Community Mobilization. The CARE-MINSA project has undertaken three main community mobilization activities: • Formation of community committees • Formation of health worker networks • Revitalization of community Base Houses which are used for distribution of ORS, chlorine for disinfecting water, and referral to health facilities. During the MTE, it was reported by community members that there is an increased interest on the part of most communities in health activities. CHWs have become more active and are taking a renewed interest in health activities, and new volunteers have been trained to more evenly distribute the workload. The project reports that 58 Base Houses are currently functioning, there is more of an interest in utilizing the Base Houses as a center for health activities, including the Integrated Health Visits of the MINSA team. The improved coordination between health posts and communities have strengthened community empowerment. One of the goals of the project is: To empower communities to organize, analyze health and nutrition problems, and seek solutions. Of the three goals, this is the most problematic in terms of reaching project objectives and having a sustainable impact. The project lacks a clear vision of what they anticipate as an end product for community organization. A number of models exist for organization and there is no one model that will fulfill the needs of all communities, particularly given the difference in needs between urban neighborhoods and rural communities. During the MTE, 56% of the committees saw their function as providing health education and only 31% mentioned community organization. 85% of the committees had been trained in breastfeeding, but only 25% of the committees mentioned that they had received training in community organization. In most communities, a “Network” of volunteers has been established which serves an extremely important function of providing mutual support among community volunteers. These networks meet on a regular basis to discuss problems, plan activities and implement activities together. In many instances these Networks also form the community committee. Their focus centers on health activities of the project, not the concept of Community Development Committees with health as an integrated activity within a broader developmental context. Analyze, with communities, the concepts of Community Development Committee and Network of Volunteers to define their roles and potential for sustainability. One of the major...
Community Mobilization. (a) Support to MURIGAs and development of health mutual companies offering broader health coverage through provision of medical equipment, vehicles, technical advisory services, and training to MURIGAs and new health mutual companies;
Community Mobilization. 6.1.1 The GNWT and BHP agree to continue supporting the community mobilization initiatives.
Community Mobilization. Activity 2.1:
Community Mobilization. The government recognizes the role of community health volunteers implicitly as noted in the policy for the Basic Package of Health and Social Welfare Services (BPHSWS) which calls for community support for such volunteers but does not support, at 11 “The Basic Package of Health and Social Welfare Services”, Republic of Liberia, Ministry of Health and Social Welfare; Monrovia. present, the use of any essential medicines by CHVs due to the national perception of existing CHV skill levels. The MOHSW is in the process of further developing policies related community health volunteers. The government mandates Community Health and Development Committees to be linked with health facilities, but policies for how these are to be linked to other elements, such as Community Development Committees (what this CSP terms “Community Health Committees”) are not yet defined. Within MTI’s CSP, communities are mobilized in several ways. First, the project provides training to female Household Health Promoters for C-IMCI behavior change communication through the Care Group model. These HHPs conduct home visits, occasional group sessions with women of influence in the community, and periodic community-level clean-up campaigns through linkage with local leaders, such as the Town Chief. Secondly, a referral system between HHPs and health facilities has been established, mobilizing mothers and other caregivers to seek available services for child and maternal health. Thirdly, Community Health Committees have been formed or revitalized and these are linked in support of HHP activities. At project start-up, a local consultant (Xxxxxx Xxxxx) provided training to MTI staff and partners (CHAL and the County Health Team), along with some Health Clinic staff, on the Care Group model and community mobilization in a “Training for Transformation” workshop. A refresher training on this topic and orientation to participatory action and learning methods was provided by the MTI HQ CS Advisor in May 2008. (See also training provided by MTI HQ staff on social and behavioral change communication and C-IMCI in section 4b.Communication for Behavior Change.) At midterm evaluation, the first two elements of the community mobilization strategy are quite strong, while the third has just been initiated. CHCs have been encouraged to include women on their committee, with about 75% having 1 or 2 women among a group of 5 members. CHCs have been trained on problem analysis and action planning. Local leaders...
Community Mobilization. (1) The FE team noted that the community mobilization strategy of the project has been successful and included the involvement of the Community Health Team comprised of CLC members, TBAs, Activistas, and Traditional Healers. The Community Health Team’s community mobilization plans include IEC and BCC activities for the promotion of key behaviors related to the project interventions.
Community Mobilization. Interviews with CHWs during the final evaluation showed that all had sufficient educational materials based on the IMCI approach for teaching families about diarrhea control, nutrition, pneumonia case management, and growth monitoring. CHWs knew the key messages and how to use the materials. The majority of CHWs had attended monthly meetings at the Health Post. The main activities at the meeting included presentation of reports using the information system sheet and reception of feedback from the RAN. The majority of CHWs interviewed had their information system forms in order, including a diagram of the community with all the homes marked with children under two, growth monitoring information was up to date, as was the information system summary sheet. CHWs receive supervisory visits by the CARE Extensionist or the RAN on a monthly basis. Activities during the supervision visit included: revision of the information system, education and guidance on use of materials and key concepts, joint home visits and assistance in counseling mothers, and assistance with the growth monitoring session. The MTE recommended better use of community maps prepared by CHWs, as a way to plan and evaluate activities and nutritional status. CARE provided refresher training to CHWs in the use of maps, census data and growth monitoring information for decision- making. As a result of the training, communities have updated their maps with data about children and pregnant women. Each Base House was given a bulletin board that facilitated the use of colored pins to indicate children under two, pregnant women, homes with gardens, and homes of volunteers. The work of CHWs was a subject of analysis during the Final Evaluation. Following is a summary of the positive aspects gleaned from field visits and interviews with CHWs. ❑ There are now 366 active CHWs, and 80% use IMCI protocols, refer patients, and distribute ORS packets, chlorine and acetaminophen. ❑ Before the CS Project, the main role of CHWs was to call the community together for Health Days and the CHW did not have a close relationship with the Health Post. ❑ There is good coordination with the RAN and monthly planning and evaluation meetings take place between CHWs and RANs. ❑ Each CHW has an identification card. ❑ Base Houses did not exist prior to the CS Project, although their formation is MOH procedure. Base Houses have signs to designate the location. ❑ CHWs now know their community much better because they do a census a...
Community Mobilization. The design of the CLICS program is predicated on a strong community foundation. The MGIMS management understands that with the community’s involvement, anything is possible. Conversely, they appreciate that without genuine community ownership and participation, little can either be achieved or sustained. Therefore, the focus of the first half of CLICS was devoted to establishing the strong foundation at the community level in the 67 CLICS villages. As such, considerable attention was focused on this aspect in the MTR, and this iteration will update what has been achieved or issues that have arisen during the past two years. The formation of the CBOs was paramount. The health awareness building and behavior change strategy underlying CLICS was dependent of the group formation as a means of delivering their health messages. As seen in Table 8 below, most of CLICS group formation was completed by the time the MTR was carried out. Only 12 SHGs and four KVMs were established in the last two years. No KPs were added. Table 8: Increase in Number of Community-Based Organizations CBO Xxxx Xxxx Talegaon Total MT Final MT Final MT Final MT Final SHGs 76 85 65 70 122 121 263 276 KVMs 24 27 22 22 25 26 71 75 KPs 20 20 21 21 23 23 64 64 The VCCs have been operating effectively during the second half of the CLICS project. The one remaining VCC, which had not signed the Social Franchise Agreement by the MTR, completed the process. The final evaluation team noted that there were only two signatories on the agreement, the VCC and MGIMS, with the sarpanch (head of the GP or village council) as a witness to the agreement. The FE team suggests that it might have assisted program implementation and increased partner involvement if the sarpanch, the ANM, and the AWW, even though they are included in the VCCs, signed the agreement and understood their respective roles and responsibilities vis-à-vis the VCC and the community. The MTR recommended that community health rights be developed based on promises the government has made over the years and that neighboring VCCs join forces in association for the purpose of making demands on the health system based on these rights. The health rights developed by CLICS included: • All children receive complete immunization; • All children have growth monitored each month; • All children have access to supplementary nutrition through the Anganwadi Center; • All pregnant women get complete antenatal check-up; • Female child has the right to be ...
Community Mobilization. The work done so far by the CSP at the community level has been minimal and needs to be the focus for the next two years. Work with RPSs is a very weak area, as is a project definition of what the role of the community and municipalities should be in the health interventions. The CSP needs to involve communities more if any sustainability of health activities is to be attained. Communities need to be aware of what the CSP is trying to accomplish, and why, so that communities can advocate for health services to municipal authorities. Formalizing Community/Municipal relations With the Popular Participation Law of decentralization, funds are available at the municipal level for social services and development activities. A set percentage of the municipal budget is dedicated to health. This requires constant pressure to make sure that what is supposed to be for health is used for health. Fund disbursement is behind schedule from municipal authorities in paying the national Basic Insurance. Very little has been formalized with the municipalities and communities as to their role in health activities except for minor discrete contributions; the municipalities will transport the new cold chain equipment to the sites, and provide gas for refrigerators, etc. CEPAC/IEF need to take a more proactive position in working with communities and municipalities to define responsibilities. Agreements should be formally signed with communities to ensure their participation in health activities and sustaining the RPS. During MTE interviews there was an openness on the part of community leaders towards paying the transportation costs of the RPS to training events, but this has never been formally presented to them. Some concrete steps which can be taken by XXXXX/IEF include:
Community Mobilization. The terms of reference of the consultants shall be as determined by agreement between ADB and MRD.
