ONE DAY NATIONAL LEVEL WORKSHOP ON CHBC GUIDELINES FOR NGOS AND CBOS

NUR CENTER FOR RESEARCH AND POLICY

ONE DAY NATIONAL LEVEL WORKSHOP ON CHBC GUIDELINES FOR

NGOS AND CBOS A Joint Collaborative Project of the

Fatima Memorial Hospital and the Association of People Living with HIV

Dr. Shabnum Sarfraz Chief Operating Officer,

Nur Center for Research and Policy February, 2013

ONE DAY WORKSHOP ON CHBC GUIDELINES FOR NGOS AND CBOS

2 Copyrighted to the Nur Center for Research & Policy at the Fatima Memorial Hospital, Feb 2013

Contents Contents ...................................................................................................................... 2

Introduction ................................................................................................................. 3

Objective of training................................................................................................... 3

To orient participants from NGOS and CBOs working for PLHIV, on the CHBC Guidelines,

also developed by Nur Center for Research and Policy .................................................. 3

Scope ....................................................................................................................... 3

Facilitator’s Profile ...................................................................................................... 3

Training Methodology................................................................................................. 4

Agenda ........................................................................................................................ 5

Workshop evaluation .................................................................................................. 6

Feedback .................................................................................................................. 6

Trainer’s Feedback: ................................................................................................ 6

Participants’ Feedback: ........................................................................................... 6

Annex 1- Registration Sheet ( 1 of 2) ............................................................. A

Annex 1- Registration Sheet ( 2 of 2) ............................................................. B

Annex 2- Trainer Evaluation Form .................................................................. C

Annex 3- Training Evaluation Form ................................................................. D

Annex 4- Participants Evaluation of the Facilitators .......................................... E

Annex 5- Pictures from the Workshop............................................................. F

Annex 5- Pictures from the Workshop............................................................. G

Annex 5- Pictures from the Workshop............................................................. H



Introduction The one-day national level workshop for NGOs and CBOs was a project of Global Fund Round 9

organized by the Association of People Living with HIV. The technical assistance for the project was

provided by the Nur Center for Research and Policy, the technical arm of the Fatima Memorial

Hospital. Both Fatima Memorial Hospital and the Association of People Living with HIV are both sub

recipients of the Global Fund Round 9 and the present workshop was a joint collaborative project of

both the SRs for which they worked closely together.

Objective of training

To orient participants from NGOS and CBOs working for PLHIV, on the CHBC Guidelines, also

developed by Nur Center for Research and Policy

Scope The aim of the training was to orient the staff of different NGOs in understanding the need of

standardized guidelines and learning the use of CHBC Guidelines. The topics covered in this

workshop included:

1. Introduction to CHBCs and the Rationale for Guidelines

2. Using the CHBC Guidelines

3. Monitoring and Evaluation

Participant Profile

The workshop was designed for middle and lower level staff of NGOs and CSOs working for PLHIV

and they were selected in consultation with PR, UNAIDS, SRs and the association. Participants

included program managers, M&E managers, field officers, health care providers, outreach workers

and administrative staff from NGOs, CHBCs, COPCs from all over the country.

Facilitator’s Profile

Keeping in view the need of the content, the workshop was designed to be interactive so that

participants participate fully in the activities and learn about the guidelines.

The module on need of guidelines and standardization was led by Prof. Dr. Aman Ullah Khan, Dean

Faculty Fatima Memorial Hospital Medical and Dental College, Supervisor for FCPS Community

Medicine and Senior Technical Advisor to Nur Center for Research and Policy. He is a senior

academician in public health with numerous publications and trainings to his credit.

The directions to the actual guidelines and activity sessions were taken up by Dr. Roomi Aziz. She is

the Senior Manager Strategy and Planning at Fatima Memorial Hospital, working as one of the lead

trainers at Nur Foundation. Dr. Aziz is an MBBS Doctor with an MBA from LUMS. She has in-country

and international experience in trainings on leadership development, governance and planning in



social and corporate sector. She has done a leadership development for social sector module from

LUMS-REDC Hewlett & Packard Foundation.

Training Methodology Design and delivery of the training was via powerpoint presentations with aim of strengthening civil

society and foster institutional capacity building on care and support for PLHIV. The training

followed the following protocol:

a. Participants were registered as they come in and seated.

b. At 9:15 am, registration was closed and there was recitation of Holy Quran, followed by a

short welcome speech by the keynote speaker.

c. Moderator introduced the participants to the main objective of the training, the

stakeholders, set the ground rules and the expected outcome of the trainings.

d. This was followed by the first session on introduction to the workshop.

e. The senior trainer began with the objectives of the workshop, followed by various sessions

on different topics.

f. The sessions were also accompanied by activities to improve the understanding of

participants. At the end of training, evaluations were collected and after that the

participants were asked to share their experiences with the rest of the group.

g. The workshop ended at 4pm with certificate distribution and a group photograph, followed

by message dedication.

h. The training methodology included:

i. Illustrated lectures, visual aids in addition to verbal explanation

ii. Discussion/ Brainstorming to share views and problems using reasoning power, to

get all possible ideas from the group members

iii. Group work, to interact with each other and learn together

iv. Self study, to gain deeper insight and more profound knowledge



Agenda

Workshop Program

Instructor Name: Prof. Dr. Amanullah Khan, Dr. Roomi Aziz

Date: 19th February 2013

Venue: Beach Luxury Hotel, Karachi,

Session Name Time Objectives

Registration 9:00 –9:15 am

Orientation to Workshop 9:15 –10: 15 am o Introduction of participants

o Pre-workshop assessment

Session #1: Introduction to

CHBCs and Rationale for

Guidelines

10: 15 –11:00 am

o Overview of CHBCs

o Orientation to the Global Fund R-9 CHBC Component

o Why do we need guidelines?

Tea/Coffee Break 10:30 –10:45 am

Activity#1: Making signboards 10:45 –11:00 am

Session #2: Using the CHBC

Guidelines- The Text 11:00 –12:00 noon

o Understanding the structure of the

guidelines

o How to use the CHBC Guidelines

o How to use the study aid material

o SOPs for CHBC

Session #3: Using the CHBC

Guidelines- The Study Aid

Material

12:00 – 12:30 pm

Activity # 2: What do you

see? 12:30 –12:50 noon

Session #4: Monitoring and

Evaluation 12:50 –01:30 noon

o Difference between Monitoring & Evaluation

o M&E at the CHBC

Lunch & Prayer Break 01:00 – 02:00 pm



Workshop evaluation

Workshop evaluation forms were filled and collected from the participants at the end of the day.

This was done in order to gain better insight about the different aspects of the workshop. All

participants showed satisfaction with the achievements of the program objectives stating that the

training met their expectations. They also believed that the acquired knowledge would help them in

their professional fields in future. The objectives of the each session were clearly explained and

stated to the participants with the content being easy to follow. However they did suggest adding

more field base work along with theory. The participants showed satisfactions with the trainer and

stated that they had full command of the subject. The group activities were appreciated as well by

the participants.

Feedback

Trainer’s Feedback:

The trainers believed that the participants were eager to learn and share the knowledge. Their

backgrounds were relevant to the scope of the program and hence not only were the participants

better informed but also stood at gaining the most out of this workshop.

The participants should have been provided with the actual guidelines so that the workshop could

have rendered more utility to them and they could have asked questions in real time, as opposed to

seeing screenshots of the guidelines on the screen.

Participants’ Feedback:

The participants insisted on provision of CHBC guidelines before the beginning of the workshop.

Budgetary allowance for provision of support material needs to be made.

0

5

10

15

The training met my

expectations.

The knowledge acquired is

practical for my present professional

role

The training objectives for

each topic were

identified and followed

The content was

organized and easy to

follow.

The presentations were easy to

follow

The activities were

educative and useful

The duration of the

workshop was enough

for the content of

the workshop

Workshop Evaluation

Strongly agreed

Agree

Disagree

Strongly disagree

ONE DAY WORKSHOP CHBC GUIDELINES FOR NGOS AND CBOS ANNEXURE

A Copyrighted to the Nur Center for Research & Policy at the Fatima Memorial Hospital, Feb 2013

Annex 1- Registration Sheet ( 1 of 2)


B Copyrighted to the Nur Center for Research & Policy at the Fatima Memorial Hospital, Feb 2013

Annex 1- Registration Sheet ( 2 of 2)


C Copyrighted to the Nur Center for Research & Policy at the Fatima Memorial Hospital, Feb 2013

Annex 2- Trainer Evaluation Form


D Copyrighted to the Nur Center for Research & Policy at the Fatima Memorial Hospital, Feb 2013

Annex 3- Training Evaluation Form TRAINING EVALUATION FORM

Please check against the box which states the extent of your agreement to the following statements

about this training program:

STRONGLY

AGREED AGREE DISAGREE

STRONGLY

DISAGREE

1. The training met my expectations.

2. The knowledge acquired is

practical for my present professional

role

3. The training objectives for each

topic were identified and followed.

4. The content was organized and

easy to follow.

5. The handouts and readings were

given to me before the sessions

began.

6. The material distributed was easy

to follow and useful

7. The presentations were easy to

follow

8. The activities were educative and

useful

9. The video was educative and

useful

10. The duration of the workshop was

enough for the content of the

workshop


E Copyrighted to the Nur Center for Research & Policy at the Fatima Memorial Hospital, Feb 2013

Annex 4- Participants Evaluation of the Facilitators

PROF. DR. AMANULLAH KHAN

DR. ROOMI AZIZ

0

5

10

15

20

25

Trainer’s understanding of

concepts was thorough

Trainer was well-prepared and

answered to the questions raised by participants appropriately

Trainer made use of the handouts

given to the participant to

explain things in a better way

Trainer has good presentation

skill/style, knowledge and command over

the subject

Trainer has an interactive

teaching style, involving

participants in discussion.

Prof. Amanullah

Strongly agreed

Agree

Disagree

Strongly disagree

0

5

10

15

20

25

Trainer’s understanding of

concepts was thorough

Trainer was well-prepared and

answered to the questions raised by participants appropriately

Trainer made use of the handouts

given to the participant to

explain things in a better way

Trainer has good presentation

skill/style, knowledge and command over

the subject

Trainer has an interactive

teaching style, involving

participants in discussion.

Dr. Roomi Aziz

Strongly agreed

Agree

Disagree

Strongly disagree


F Copyrighted to the Nur Center for Research & Policy at the Fatima Memorial Hospital, Feb 2013

Annex 5- Pictures from the Workshop


G Copyrighted to the Nur Center for Research & Policy at the Fatima Memorial Hospital, Feb 2013



H Copyrighted to the Nur Center for Research & Policy at the Fatima Memorial Hospital, Feb 2013


08/03/2013

1

UNDERSTANDING THE NATIONAL CHBCGUIDELINES

19th February, 2013Beach Luxury Hotel, Karachi

Agenda

Copyright 2012- Intellectual Property ofNur Center for Research and Policy

To understandthe need of

CHBCGuidelines

To understandthe need of

CHBCGuidelines

Understandingthe GuidelinesUnderstandingthe Guidelines

Need ofMonitoring and

Evaluation

Need ofMonitoring and

Evaluation

Why are we here today?

Going through theguidelines step by

step and usingdifferent sections

Simplemeasures

andapproaches

ParticipantsPARTICIPANTS ORGANIZATION AIM

Irshad AhmedKhan

Bridge Stop HIV/AIDS totally

Abdul LatifSheikh

APLHIV- Karachi To work for PLHIVs

Farooq Bridge Serve the humanity,specifically PLHIVs

Shezad Sheikh Bridge

Kashif Gender andReproductive HealthForum

HIV Prevention- FSWs



Hina Feroz GRFH

FSWs focussed- highlysuccessful

Zeba Ramzan GRFH

Raheela GRFH

Masooma GRFH

Dr. Ashraf Indus Hospital To serve humanity/Camps/fundraising

MohammadAmir

Indus Hospital 370 pts registered



Syeda Almas Bridge

Ursila Zafar Bridge

Lubna Rubab Bridge

Muneer Jabbar Sukkur SKR1 CHBC site

Saliha Pakistan Society Counselling of PLHIVs

Rubina Iqbal Pak Positive WelfareOrganization

Mukhtiyar AliMughal


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Muhammad Iqbal Pak Positive Society

Shahnawaz Sheikh CHBC Site Larkana

Ameer Ali Abro CHBC Site Larkana

Dr. Nayab Tarique Bridge- CHBC SiteKarachi


Agenda


Why need aguideline?

Why need aguideline?

Reading theguidelines

Reading theguidelines

UnderstandingM&E for CHBCsUnderstandingM&E for CHBCs

Introduction to CHBCs andrationale for guidelines

Using the CHBCGuidelines

Monitoring and Evaluation

WHY ARE WE HERE TODAY?


Why need guidelines?

• How to behave with PLHIVs• How to deal• To achieve standardization- Why?

– Same PLHIVs, deserving same level of care– To achieve quality in services– Same services!!!!


Objective

• To follow comprehensive guidelines for theCommunity Home Based Care Centres thatinclude:1. Standards for Case Management2. Formats for monitoring, evaluation and reporting3. Training requirements for CHBC Staff


WHAT ARE CHBCS?


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Defining CHBC

• ‘Any form of care given to ill people in theirhomes.’

• (WHO, 2011)


Challenges of Community HomeBased Care


• Stigma• Trust• Economic Status• Awareness• De-motivation• Drug Addiction• Accountability

Challenges of Community HomeBased Care

• Child care and HIV• Confidentiality• Economic distress• Lack of awareness about CHBC programs• Access to CHBC programs• Stigma associated with HIV/AIDS• High illiteracy rate• Care for the caregiver• Limited resources• Tb/HIV co-infection• Geographic scatter of the patients


7 Essential Elements of CHBC1. Provision of care- includes assessment and entry criteria,

care plan and exit strategy2. Continuum of care3. Education4. Supplies and equipment5. Staffing6. Finance and sustainability7. Monitoring and evaluation8. Effective governance and management structures

Source : WHO


CATEGORY SUBCATEGORY1. PROVISION OF CARE Basic Physical care

Palliative care Psycho-social support & counselling Care of affected & infected children

2. CONTINUUM OF CARE Accessibility Continuity of care Knowledge of Community resources Accessing other forms of community care Community coordination Record-keeping for PLHIV Case- finding Case management

3. EDUCATION Curriculum development Education management & curricular delivery Outreach Education to reduce stigma Mass media involvement Evaluation of education

4. SUPPLIES &EQUIPMENT

Location of CHBC team Health center supplies Management, monitoring &record keeping Home-based care kits

5. STAFFING Recruitment Supervising and coordinating CHBC Retaining staff

6. FINANCING ANDSUSTAINABILITY

Budget and finance management Technical support Community funding Encouraging volunteers Pooling resources Out-of-Pocket payments Free services

7. MONITORING ANDEVALUATION

Quality assurance Quality of care indicators Monitoring and supervision Informal evaluation Formal evaluation Flexibility


SIGNBOARDS

ACTIVITY SHEET


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USING THE CHBC GUIDELINES


Abbreviationsand Acronyms


Glossary of Items


Table of Contents


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Section 1:Background

andIntroduction


CONFIDENTIALITY IS A PROMISEPrivacy is a practice


Section 2:Standards forCommunityand HomeBased Care


Section 3:Standardsservices


Section 4:Standardsservices


Section 5:ReferralSupportServices


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Section 6:Establishing

andMaintaining

CHBC


Section 7:Staffing andTraining at

CHBC


Section 8:Financing

andSustainabilityof the CHBC


Section 9:Monitoring

andEvaluation at

the CHBC


Section 10:StandardOperating

Procedures


Section 10:StandardOperating

Procedures-contd.


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MONITORING AND EVALUATION AT CHBC


Dancing elephantTry to count the number of his legs


Difference Between Monitoringand Evaluation

Monitoring EvaluationContinuous: day-to-day Periodic: At important

milestonesDocuments progress In-depth analysis of

achievements and gapsFocuses on inputs andoutputs

Focuses on outcomes andimpacts

Alerts managers toproblems

Provides managers withstrategy andpolicy options

Self-assessment External analysisCopyright 2013- Intellectual Property ofNur Center for Research and Policy

Feedback• Awareness of CHBCs and their work• Standards- Services• Knowledge of an existing guideline• Less Duration• Knowledge sharing• Networking/ Collaboration• Confidentiality/ Trust!• Empowerment• Accountability/ Responsibility• SOPs/policies/procedures• Higher frequency of such programs/ more to increase impact• Language- URDU


Questions?

Thank you


ONE DAY NATIONAL LEVEL WORKSHOP ON CHBC GUIDELINES FOR NGOS AND CBOS

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