CORE Global Health Practitioner Conference, Fall 2014

1. 1
Using a Community Health System to Strengthen the performance of Village Health Committee
Ram Kumar Shrestha
Senior Improvement Advisor, Community Health and Nutrition
USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project
University Research Co, LLC
CORE Group Conference Fall 2014

2. CHV
Current situation of the CHW / CHV
Ram Shrestha

3. USAID Applying Science to Strengthen and Improve Systems
Current Situation of Community Health Workers
Ram Shrestha

4. USAID Applying Science to Strengthen and Improve Systems
SUPPORT TO COMMUNITY HEALTH WORKERS
Ram Shrestha

5. Schools
Religious Community
Health Clinic
Community Health System
Village Committee
Savings & Credit Group
$
Women’s Group
Local Government
Community Health Volunteers
NGOs Volunteers
© 2013 Ram Shrestha

6. Schools
Religious Community
Women’s Group
Local Health Clinic
$
Savings & Credit Group
Local Government
CHW
Community Health System
Ram Shrestha

7. USAID Applying Science to Strengthen and Improve Systems
Community QI Team, Buikwe, Uganda

8. USAID Applying Science to Strengthen and Improve Systems

9. USAID Applying Science to Strengthen and Improve Systems
QI team member’s register with name and number of pregnant women

10. 10

11. USAID Applying Science to Strengthen and Improve Systems
PLHIV identification in the community
11
679
741
364
0
100
200
300
400
500
600
700
800
900
1000
Cumulative number of PLHIV identified in 10 villages of Uganda, June 2012 - January 2014
Total identified by VHTs alone in the community system
Total HIV patients
identified in a
community system
including VHTs
Estimated number of people living with HIV in the community (9% prevalence)

12. USAID Applying Science to Strengthen and Improve Systems

13. USAID Applying Science to Strengthen and Improve Systems
Lessons Learned
•Every community has an informal system of networks, including the CHV/CHW
•Community Health System strengthens the function of Village Health Committee
•Support of Village Health Committee improves the performance of CHVs
•Linkages between the community and health facility can be strengthened by working through the community system

14. March 2014
April 2014
May 2014
Back to ART March: 8
Back to ART April: 6
Back to ART May: 3
Back to ART 17
Died 11
Relocated 5
Status of the 33 individuals who were traced from March-May
Getting Lost-To-Follow-Up (LTFU) Patients Back in Care
Community Linkages Improvement Demonstration Project in Muheza, Tanzania, March-May 2014

15. •Individual responsible ( Find concrete things to work on)
•Team responsible ( equipped with skills to solve problem)
•Joint problem solving
•Motivation
•Achieving something with data (seeing improvement)
•Status of member in the village