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CORE Global Health Practitioner Conference, Fall 2014
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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
CHV
Current situation of the CHW / CHV
Ram Shrestha
USAID Applying Science to Strengthen and Improve Systems
Current Situation of Community Health
Workers
Ram Shrestha
USAID Applying Science to Strengthen and Improve Systems
SUPPORT TO COMMUNITY HEALTH WORKERS
Ram 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
Schools
Religious Community
Women’s
Group
Local Health Clinic
$ Savings & Credit Group
Local Government
CHW
Community Health System
Ram Shrestha
USAID Applying Science to Strengthen and Improve Systems
Community QI Team, Buikwe, Uganda
USAID Applying Science to Strengthen and Improve Systems
USAID Applying Science to Strengthen and Improve Systems
QI team member’s register with name and number of pregnant women
10
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)
USAID Applying Science to Strengthen and Improve Systems
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
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
• 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