Technology to empower community health workers

Initiative to help reduce maternal and child mortality through a community-based interventional approach

About

The “Save a Mother” project aimed to improve maternal and child healthcare demand and outcomes in sparsely populated remote areas by systemically strengthening existing community-based interventions by empowering community health workers with technology provision, capacity development, data collection and better linkage to the health system.

Partners

How

The overall goal of the project was to improve maternal, newborn and child health status through community-based interventions in the 4 sub-counties with a specific focus on 20 priority villages in Marsabit County.

The systemic transformation intervention consisted of three interlinked packages:

Community sensitization and behavior change communition: Building awareness and demand for quality services and uptake of maternal, neonatal and child health services. Implementation of high-impact maternal and health intervention. It also included engagement with religious, elders and community leaders in addressing culture change and traditional habits.

Community Health Worker empowerment by capacity building and equipment: Provision of community outreach backpack with diagnostic tools, training and mentoring, supply of commodities and counseling material, monitoring and supportive supervision. The project also increased the reach of CHWs through motorbike based outreach.

Health System Strengthening: Setting up a Community based Health Information Management System (HIMS) as basis to engage involved health teams and stakeholders. Active involvement of county health management team to ensure effective planning, monitoring and evaluation of health interventions.

How

The overall goal of the project was to improve maternal, newborn and child health status through community-based interventions in the 4 sub-counties with a specific focus on 20 priority villages in Marsabit County.

The systemic transformation intervention consisted of three interlinked packages:

Community sensitization and behavior change communition: Building awareness and demand for quality services and uptake of maternal, neonatal and child health services. Implementation of high-impact maternal and health intervention. It also included engagement with religious, elders and community leaders in addressing culture change and traditional habits.

Community Health Worker empowerment by capacity building and equipment: Provision of community outreach backpack with diagnostic tools, training and mentoring, supply of commodities and counseling material, monitoring and supportive supervision. The project also increased the reach of CHWs through motorbike based outreach.

Health System Strengthening: Setting up a Community based Health Information Management System (HIMS) as basis to engage involved health teams and stakeholders. Active involvement of county health management team to ensure effective planning, monitoring and evaluation of health interventions.

Results

The project interventions increased access to primary health care in the remote areas, as was evidenced by significant changes noted in project indicators at output and outcome levels.

The innovative interventions, most notably the provision of the Community Outreach Backpack to CHWs have gained acceptance and popularity at local level. This has also improved health seeking behavior of community members requesting for more services to be included during home visits. Greater equity has also been realized due to increased access of women and children to primary health care.

Learnings and next steps

The outreach kits have enabled the CHWs to conduct several screening away from the static health facilities before making informed referrals, which has added value and recognition to their work. For this reason, they are now more welcomed to the households enhancing cooperation when it comes to embracing health promotional messages.
CHWs in the areas of operations have increasingly become frontline health service providers even though they are not paid. Their role in the health care system has a significant bearing on the attainment of universal health care coverage.
CHWs play various roles in support of the community health strategy to deliver primary health care at the community level. A model that incorporates a stipend on top of any other non-tangible reward would go a long way in ensuring sustainability.
AMEN Kenya provided the CHWs with a visibility jacket and cap for purpose of recognition and identification. The CHWs are reporting that generally the uniform symbolically confers higher status to them beyond their locality and also recognition beyond the community in which they serve.
Using data generated at the first level (the community level) – through routine facility reporting to track progress and performance over time – strengthens accountability for improved outcomes.
The full involvement in the community strategy ensured that there was synergy and necessary moving part from the communities in terms of factual relevant strategic messaging that spurred behavior change among the locals
Strategic Behavior Change Communication (SBCC) platforms from print media (information education and communication, flip charts) materials and electronic media (animations, mobile videos, and audios) and broadcast media like radio stations ensured that the reach of the hard to reach masse.