Evaluating the Family Health Promoters Program

8/14/2019 Evaluating the Family Health Promoters Program

1/16


2/16

AcknowledgementsAcknowledgements The MOH and TAIS would like to thank the twelve The MOH and TAIS would like to thank the twelve

partner organizations for their involvement in thepartner organizations for their involvement in theevaluation in the areas of fieldwork andevaluation in the areas of fieldwork andpresentation of preliminary findings to the MOH:presentation of preliminary findings to the MOH: Health Alliance International (HAI)Health Alliance International (HAI) Services for the Health in the Asia Africa RegionServices for the Health in the Asia Africa Region

(SHARE)(SHARE) OxfamOxfam CARECARE Cruz Vermelha Timor-Leste (CVTL)Cruz Vermelha Timor-Leste (CVTL)

Alola FoundationAlola Foundation Alliance of Friends for Medical care in East TimorAlliance of Friends for Medical care in East Timor

(AFMET)(AFMET) Medicos del Mundo (MdM)Medicos del Mundo (MdM)

ConcernConcern


3/16

General ObjectivesGeneral Objectives

Understand how well the PSFUnderstand how well the PSFprogram is working, compared toprogram is working, compared toexpectations expressed in the PSFexpectations expressed in the PSF

and SISCa program guidelines andand SISCa program guidelines andby the MoHby the MoHShow which aspects are workingShow which aspects are workingwell / not working well and whywell / not working well and whyProvide recommendations forProvide recommendations formaking the program more effectivemaking the program more effectivein achieving health goalsin achieving health goals


4/16

Background and History FHPBackground and History FHPprogramprogram

20062006- Initially a Pilot Program in 4 districts Viqueque,- Initially a Pilot Program in 4 districts Viqueque,Aileu, Manatutu and Liquica Aileu, Manatutu and Liquica aldeiaaldeia based.based.-- Family Health Promoter as a volunteer was to be anFamily Health Promoter as a volunteer was to be anEducator, a Mediator, a Motivator, and a Provider of Educator, a Mediator, a Motivator, and a Provider of

Information.Information.20082008- SISCa: an initiative to increase access to health care- SISCa: an initiative to increase access to health careand health promotion and prevention.and health promotion and prevention.- Monthly service provision in every- Monthly service provision in every sucosuco . Necessitated. Necessitatedrapid expansion of training and installation of therapid expansion of training and installation of theFamily Health Promoters (FHP in English PSF inFamily Health Promoters (FHP in English PSF inPortuguese) to all 13 districts.Portuguese) to all 13 districts.


5/16

Methodology - 1Methodology - 1A qualitative assessment of the volunteerA qualitative assessment of the volunteerprogram was expected to examine the following:program was expected to examine the following:

Training modules. Training modules.Supervision and management.Supervision and management.Strengths and limitations of the PSF program asStrengths and limitations of the PSF program as

perceived by different stakeholders.perceived by different stakeholders.Awareness of roles of PSF in the communityAwareness of roles of PSF in the communityamong PSF and among MoH staff at differentamong PSF and among MoH staff at differentlevels.levels.Competence in technical / health knowledge /Competence in technical / health knowledge /

behavior change communication skills.behavior change communication skills.Perceptions about what needs to change andPerceptions about what needs to change andhow for the volunteer program.how for the volunteer program.


6/16

Methodology - 2Methodology - 2Samplingcategory

FocusGroup

Key Informant andIn-depth Interviews

CompetencyTests

Chefe sucoChefe aldeia

none Chefe aldeia of the twosampled aldeia (close toSISCa, far from SISCa),Chefe suco

No

HP/CHC Staff

none Focal Point for HP, Head of CHC, Midwife, Nurse

Yes

PSF / CHW none With all available PSFs insuco

Yes

Community none 10 mothers with childrenunder 5 (5 from close aldeia,5 from far aldeia)

Yes

DPHO none One Yes

DTT / MTT 12 DTT12 MTT

Eight National Level All FGDparticipants


7/16

Results - StrengthsResults - Strengths

Recruitment Training Implementation Management

MOH able torecruit manyPSFs

MOH able totrain PSFsfollowing the6-day trainingschedule

Training hasbeen popular among PSF

PSFs active atmonthly SISCaactivities

SISCa providessolid structureto managePSFs


8/16

Results - WeaknessesResults - WeaknessesRecruitment Training Implementation Management

Majority of PSFsselected by

health staff

Many PSFshaveforgotten

what topicsthey weretrained in

PSFs do limitedwork outside of SISCa

No supervisiontoolsHealth staff

unclear abouttheir managementrolesManagementcommitteeshave never functionedconsistently atany level


9/16

Results Competency/

Knowledge testing


10/16

Komunidade test scores

0.00.20.40.60.81.01.21.41.61.82.0

S I S C a

I s i n R u a

S u s u

b e n

F a s e

l i m a n

N u

t r i s a u n

I m m u n

i z a s a u n


11/16

PSF test scores

0.00.20.40.60.81.01.21.4

1.61.82.0

S I S C a

_ P S F

I s i n R u a

S u s u

b e n

D i a r e a

_ f a s e

l i m a n

N u

t r i s a u n

I m m u n

i z a s a u n


12/16

Pessoal Saude test scores

0.00.20.40.60.81.01.21.41.61.82.0

S I S C a

_ P S F

I s i n R u a

S u s u

b e n

D i a r e a

_ f a s e

l i m a n

N u

t r i s a u n

I m m u n

i z a s a u n


13/16

DTT & MTT test scores

0.00.20.40.60.81.01.21.41.61.82.0

S I S C a

_ P S F

J e s

t a u n

I s i n R u a

S u s u

b e n

D i a r e a

_ f a s e

l i m a n

N u

t r i s a u n

I m m u n

i z a s a u n


14/16

Recommendations - 1Recommendations - 1Recruitment Training

Need regular communication betweenhealth staff and communityleaders

Replacement policy for PSF needs to bearticulated; communityinvolvement in PSFrecruitment needs better definition

Use supportive supervisiontools to understand andimprove areas of PSFweakness and to help

knowledge and skill retention

Classify PSF by whether they have been given thenew training, and ensureone round of new trainingto all.


15/16

Recommendations - 2Recommendations - 2Implementation Management

Start regular internalcommunication betweenprogram staff and PSFs

Provide clarity on jobdescription for PSFs particularly on what they areexpected to do beyondSISCa.

Implement supervisiontools and mentoring / OTJtraining

Conduct monitoring visitsClarify rolesCreate transparent system

for PSF paymentsStrengthen PSF database

to maintain updated name-based list of recruited andtrained PSF at sub-districtlevels

Health workers needtraining in supervision and

support functions.


16/16

Implications for Health WorkerImplications for Health Worker Training Training

Communication skills - interpersonalCommunication skills - interpersonaland group education / advocacyand group education / advocacySituational analysis and planning skillsSituational analysis and planning skillsCommunity involvement andCommunity involvement andparticipation skillsparticipation skills

Adult education skills / adult learningAdult education skills / adult learningmethodologiesmethodologiesFollow-up, supervision, monitoring andFollow-up, supervision, monitoring and

on-the-job training / mentoringon-the-job training / mentoring

Evaluating the Family Health Promoters Program

Documents

Transcript of Evaluating the Family Health Promoters Program