FBOs and Womens, Maternal, and Neonatal Health Care

1
FBOs and Womens, Maternal, and Neonatal Health
Care

• A Review of Faith Based Models of Community Based
  PNMCH

2
Overview of Presentation

• Background of Initiative to Review FBO Work in
  Community Based PMNCH Programming
• Indicators Reviewed
• Review of Community Based Programs
• World Relief
• Jamkhed
• Church of Central Africa Presbyterian
• Conclusions/Recommendations

3
Background

• Role of FBOs in Womens Maternal, and Neonatal
  Health under recognized
• Presence of Faith Based organizations, churches
  and hospitals
• JHPIEGO and IMA World Health Collaboration on
  ACCESS Project

4
Indicators Reviewed

• Infant Mortality
• Immunization uptake
• Use of Antenatal Care
• Exclusive Breastfeeding
• Uptake of Family Planning Services
• Rates of Malnutrition

5
MCH Programming in Mozambique
6
Situation in Mozambique

• 4 out of 10 Mozambicans live on less than 1 per
  day
• 3 in 10 children in Mozambique die before they
  reach the age of five
• Ten years ago, when a child got sick or
  diedmothers blamed witchcraft because they did
  not know the truth about disease.

7
WORLD RELIEFVurhonga Projects I, II, III

• World Reliefs Care Group Model trains
  volunteer health promoters in Mozambique
• Every household in five health districts learns
  the truth about hygiene, nutrition,
  immunizations, diarrhea, malaria control, etc. 
• The resultcommunities change as families protect
  and care for their health

8
Care Group Model

• 5 Supervisors
• 26 Promoters
• 220 Care Groups of 10-15 Volunteers
• 10 Households per Volunteer

9
Care Group Model contd

• Goal Achieve sustainable impact by engaging a
  network of community health volunteers and
  training them in Care Groups as behavior change
  agents.

10
Care Group Model Contd

• Each volunteer commits to sharing knowledge with
  10 neighbors. Knowledge transferred mother to
  mother. Combat Dehydration
• Facilitate Practice of Birth Spacing
• Follow Good Nutrition and Hygiene Habits
• Learn Importance of Breastfeeding, Vitamins, Iron
  Supplements, and Immunization

11
Care Group Model Results
12
Community Rural Health Project Jamkhed
13
CRHP Model

• The Village Health Worker (VHW) acts as the local
  agent of positive health and social change. She
  is selected by her community and receives
  training in health, community development and
  organization, communication skills, and personal
  development from CRHP.

14
Village Health Workers contd

• VHW training was designed to empower these often
  oppressed women by increasing their knowledge,
  building skills, and demystifying medicine so as
  to truly put health in the peoples hands. The
  initially high rates of diseases and premature
  deaths in the area were primarily linked to
  malnutrition, water-borne diseases resulting in
  diarrhea and infections, untreated communicable
  diseases, lack of family planning, and harmful
  superstitious beliefs and practices. The training
  these women received opened a doorway for
  effective, locally-managed and relatively simple
  interventions to halt this vicious cycle that was
  causing so much pain and suffering.

15
VHW Delivering Basic Care
16
CRHP Model Contd

• What Do Village Health Workers Do?
• Visit households and share information
• Work directly with womens, youth, and farmers
  groups,
• Teach about harmful cultural practices such as
  discrimination against women
• Refer severe health conditions to the hospital

17
VHWs in Action
18
CRHP Model

• To Improve PNMCH, Jamkhed has
• Promoted a comprehensive approach to health and
  empowered the community to improve
  infrastructure, water quality, hygiene, etc
  through multi-sector approaches.
• Introduced participatory decision making at the
  community level by encouraging community meetings
  and working with womens and youth groups on
  skill development
• Mobilized the community to emphasize beneficial
  traditional practices and eliminate harmful ones.

19
Outcomes for CRHP Villages
20
Additional CRHP Outcomes

• People now willingly accept family planning since
  they no longer expect their children to die from
  communicable diseases.
• Most health problems are effectively taken care
  of and monitored at the villages themselves by
  well-trained and confident VHWs.
• The impact of CRHPs training activities has led
  to a true grassroots movement for health and
  social justice, shaping public health policy as
  well as the direction taken by health conscious
  NGOs involved in development work.

21
Church of Central Africa Presbyterian

• Operating in areas with traditionally low
  coverage in terms of availability of services
• Local Congregations promote womens and
  childrens health through their womens groups.
• Engages religious leaders in delivering health
  messages.
• Provides health messages through youth groups

22
CCAP contd

• Malaria Prevention Program provides the
  following
• Health Education about prevention and early
  treatment of malaria
• Insecticide Treated Nets at subsidized prices to
  pregnant women and children five and under
• Re-treatment of nets
• Follow up services for pregnant women and
  children who have malaria

23
Insecticide Treated Net
24
CCAP Program Impact

• High percentage (81) of respondents aware of
  benefits of sleeping under a mosquito net.
• Significant increase in the percentage of
  respondents reporting having nets in their homes

25
Conclusions and Recommendations

• Community, and congregation based FBO health
  programs are a valuable national asset and
  provide a critical link to ensuring access to
  health care, especially for rural and
  marginalized populations
• FBO led community based programming is one of the
  most effective and sustainable avenues for
  ensuring health women, mothers, and babies and
  should receive political support from
  governments, as well as financial support from
  donors.

26
Thank You

• Sarla Chand, MD
• IMA World Health
• sarlachand_at_imaworldhealth.org
• 410-635-8720
• Jacqui Patterson MSW, MPH
• ActionAid International USA
• Jacqui.Patterson_at_actionaid.org
• 202-370-9916
• To DOWNLOAD a copy of this report-
  www.accesstohealth.org