activities focusing on primary health care Evolution • Selection and training of CHWs countrywide • Linkage to a diversification of strategies • to reduce child and maternal mortality • community case management

  3. 1 Female in charge of maternal Health 1 Binome female & male Community Health Workers 4 CHWs/ village 1 CHSA (in charge of social affairs)

  4. CHW PROGRAMMES CHWs PACKAGES Preventive Services Promotion Services Curative Services C-HMIS & C-PBF COOPERATIVES • Community sensitization on prevention of common: diseases: malaria, diarrhoea, ARI, for prevention of sexual transmitted infections,, health campaign on hygiene and sanitation, immunization etc. • Educate communities on use of water treatment solutions and distribute them • Vaccination campaign • Provision of family planning services including FP products • Community Maternel Newborn Health ( Rapid SMS) • Community Case Management of malaria, ARI, diarrhoea, vaccination, malnutrition (e.g. Community Integrated Management of Childhood Illnesses/Community IMCI) • MISO • Engage in community DOTs for tuberculosis, HIV • Nutrition education to communities • Growth monitoring particularly among children under five years old • Nutrition surveillance • Routine home visits for active case finding • Hygiene Clubs • C-HMIS: • mUbuzima : all CHW received the mobile phone • Monthly report : 40 indicators • Rapid SMS • C-PBF: • 5 Maternal and Child Health Indicators • 2 TB indicators • Report • 499 CHWs cooperatives • They help CHWs to use the PBF money to collectively invest it in profitable ventures • They generate income to allow CHW’s .

  5. Motivational mechanisms • Community PBF • Unplanned donations • Community respect (they participate in all decisions in the village). • Etc.

  6. CHALLENGES • Huge number of CHWs who need training and supportive supervision; • Low education level of CHWs call for demanding and frequent training • Weak financial management skills and systems hampering initial stages of business growth • Logistical support to meet CHW need Strengthening the functionality of CHW Cooperatives (need for technical support)

  7. THANKSHE KAGAME PAUL WITH ALL CHWs

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