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1 Using a Community Health System to Strengthen the performance of Village Health Committee Ram Kumar Shrestha Senior Improvement Advisor, Community Health and Nutrition USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project University Research Co, LLC CORE Group Conference Fall 2014

Using a Community Health System to Strengthen the performance of Village Health Committee_Shrestha

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CORE Global Health Practitioner Conference, Fall 2014

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Page 1: Using a Community Health System to Strengthen the performance of Village Health Committee_Shrestha

1

Using a Community Health System to Strengthen the performance of Village

Health Committee

Ram Kumar Shrestha Senior Improvement Advisor, Community

Health and Nutrition

USAID Applying Science to Strengthen and

Improve Systems (ASSIST) Project

University Research Co, LLC

CORE Group Conference Fall 2014

Page 2: Using a Community Health System to Strengthen the performance of Village Health Committee_Shrestha

CHV

Current situation of the CHW / CHV

Ram Shrestha

Page 3: Using a Community Health System to Strengthen the performance of Village Health Committee_Shrestha

USAID Applying Science to Strengthen and Improve Systems

Current Situation of Community Health

Workers

Ram Shrestha

Page 4: Using a Community Health System to Strengthen the performance of Village Health Committee_Shrestha

USAID Applying Science to Strengthen and Improve Systems

SUPPORT TO COMMUNITY HEALTH WORKERS

Ram Shrestha

Page 5: Using a Community Health System to Strengthen the performance of Village Health Committee_Shrestha

Schools

Religious Community Health Clinic

Community Health System

Village Committee

Savings & Credit Group

$

Women’s Group

Local Government

Community Health Volunteers

NGOs Volunteers

© 2013 Ram Shrestha

Page 6: Using a Community Health System to Strengthen the performance of Village Health Committee_Shrestha

Schools

Religious Community

Women’s

Group

Local Health Clinic

$ Savings & Credit Group

Local Government

CHW

Community Health System

Ram Shrestha

Page 7: Using a Community Health System to Strengthen the performance of Village Health Committee_Shrestha

USAID Applying Science to Strengthen and Improve Systems

Community QI Team, Buikwe, Uganda

Page 8: Using a Community Health System to Strengthen the performance of Village Health Committee_Shrestha

USAID Applying Science to Strengthen and Improve Systems

Page 9: Using a Community Health System to Strengthen the performance of Village Health Committee_Shrestha

USAID Applying Science to Strengthen and Improve Systems

QI team member’s register with name and number of pregnant women

Page 10: Using a Community Health System to Strengthen the performance of Village Health Committee_Shrestha

10

Page 11: Using a Community Health System to Strengthen the performance of Village Health Committee_Shrestha

USAID Applying Science to Strengthen and Improve Systems

PLHIV identification in the community

11

679

741

364

0

100

200

300

400

500

600

700

800

900

1000

Cumulative number of PLHIV identified in 10 villages of Uganda, June 2012 - January 2014

Total identified

by VHTs alone

in the community

system

Total HIV patients

identified in a

community system

including VHTs

Estimated number of people living with HIV in the community (9% prevalence)

Page 12: Using a Community Health System to Strengthen the performance of Village Health Committee_Shrestha

USAID Applying Science to Strengthen and Improve Systems

Page 13: Using a Community Health System to Strengthen the performance of Village Health Committee_Shrestha

USAID Applying Science to Strengthen and Improve Systems

Lessons Learned

• Every community has an informal system of

networks, including the CHV/CHW

• Community Health System strengthens the function

of Village Health Committee

• Support of Village Health Committee improves the

performance of CHVs

• Linkages between the community and health facility

can be strengthened by working through the

community system

Page 14: Using a Community Health System to Strengthen the performance of Village Health Committee_Shrestha

March 2014 April 2014 May 2014

Back to ART March: 8

Back to ART April: 6

Back to ART May: 3

Back to

ART 17

Died 11

Relocated

5

Status of the 33 individuals who were

traced from March-May

Getting Lost-To-Follow-Up (LTFU) Patients Back in Care Community Linkages Improvement Demonstration Project in Muheza, Tanzania, March-May 2014

Page 15: Using a Community Health System to Strengthen the performance of Village Health Committee_Shrestha

• Individual responsible ( Find concrete things to work on)

• Team responsible ( equipped with skills to solve problem)

• Joint problem solving

• Motivation

• Achieving something with data (seeing improvement)

• Status of member in the village