Strengthening Health Worker Performance. The project identified CHWs who had been previously trained, to recover this underutilized resource. According to results from the MTE, 11of the 32 CHWs interviewed had been working over 2 years. Nine of the 32 CHWs had been recently selected and trained (worked less than 6 months). By increasing the number of volunteers in each community, the workload has been more adequately divided. Project records show 248 CHWs as actively working, far above the original target number. An excellent strategy has been the formation of a network of volunteers within each community, which include volunteers with various roles, such as the CHW in charge of the Base House, Breast feeding Volunteer, and Growth Monitoring Volunteer. This network provides a strong support system for volunteers, where new volunteers can learn from more experienced volunteers and responsibilities can be shared. The project has encouraged the formation of sectors within each community, so that each volunteer would be responsible for specific families. This idea has not been adopted in all areas, but many communities have found it to be an effective way to organize. CHWs are visited on a regular basis by either/or the CARE Extensionist and MINSA health xxxx xxxxx. Eighty-three percent of the CHWs stated that they receive visits at least once a month. The main purpose of these visits was to strengthen knowledge in health and to help in organizing their work. CARE/MINSA staff uses this opportunity to evaluate the competency of the CHWs to identify areas that need further emphasis. Maps, drawn by the network or committee were observed in most communities visited during the MTE. This has helped develop a sectorization plan but has not been fully exploited. The project planned to teach mapping techniques to communities to facilitate the identification of high-risk cases, population, etc. Volunteers and committees need to be taught how to use the information from community maps to plan and evaluate actions to improve heath and nutrition status.
Strengthening Health Worker Performance. The approach to strengthening health worker performance has been effective, especially with the implementation of the recommendations of the MTE. Health facility staff received extensive training in breastfeeding promotion, nutrition, IMCI, formation of support groups, community empowerment, adult education methodologies, community organization, planning and evaluation. The quarterly quality assessments are a way for health personnel to continually improve service delivery and the action plans developed give staff an opportunity to use knowledge and skills acquired during the CS Project.
