(5) community outreach for cmam

7/29/2019 (5) Community Outreach for CMAM

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Community Outreach


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Learning Objectives

Importance of Community outreach

Key elements of community assessment

Formulation of community outreach strategy

Considerations for developing and using CMAM

messages

Preparation for community mobilization and Training


3/19

Core Components of CMAM


4/19

4

Components of CMAM

Outpatient care for themanagement of SAM (OTP)

Inpatient care for themanagement of SAM

Services or programmes for themanagement of MAM (SFP)

Community outreach


5/19

Purpose of

Community outreach

Active case finding for early detection and

referral

Case follow up in the home

Check on a child who is not thriving or

responding well to the treatment

Learn why a child was absent from a out-patient

care follow up session

Learn why a child defaulted (defined as missing

three out-patient care follow up sessions in row)


6/19

Importance of Community

outreach to CMAM-1

It helps to ensure that children with SAM

are detected early;

- before the onset of medical complications

- referred for treatment, leading to better clinical

outcomes and decreased strain on in patient

services


7/19

Obstacles to participation in CMAM

Barriers to Access (Role Play) Exercise

Overcoming Obstacles to Community

participation in CMAM - Exercise

Importance of Community

outreach to CMAM (cont)


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Obstacles to participation

in CMAM

Poor awareness

Community mobilization is overly broad

Referral and admission criteria are not aligned

Local medical or cultural traditions do not connectadvance wasting or swelling with under nutrition

Community mobilization or site selection may have

overlooked important gatekeepers

Other services at the PHC facility not well regarded Location of the outpatient care site

Participation interrupted by seasonal labour


9/19

Community Worker

Nutrition Volunteer

First Neighbour (in community)

Husband

Second Neighbour (returning on the road) Outpatient care nurse

Barriers to Access: Role Play


10/19


11/19

Understanding demand Understanding local perceptions and practices to

develop a sense demand inhibitors

Area of investigation include ; Local diseaseclassification, attitude towards formal health

services, other paths to treatment, communityhomogeneity/heterogeneity

Community Assessment-(Contd)


12/19

Understanding Supply Also involves community level discussions but the

assessors also consider institutional and organizational

factors at the facility and district levels.

Questions include; Who are the likely candidats for case-finding? Where is the supervision of case-finding bettersituated? How strong or weak are the links between healthfacility and community? What channels exist to spread

information on CMAM, what risks and advantages areassociated with each?

Community Assessment-(Contd)


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Community Assessment Steps

Defining the parameters of CMAM programme District level review to understand the local context

Community level review to complete information gatheredat district level

Beneficiary level discussions to determine perspective,knowledge, vocabulary of SAM

Community Assessment-(contd)


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Insights from community assessment

Objectives and nature of the CMAM strategy

Methods of case finding-How the case

finding will be conducted;

House to house/ tent to tent case finding

Community case finding

Passive case finding

Key Steps in CMAM Outreach

Strategy-3


15/19

Appropriate models to use will depend on;

The level of SAM in the community

Community awareness on the signs of SAM

Accessibility of homes ; clustered or dispersed

Existing networks of outreach workers

Time and resources available for training

Whether active case finding is envisioned as permanent or

temporary

Key Steps in CMAM Outreach

Strategy- (contd)


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The need for standard CMAM messages;

simple, standardized messages,

describing the program

Standard CMAM messages

Developing and using handbills

Considerations for

CMAM Messages


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Key actions in community mobilization

and training

Reliable communication between health careproviders and community

Help communities select outreach workers

when necessary

Train outreach workers

Engage civil society partners

Community Mobilization

and training


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Community Outreach

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Promote CMAM services

Make CMAM and thetreatment

of SAM understandable

Understand culturalpractices,

barriers and systems

Dialogue on barriers touptake

Promote community case-finding and referral

Conduct follow-up homevisits for problem cases

Key individuals in thecommunity:


19/19

Thank You..

(5) community outreach for cmam

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