The USAID-sponsored Community Health Worker (CHW) Regional Meeting held in Addis Ababa, Ethiopia was intended as a forum through which to demonstrate and discuss tools and strategies to strengthen the functionality, scale-up and sustainability of government and NGO-led CHW programs.
The main purpose of the workshop was to highlight tools and strategies to support CHW program performance by using presentations, case studies, small group activities and participant exchanges to help attendees absorb and then practice what they learned.
By the end of the meeting, five countries: Ethiopia, Kenya, Rwanda, Uganda, and Zambia, will have developed action plans to guide their post-workshop follow up. This report includes the five countries’ plans and updates.
This short report describes the work of the USAID Health Care Improvement Project (HCI) in Ehtiopia to apply a community health system strengthening approach to improve the competence and performance of health extension workers (HEWs), strengthen the linkage between the community and the health system, and improve the capacity of community groups to take ownership of health programs in their catchment areas and establish an effective community health system.
The USAID-sponsored Community Health Worker (CHW) Regional Meeting held in Addis Ababa, Ethiopia from June 19 to 21, 2012, was attended by over 60 government and nongovernmental (NGO) representatives from six African countries (Ethiopia, Kenya, Mali, Rwanda, Uganda, and Zambia) as well as participants from international NGOs and organizations. The meeting was planned by Initiatives Inc. under the USAID Health Care Improvement Project (HCI) and designed to share new tools and strategies to strengthen the functionality of government and NGO CHW programs; facilitate dialogue about challenges and best practices among participating countries and identify and support evidence-based strategies for scale-up. This report details proceedings from the meeting.
A follow-up report describing actions taken by participants following the meeting is now available at:http://www.hciproject.org/publications/chw-regional-meeting-country-follow-plans-and-actions
This cross-sectional, mixed-methods study conducted in two regions in Ethiopia, Dire Dawa and Hawassa, seeks to inform the development a community-friendly standard framework to measure capacity within the community to coordinate care for orphans and vulnerable children. The study will assess community-based organization’s capacity looking at the following dimensions: governance and legality, leadership and decision making, strategic planning, organizational structure, program planning and implementation, beneficiary selection and graduation, service delivery, monitoring and evaluation, networking, marketing and communication, community and resource mobilization, financial management, property management, infrastructure and office facilities, volunteer management, and sustainability.
Health worker gaps have been demonstrated by the USAID Health Care Improvement Project (HCI) to be effectively addressed through the combined application of human performance technology and quality improvement (QI) methods. Through this approach in Niger, Tanzania, and Ethiopia, health workers have been shown to maximize their efficiency, work more effectively, and perform better—resulting in measurable gains in the quality of care. Similar approaches have been supported by HCI in Uganda over the last three months. This short report describes the appraoches and experiences applied to strengthen human resources for health at the community, facility and management levels.
This short report describes the activities of HCI under the PEPFAR-funded Care that Counts Initiative to provide technical assistance to ministries and partner organizations to develop and implement minimum care standards for services to vulnerable children and families.
The Strengthening Community Safety Nets (SCSN) project, managed by ChildFund International with its partners University Research Co., LLC (URC) and Christian Children’s Fund of Canada (CCFC), was a three-year (September 2008 – August 2011) project in Ethiopia. Its goal was to promote healthy child development for 50,000 orphans and vulnerable children (OVC) and to assist 8,500 primary and secondary caregivers through comprehensive, family-centered, and child-focused care and support services. The project served nine Ethiopian catchment areas with high HIV prevalence rates, poverty levels, and numbers of vulnerable children and with limited coverage of social and health services. The catchment areas served were five urban areas of Addis Ababa (Gulele, Kolfe Keranyo, Nefasilk Lafto, Arada, and Akaki Kality sub-cities) and four woredas (districts) of the Oromia region (Fentale, Dugda, Debre Zeit, and Shashemene).
Ethiopia’s Health Extension Program (HEP) works to improve access to and utilization of care, recognizing that a major factor underlying the poor health status of the country’s population is the lack of physical access to health services. The program has deployed more than 30,000 frontline community health workers in health posts in rural communities across Ethiopia where they deliver services in four major areas. Health posts are expected to be staffed by two female Health Extension Workers (HEWs), women nominated by their communities and receive one year of training in public health, hygiene, health promotion, and certain interventions. Oversight, training, and support of HEWs are provided by Health Centers. HEWs train and supervise at least one volunteer Community Health Worker (vCHW) to provide health education and promotion services as well as make referrals.
To date, the HEP has resulted in encouraging achievements such as access to sanitation, increased immunization, family planning, malaria services, and cost-effective DOTS programs (Datiko and Lindtjorn, 2010). The success of the program can be linked to key factors including political commitment of both health and political stakeholders and local ownership by communities and local political bodies. However, studies have shown that the HEP requires improvement in certain areas of management and health services such as supportive supervision from the Woreda level (Negusse et al., 2007), supplies of drugs and equipment, a well established referral and follow-up system, good transportation and communication systems, and in-service refresher training (Haines et al., 2007). The absence of these factors has placed limitations on the effectiveness of HEP and the performance of HEWs and vCHWs.
This short report summarizes the ways in which the USAID Health Care Improvement Project (HCI) is working with local groups and partners to apply quality improvement (QI) methods within the Community Health System in order to strengthen the impact of CHWs and other service providers at the community level, while at the same time increasing sustainability of programmatic impacts. Currently carrying out activities in more than 30 countries globally, HCI seeks to develop the capacity of health systems to apply modern QI approaches to make essential services better meet the needs of underserved populations; improve efficiency and outcomes; reduce costs from poor quality; and improve health worker capacity, engagement, and performance.
The Uganda Ministry of Health (MoH) Quality Improvement Strategy Meeting was convened in Kampala, Uganda, on March 21–22, 2011. The meeting provided a forum for various departments within the MoH, selected partners, and international improvement experts to share experiences, clarify the role of Government partners, and discuss lessons learned from implementing health care quality improvement initiatives at national and local levels. The MoH Quality Assurance Department (QAD) together with the United States Agency for International Development Health Care Improvement Project (HCI) organized and supported this meeting.
Dr. Henry Mwebesa, Commissioner of QAD, chaired the meeting. Dr. M. Rashad Massoud, Director of HCI and Senior Vice President of the Quality & Performance Institute, University Research Co., LLC, designed and facilitated for the meeting.
Throughout the two days, participants shared their experiences with quality improvement (QI) efforts across multiple levels of the health sector, identified challenges and interventions while implementing QI, and made recommendations for harmonizing and sustaining QI efforts in Uganda. Examples discussed were from Uganda, Afghanistan, Sweden, Niger, South Africa, Ethiopia, Russia, and Palestine.
This report summarizes the key discussions during the meeting.