Transcript FBO’s and Women’s, Maternal, and Neonatal Health Care

FBO’s and Women’s, Maternal,
and Neonatal Health Care
A Review of Faith Based Models of
Community Based PNMCH
Overview of Presentation
► Background
of Initiative to Review FBO
Work in Community Based PMNCH
Programming
► Indicators Reviewed
► Review of Community Based Programs
 World Relief
 Jamkhed
 Church of Central Africa Presbyterian
► Conclusions/Recommendations
Background
► Role
of FBOs in Women’s Maternal, and
Neonatal Health under recognized
► Presence of Faith Based organizations,
churches and hospitals
► JHPIEGO and IMA World Health
Collaboration on ACCESS Project
Indicators Reviewed
► Infant
Mortality
► Immunization uptake
► Use of Antenatal Care
► Exclusive Breastfeeding
► Uptake of Family Planning Services
► Rates of Malnutrition
MCH Programming in Mozambique
Situation in Mozambique
4 out of 10 Mozambicans live on less than
$1 per day
► 3 in 10 children in Mozambique die before
they reach the age of five
► Ten years ago, when a child got sick or
died—mothers blamed witchcraft because
they did not know the truth about disease.
►
WORLD RELIEF
Vurhonga Projects I, II, III
► World
Relief’s “Care Group Model” trains
volunteer health promoters in Mozambique:
 Every household in five health districts learns
the truth about hygiene, nutrition,
immunizations, diarrhea, malaria control, etc.
 The result—communities change as families
protect and care for their health
Care Group Model
►5
Supervisors
► 26 Promoters
► 220 Care Groups of 10-15 Volunteers
► 10 Households per Volunteer
Care Group Model cont’d
► Goal:
Achieve sustainable impact by
engaging a network of community health
volunteers and training them in “Care
Groups” as behavior change agents.
Care Group Model Cont’d
 Each volunteer commits to sharing knowledge
with 10 neighbors. Knowledge transferred
mother to mother. Combat Dehydration
►Facilitate
Practice of Birth Spacing
►Follow Good Nutrition and Hygiene Habits
►Learn Importance of Breastfeeding, Vitamins, Iron
Supplements, and Immunization
Care Group Model Results
Project Results from Chokwe 1999-2003
INDICATOR
BASELINE
ENDLINE
ANC Visits
30%
90%
Delivery by trained
provider
66%
85%
Increased food
consumption during
pregnancy
45%
82%
Exclusive Breastfeeding
10%
79%
Knowledge of STI
Prevention
0%
53%
Family Planning use
7%
29%
ITN Use for under 5’s
>1%
85%
Community Rural Health Project:
Jamkhed
CRHP Model
► The
Village Health Worker (VHW) acts
as the local agent of positive health and
social change. She is selected by her
community and receives training in health,
community development and organization,
communication skills, and personal
development from CRHP.
Village Health Workers cont’d
►
VHW training was designed to empower these often
oppressed women by increasing their knowledge, building
skills, and demystifying medicine so as to truly put health
in the people’s hands. The initially high rates of diseases
and premature deaths in the area were primarily linked to
malnutrition, water-borne diseases resulting in diarrhea
and infections, untreated communicable diseases, lack of
family planning, and harmful superstitious beliefs and
practices. The training these women received opened a
doorway for effective, locally-managed and relatively
simple interventions to halt this vicious cycle that was
causing so much pain and suffering.
VHW Delivering Basic Care
CRHP Model Cont’d
► What
Do Village Health Workers Do?
 Visit households and share information
 Work directly with women’s, youth, and
farmer’s groups,
 Teach about harmful cultural practices such as
discrimination against women
 Refer severe health conditions to the hospital
VHWs in Action
CRHP Model
► To
Improve PNMCH, Jamkhed has:
 Promoted a comprehensive approach to health and
empowered the community to improve infrastructure,
water quality, hygiene, etc through multi-sector
approaches.
 Introduced participatory decision making at the
community level by encouraging community meetings
and working with women’s and youth groups on skill
development
 Mobilized the community to emphasize beneficial
traditional practices and eliminate harmful ones.
Outcomes for CRHP Villages
Indicators
1971
2004
Crude Birth Rate
40
176
18.6
24
India
(2004)
23.9
62
5%
<5%
<1%
99%
99%
68%
64%
64%
41%
Immunization
(<5)
5%
99%
70%
Malnutrition (<5)
40%
5%
47%
Infant Mortality
Rate
Access to ANC
Safe Delivery
Use of Family
Planning
Additional CRHP Outcomes
► People
now willingly accept family planning
since they no longer expect their children to die
from communicable diseases.
► Most health problems are effectively taken care
of and monitored at the villages themselves by
well-trained and confident VHWs.
► The impact of CRHP’s training activities has led to
a true grassroots movement for health and
social justice, shaping public health policy as
well as the direction taken by health conscious
NGOs involved in development work.
Church of Central Africa Presbyterian
► Operating
in areas with traditionally low
coverage in terms of availability of services
► Local Congregations promote women’s and
children’s health through their women’s
groups.
► Engages religious leaders in delivering
health messages.
► Provides health messages through youth
groups
CCAP cont’d
► Malaria
Prevention Program provides the
following:
 Health Education about prevention and early
treatment of malaria
 Insecticide Treated Nets at subsidized prices to
pregnant women and children five and under
 Re-treatment of nets
 Follow up services for pregnant women and
children who have malaria
Insecticide Treated Net
CCAP Program Impact
► High
percentage (81%) of respondents
aware of benefits of sleeping under a
mosquito net.
► Significant increase in the percentage of
respondents reporting having nets in their
homes
Conclusions and Recommendations
► Community,
and congregation based FBO health
programs are a valuable national asset and
provide a critical link to ensuring access to health
care, especially for rural and marginalized
populations
► FBO led community based programming is one of
the most effective and sustainable avenues for
ensuring health women, mothers, and babies and
should receive political support from governments,
as well as financial support from donors.
Thank You
Sarla Chand, MD
IMA World Health
[email protected]
410-635-8720
Jacqui Patterson MSW, MPH
ActionAid International USA
[email protected]
202-370-9916
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