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Experiences with Integrated Community Health Workers in the Partnership for HIV-Free Survival Project

This content outline discusses the background, achievements, lessons learned, and challenges of integrating community MNCH activities with home-based care in the Partnership for HIV-Free Survival project.

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Experiences with Integrated Community Health Workers in the Partnership for HIV-Free Survival Project

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  1. Experiences with integrated Community Health Workers in the Partnership for HIV Free Survival project Roland van de Ven – Technical Director Tatu Mtambalike – Program Coordinator Community Linkages 14 January 2015

  2. Content outline • EGPAF Background • Integration of Community MNCH activities with Home Based Care • Achievements • Lessons learnt • Challenges

  3. Background • EGPAF supports the national RCH/PMTCT program through the USAID funded LIFE Program (Linking Initiatives For Elimination of pediatric AIDS) • EGPAF applies a health system strengthening approach at district level, to build local capacity for program planning, implementation and monitoring • Partnership for HIV Free Survival is implemented in Nzega district in Tabora region leveraging the LIFE program

  4. Integration of Community MNCH • EGPAF supported the integration of Community MNCH with the existing Home Based Care program in Nzega district: • Using national integrated Community MNCH guideline the program trained 50 HBC providers as MNCH CHWs • Trained 10 HF staff as supervisors • Mentoring the CHWs in collaboration with MOHSW and JHPIEGO

  5. Community MNCH main activities • CHWs (with support from the site supervisors and village leaders) conduct: • Mapping of households to identify and follow up clients, • i.e. pregnant and lactating women, children, HIV+ women on ART and HIV exposed children. • Household visits and community meetings to promote clinic attendance, facility delivery, birth planning counselling, the use of ITN etc • Referrals to health facilities • Monthly reporting at health facility where supervisor meets with all CHWs and discusses: • The contents of the monthly reports comparing clients in the registers with report forms • Successes, challenges and solutions • Learn from others

  6. Progress on RCH clients followed up by CHWs

  7. Trends in couple testing

  8. Increased attendance of HIV+ mother-baby pairs

  9. Increased uptake of PNC services

  10. Tracing efforts by integrated CHWs

  11. Main lessons learnt • Working with already known and accepted volunteers in the community has enabled the program to introduce the MNCH aspect smoothly • Enabling HBC providers to offer additional health education on MNCH services has provided an opportunity to remove stigma around HIV and HBC. • CHWs improve relationship between HF and community • CHWs substantially contribute to increased uptake of RCH services.

  12. Sustainability and scale up Concerns: • CHWs are mainly supported through NGOs budgets • Number of volunteer CHWs limited, which does not allow a large coverage of households in the area. • Integration of HBC and MNCH services adds a huge burden on volunteer CHWs Way forward: • Integration of CHWs support into district health plans and budgets • Establishment of a fulltime cadre of Community Health Workers / Extension Workers

  13. Asanteni

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