Integrating Community-Based Strategies into Existing Health Systems_David Shankin_5.6.14
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Transcript of Integrating Community-Based Strategies into Existing Health Systems_David Shankin_5.6.14
Senegal Case Study: Scaling Up Community Health Services to the National Level
through INGO Partnerships
Presentation:David Shanklin, MSIntegrating Community-Based Strategies into Existing Health Systems: The Unique Role of INGOsMay 5 – 9, 2014Silver Spring, MD
Original Purpose of the Program • Health huts in Senegal have been in existence since 1978,
inspired by the spirit of the Alma Ata Declaration and the promise of universal primary health care.
• Health juts were intended to provide basic health promotion and selected curative services in areas without immediately available public health facilities.
• Public support for health huts was abandoned by the mid-1980s, and almost all were closed by the end of the decade.
• A new health hut initiative was begun in 1998 as a pilot project by ChildFund (then known as Christian Children’s Fund) in order to resuscitate health huts at a local level.
Scaling Up Senegal’s Community Health Services
Project Characteristics USAID Projects
CANAH CANAH II CAMAT PSSC PSSC II
Dates 1998-02 2002-06 2003-06 2006-11 2011-16
USAID Funding Source CSHGP CSHGP Mission Mission Mission(Sector Focus) (MCH) (MCH) (TB/Malaria) (Integrated) (Integrated)
USAID Funding Levels $992,218 $1.25 Million $870,846 $26 Million $40 Million
Geographic Coverage 2 Districts 3 Districts 4 Districts 13 Regions 14 Regions65 Districts 71 Districts
Target MCH Population 137,000 163,393 502,035 3,369,633 9,098,014(>25% of Nat'l Pop) (>70% of Nat'l Pop)
Health Huts/ 60 HH 154 HH N/A 1,620 HH/ 2,245 HH/Outreach Sites 703 Sites 1,969 Sites
Scaling Up: Project’s Learning Transitions
CANAH:• Formative
research identifying and working with key community stakeholders
• Organizing & training health committees and HVs
• Organizing HH and later, Outreach Sites
CANAH II:• Extending community
health services • Liaising with local
MOH• Formulating unified
vision of health
PSSC:• Standardizing basic CB MCH• Coordinating CB MCH with multiple
implementing partners• Nationwide scale-up
PSSC II:• Urban extension• Additional service components• Transfer of HH/OS to community and MOH
CAMAT:• Additional services,
such as TB, Malaria and Nutrition
• Increased service area coverage
Health Promotion/Communication
Health Systems Strengthening
EP
I
Facility
S
erv
ices
Com
mu
nity
H
ealth
HIV
/AID
S/T
B
USAID/Senegal's Conceptual Pirogue: Improved Health Status of the Senegalese Population
Community-Based Strategy
Community mobilization using multiple local groups with consistent health messages and practices (based on early formative research) –
• Project’s community mobilizers
• Community health workers and volunteers (TTBA, health volunteers, community educators, health committee members)
• TB cells• Youth
Community-Based Strategy (cont’d)
• Pregnant women’s solidarity groups• Grandmothers and godmothers• Community leaders
Rural and urban populations dependent primarily on the health huts and outreach sites for health services.
Estimated total population – 9,098,014
Infants and children 0–5 years – 1,771,968
Children of school age – 2,544,364
Pregnant/lactating women – 354,394
Women of reproductive age – 2,090,013
Target Population
Strengths of INGO Participation• Geographic expansion and population coverage• Expansion in the number of services provided• Standardization of services and systems• Engagement of MOH at the local, regional and
national levels
Most Recent Results• October 2013 national Community Health Policy• April 2014 Five Year Strategic Plan for Community
Health