Board MeetingJune 29, 2011
Haiti ProgramsFY 2012
Areas of involvement Approaches Outcomes/Outputs
Community-based health outreach
Animal husbandry
Clinic support
Supporting CHWs, TBAs
Farmer training and support
# Trained CHWs, TBAs
# patients seen at clinic (mobile & stationery)
#births assisted by TBAs
# vaccinations provided by CHWs
# families participating in goat training
# pregnant goats distributed
GHA in Haiti…
Technical interventions in health: General health promotion (CHWs), MCH (primarily through TBA outreach) primary health care (at health facility, includes HIV testing);
Other technical interventions: skill-building in goat care; follow-up care
Technical interventions in health: General health promotion (CHWs), MCH (primarily through TBA outreach) primary health care (at health facility, includes HIV testing);
Other technical interventions: skill-building in goat care; follow-up care
What do we have to work with…
• What does community-based mean?
• What already exists in the community &what can be leveraged?
• Where & how will our interventions work?
• Is there a need for ____ intervention?
• And, how we can get from interventions/programs to community-led initiatives?
Family unit…adult male, female,
children, infants, grand parents,
aunts, uncles….
Clinic/dispensary/hospital
Church/FBO
CHW/TBA/Animal
HW
Children under 5
Adolescents (with raging hormones)
Local committee--
health, savings, women's groups
Care groups
Municipal/political council
NGO/CBO/(other services)…
Inst. Mechanism (state)
What makes up a
community (as we
would imagine
it)?
Pregnant women
Etc, etc?
Any number and types of services by other NGOs/
INGOs/CBOS
Specific interventions (FP, WASH,
clinical referrals and care, HIV/STI, micro credit, training-skill building,??)
The state, also a
service provider
This could be
mothers/fath
ers
groups/savin
gs
groups/munic
ipal councils
Clip art, source: all over the internet
Bringing it all together…
What does a CHW do now?
What could a CHW do?
Source: Earth Institute, Columbia Univ, 2010
CHW sub-system as part of the PHC system
Source: Earth Institute, Columbia Univ, 2010
Goat Program training—what we do now
Goat Program services—what we do now
Goat Program training—what we could do
Goat Program services—what we could do
Integration? Between Health and Rural Development
• Working within the same communities (serving the same population)
• Linking community-based animal health workers with CHWs
• Community groups (micro credit/finance) that could also be care groups (for health promotion)
• Work with partners that provide other services (Fonkoze, UPA) • What’s been done elsewhere and what can work?
Conventional Community Health…
• Goal: decreased infant/maternal mortality, fixed interventions
• Focus: programs and activities
• Agenda: set by organization
• Generally not sustainable; changes do not last if program stops
• Poorest of poor still excluded
• Values remain unchanged
GHA’s approach should be based on...
• Goal: Self-reliant healthy communities
• Focus: community organization around needs, and priorities
• Agenda: set by community
• Has great potential to be sustainable since is community-driven
• Specific targeting of poorest
• Values will be transformed
From projects and programs to community-driven change….
Ref: Tear fund (1999)
Outputs for FY 2012:• 25 newly trained CHWs in Leogane commune
• 19 newly CHWs in Petit-Goave (PG) commune
• 3 day-long TBA refresher trainings
• 5-day refresher training for CHWs in Leogane and PG
• 10 group meetings with CHWs/TBAs (refresher trainings, support, supervision)
• Re-start the community health committees in Petit-Goave (in partnership with the UCS; 12 committees, 10 meetings each)
• Cholera prevention and treatment training for health committee members in partnership with UCS in PG commune
• 3500-4000 patient visits at Olivier clinic (in partnership with Methodist Church of Haiti)
Outputs, contd: • 2500-3000 patients seen at mobile clinics organized by Olivier.
• Adapt and update CHW training curriculum
• Conduct needs assessment project (identify new technical interventions within community-based health & development)
• Based on results from assessment, seek and obtain funding for community-based health systems strengthening in Petit-Goave
• Conduct independent, external evaluation of Goat Program and identify tangible growth initiatives and opportunities (also based on assessment project)
• 300 farmers trained in goat care & husbandry (& 300 goats distributed)
• 2400 follow-up goat care sessions provided (average of 200 families a month)
Building our own capacity (in FY ’12)
• New vehicle• Two new hires• New field office• Staff professional development/team-building• Needs assessment to identify technical
intervention and feasible strategic partnerships• Moving from Output (e.g. training numbers) to
Impact (e.g. improvement in health indicators)• From training to programming—target setting,
from output to impact;
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