Revitalizing family planning in Christian Health Associations through community health workers and religious leaders Lauren VanEnk, MPHInstitute for Reproductive HealthGeorgetown University
Reach of CHAs across Africa
CHAK’s dream:• That family planning (FP) education and
options will become easily accessible through a community-based distribution system
• That FP will cease to be restricted to hospitals where it is offered as medical treatment but instead will be transformed into an opportunity for Family Centered Health Care
• That FP will become a right for every woman and family
- Dr. Samuel Mwenda, Director of CHAK and ACHA Platform
Mobilizing FBOs to expand access to and choice in FP
Strengthen the capacity of Christian Health Associations to improve access to FP information and services, emphasizing opportunities for regional scale-up.
World Bank
Institute for Reproductive Health (IRH)
Christian Health Association of Kenya (CHAK)
Christian Connections for International Health (CCIH)
Goal
Don
or
Part
ne
rs
Project Objectives
1. Strengthen FP service delivery– TOT for master trainers– Facility-based Trainings– Community-based Trainings
2. Sensitize Religious Leaders– Develop IEC materials for FBO context– Informational workshops for pastors
3. Strengthen reporting process– Develop CHW reporting tools– Ensure supportive supervision provided to CHWs
4. Develop capacity building strategy for regional implementation – Introduce project at regional conference in Ghana– Disseminate model at an end of project workshop
Pilot introduction of community-based FP through CHAK facilities• 67 community health workers
(CHWs) trained to provide FP information and methods
• CHWs distributed pills, condoms, Standard Days Method® (SDM)/ CycleBeads®, Lactational Amenorrhea Method (LAM), referrals to facility for all other methods
• SDM was introduced for the first time as a new method, bringing new users to FP
5
com
pon
en
ts Training
This capacity building strategy relies on a training curriculum for CHWs based on the WHO flipchart for FP provision.
Supervisors are equipped to provide this training as well as ongoing supervision to CHWs.
To create a supportive environment for FP provision at the community level, a one-day workshop with pastors is conducted.
Pastors create action plans detailing how they will use this information with their congregations.
CHWs attend supervision visits monthly to submit reporting forms, receive resupplies of FP commodities (if possible), and receive support and refresher instruction on knowledge gaps.
In order for project to be successful, CHWs must have access to FP supplies.
Project managers/ supervisors must ensure CHWs are able to complete FP reports.
It is equally important that facilities readily receive CHW reports and record them in their service statistics.
Create a Supportive
Environment
Ongoing Supervisi
on of CHWs
Establish Supply Chain
Establish Reporting
Mechanism
• CHW Curriculum• Presentations,
including HTSP• WHO flipchart for FP
provision• Client cards
• Bible Study guide
• WHO flipchart for FP provision
• HTSP presentation
• Supervision checklist
• Knowledge Improvement Tool
• Reporting forms
Cap
acit
y B
uild
ing
S
trate
gy A
cti
vit
ies
Tools
Capacity Building Strategy
Establish Supply Chain
Must Haves:• Pills, condoms,
and CycleBeads at the community level
• Stakeholder involvement
Training
Must Haves:• Work with existing
cadre of CHWs
Tools:• CHW Curriculum• Presentations,
including HTSP• WHO flipchart for FP
provision• Client cards
Establish Reporting Mechanism
Tools:• Reporting forms
Must Haves:• Tested reporting
forms• Facility staff
understands their role
• MOH buy-in
Create a Supportive Environment
Must Haves:• Pastors willing to
share health information with their congregations
Tools:• Bible study guide• WHO flipchart for
FP provision• HTSP presentation
Must Haves:• Stakeholder
involvement• Incentive for CHWs• Capable
supervisors equipped to support CHWs
Ongoing Supervision of CHWs
Tools:• Supervision
checklist• Knowledge
Improvement Tool
5
com
pon
en
ts Training
This capacity building strategy relies on a training curriculum for CHWs based on the WHO flipchart for FP provision.
Supervisors are equipped to provide this training as well as ongoing supervision to CHWs.
To create a supportive environment for FP provision at the community level, a one-day workshop with pastors is conducted.
Pastors create action plans detailing how they will use this information with their congregations.
CHWs attend supervision visits monthly to submit reporting forms, receive resupplies of FP commodities (if possible), and receive support and refresher instruction on knowledge gaps.
In order for project to be successful, CHWs must have access to FP supplies.
Project managers/ supervisors must ensure CHWs are able to complete FP reports.
It is equally important that facilities readily receive CHW reports and record them in their service statistics.
Create a Supportive
Environment
Ongoing Supervisi
on of CHWs
Establish Supply Chain
Establish Reporting
Mechanism
• CHW Curriculum• Presentations,
including HTSP• WHO flipchart for FP
provision• Client cards
• Bible Study guide
• WHO flipchart for FP provision
• HTSP presentation
• Supervision checklist
• Knowledge Improvement Tool
• Reporting forms
Cap
acit
y B
uild
ing
S
trate
gy A
cti
vit
ies
Tools
Capacity Building Strategy
Change in Pill Use and SDM/CycleBeads Use Pre and Post Community-based FP Provision
Pills dispersed0
500
1000
1500
2000
2500
3000
3500
Statistics from Chogoria Presbyterian Hospital
CycleBeads dispersed
0
50
100
150
200
250
300
350
Jan-Feb 2011Jan-Feb 2012
Changes in Injectable, IUD, and Implant Use Pre and Post Community-based FP Provision
Implants dispersed
0
4
8
12
16
Statistics from Chogoria Presbyterian Hospital
Injectables dispersed
1000
1050
1100
1150
1200
1250
1300
IUDs dispersed0
5
10
15
20
25
Lessons Learned
• No Product, No Program
• Lay the ground work: advocacy and stakeholder involvement is crucial
• Expanding the method mix at the community level can increase method use and bring new users to FP
Thank you!