Global Health Action-Haiti

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;