Community Mobilization Approach. The CS Project’s approach for community mobilization included five complementary strategies:
1) participation of families in the community census, 2) selection and training of HVs to provide selected preventive child survival services, 3) formation of community groups to learn about health topics, 4) participation of community volunteer leaders in health program decision making, and 5) participation of municipal governments in community health programming. This integrated approach, linking different levels of community participation to address child survival needs, is an effective one. Work with HVs has been a challenge over the life of the project, due to the fact that there is no formal mechanism for including the HVs as a recognized part of the MOH system. The focus has been on training volunteers, linking them to health facilities through the monthly CAI (information analysis meeting) at the Health Post level, providing on-going supervision, and the implementation of incentive plans. In Ancoraimes, there is a cadre of dedicated volunteers who have been active for the past 3 years. A relatively new group of women volunteers is active in Carabuco, and in Ambana and Puerto Xxxxxx there are a few active volunteers and several who are still in a learning process.
Community Mobilization Approach. The CARE/MOH community mobilization approach included five complementary strategies: 1) selection and training of CHW to provide front line primary health care services; 2) organization of monthly community growth monitoring and health education sessions; 3) strengthening, expansion, and promotion of Base Houses to support child survival activities; 4) development of home food production through CHWs specialized in agricultural promotion; and 5) participation of schools in community health education and promotion . This integrated approach, linking different levels of community participation to address child survival needs, is an effective one. Work with CHWs, implementation of growth monitoring sessions using the AIN methodology, and the formation of support groups began early in the project and is on-going, showing progressively greater impact in improved knowledge and health behaviors. Participation of schoolteachers has been excellent and will require continued support from the MED and the MOH if efforts are to continue over time. The CS Project promotes savings to assist families to confront eventual crisis situations, as well as to favor women who are not subject to credit from financial institutions. The methodology involved the formation of groups of 30 to 35 people (mainly women) who begin to save small weekly amounts of money. After a 30-60 day period of consolidation, a process of granting loans begins at interest rates and terms defined by the group. Each group named a small Board of Directors to oversee the funds and keep records on each partner. The project currently covers 15 groups, including a total of 416 women. The project is not focusing on the Community Development Committees (CDCs), as initially planned in the DIP. CARE is working more with community volunteers who dedicate themselves to health issues, and less with political structures such as the CDCs. Due to political controversies in the region, CARE decided to channel efforts towards the CHWs and women’s groups, rather than focus on the CDCs, which have a political orientation. To enhance community members’ health leadership capacity CARE provided training in conflict resolution, negotiations and self-esteem. Each Health Post elects a CHW of the Month and a Mother of the Month to motivate model behaviors and create a sense of healthy competition towards positive practices and behaviors.
