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The Care Group Model Alyssa L. Davis Health Advisor, Concern Worldwide Burundi Operations Research: Methods, Challenges, Emerging Lessons and Opportunities CORE Group Spring Meeting May 12, 2011 Operations Research in Burundi
[object Object],[object Object],Unrealistic Workloads Inadequate Training Insufficient Supervision Lack of Support Systems
Basic Description of a Care Group ,[object Object],[object Object],[object Object],Source: Tom Davis, Melanie Morrow and Carolyn Wetzel.  Presentation “Care Groups: The Essential Ingredients.” April 2010.
[object Object],Basic Description of a Care Group ,[object Object],[object Object],Source: Tom Davis, Melanie Morrow and Carolyn Wetzel.  Presentation “Care Groups: The Essential Ingredients.”  April 2010.
Under-five deaths could be could be preventing in  42 countries with 90% of worldwide child deaths in 2000 through achievement of universal coverage with individual interventions. Source of Table: Jones G, Steketee RW, Black RE, Bhutta ZA, Morris SS.  The Bellagio Child Survival Study Group. How many child deaths can we prevent this year?  Lancet  2003;  362 : 65-71.   The Care Group Model has been used to promote and support highly effective child survival interventions—and could be used to promote and support even more in the future. Focus on High Impact Interventions in  Child Survival
Contact Intensity Index Source: Jim Ricca, Senior Technical Advisor, MCHIP   Project Country 1. Health facility improvement 2. Governance 3. Behavior Change –  one-on-one 4. Outreach Services 5. Comm. treatment 6. Comm. Finance 7. Behavior change  -  mass media   Nepal x x x  x   x x   Mali x x x  x   x     Benin x   x        x   Rwanda 2   x x  x x        Ethiopia x x x  x   x     Cambodia 3   x x  x x        Madagascar x         x x   Guinea x x x  x   x     Senegal x x x  x x  x x   Cambodia 2 x x x  x   x     Rwanda 1 x x x    x  x     Kenya x               Haiti x x   x x    x   Mozambique x x   x         Malawi x x   x x  x     Cambodia 1 x x x  x           More successful 82% 82% 91% 73% 36% 73% 36%   Less successful 100% 80% 20% 80% 40% 20% 20%   Odds Ratio 0.8 1.0 4.6 0.9 0.9 3.6 1.8   Fisher Exact Test NS NS 0.05 NS NS 0.08 NS   Significant at the level p  <  0.05   Significant at the level p  <  0.10  
The Care Group network of volunteers extends the REACH  of the formal health system. Health Center Care Group Volunteers Community Health Workers Household Child Caregivers
26 Project Staff Train 200 Care Groups  -> 2,600 Care Group Volunteers Train 34,000 Households -> Total Target Population Reached: 40,000 Women of Reproductive Age 24,000 Child under Five Years.
Mabayi Health District Child Survival Project: The Integrated Care Group Model ,[object Object],[object Object],[object Object],Source: Philip Wegner, Concern Worldwide
22 Health Center Titulaires Train 153 Community Health Workers  -> 153 Community Health Workers Train 300 Care Groups  -> 2,952 Care Group Volunteers Train 44,000 Households  -> Total Target Population Reached: 53,000 Women of Reproductive Age   41,000 Child under Five Years
Contributions to National Health Policy ,[object Object],[object Object],[object Object],[object Object],Source: Alyssa L. Davis, Concern Worldwide
Operations Research Objective ,[object Object],Source: Alyssa L. Davis, Concern Worldwide
Research Questions ,[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],Hypothesises and Methods
Key Operational Monitoring Indicators Operation Research Indicator Target Value Percentage of beneficiary households that received at least one Care Group Volunteer visit per month. 80% Percentage of Care Groups that held a meeting at least once per month. 80% Percentage of Care Group Volunteers that reported registration and C-HIS data to their supervising Promoter/CHW per month. 80% Percentage of CHWs that reported registration and C-HIS data to their associated Health Center per month. 80% Percentage of CHWs that attended at least one COSA meeting per month. 80% Percentage of Care Group Volunteers who received at least one visit from a Promoters/CHW per month. 80% Percentage of Care Group meetings that are conducted according to minimum standards of quality per month. 80% Percentage of Care Group registers that meet minimum standards of quality per month. 80% Percentage of CHW supervision visits to Care Group Volunteers conducted according to minimum standards of quality per month. 80%
Challenges ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Source: Alyssa L. Davis, Concern Worldwide
Lessons Learned ,[object Object],[object Object],Source: Concern Worldwide Burundi ,[object Object],[object Object]
Tips ,[object Object],[object Object],Source: Alyssa L. Davis, Concern Worldwide ,[object Object],[object Object],[object Object]
Murakoze chane! (Thank you very much) Source: Alyssa L. Davis, Concern Worldwide Source: Philip Wegner, Concern Worldwide … et bonne chance!

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Operations Research: Methods, Challenges, Emerging Lessons, and Opportunities_Davis_5.12.11

  • 1. The Care Group Model Alyssa L. Davis Health Advisor, Concern Worldwide Burundi Operations Research: Methods, Challenges, Emerging Lessons and Opportunities CORE Group Spring Meeting May 12, 2011 Operations Research in Burundi
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  • 5. Under-five deaths could be could be preventing in 42 countries with 90% of worldwide child deaths in 2000 through achievement of universal coverage with individual interventions. Source of Table: Jones G, Steketee RW, Black RE, Bhutta ZA, Morris SS. The Bellagio Child Survival Study Group. How many child deaths can we prevent this year? Lancet 2003; 362 : 65-71. The Care Group Model has been used to promote and support highly effective child survival interventions—and could be used to promote and support even more in the future. Focus on High Impact Interventions in Child Survival
  • 6. Contact Intensity Index Source: Jim Ricca, Senior Technical Advisor, MCHIP   Project Country 1. Health facility improvement 2. Governance 3. Behavior Change – one-on-one 4. Outreach Services 5. Comm. treatment 6. Comm. Finance 7. Behavior change - mass media   Nepal x x x x   x x   Mali x x x x   x     Benin x   x       x   Rwanda 2   x x x x       Ethiopia x x x x   x     Cambodia 3   x x x x       Madagascar x         x x   Guinea x x x x   x     Senegal x x x x x x x   Cambodia 2 x x x x   x     Rwanda 1 x x x   x x     Kenya x               Haiti x x   x x   x   Mozambique x x   x         Malawi x x   x x x     Cambodia 1 x x x x           More successful 82% 82% 91% 73% 36% 73% 36%   Less successful 100% 80% 20% 80% 40% 20% 20%   Odds Ratio 0.8 1.0 4.6 0.9 0.9 3.6 1.8   Fisher Exact Test NS NS 0.05 NS NS 0.08 NS   Significant at the level p < 0.05   Significant at the level p < 0.10  
  • 7. The Care Group network of volunteers extends the REACH of the formal health system. Health Center Care Group Volunteers Community Health Workers Household Child Caregivers
  • 8. 26 Project Staff Train 200 Care Groups -> 2,600 Care Group Volunteers Train 34,000 Households -> Total Target Population Reached: 40,000 Women of Reproductive Age 24,000 Child under Five Years.
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  • 10. 22 Health Center Titulaires Train 153 Community Health Workers -> 153 Community Health Workers Train 300 Care Groups -> 2,952 Care Group Volunteers Train 44,000 Households -> Total Target Population Reached: 53,000 Women of Reproductive Age 41,000 Child under Five Years
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  • 15. Key Operational Monitoring Indicators Operation Research Indicator Target Value Percentage of beneficiary households that received at least one Care Group Volunteer visit per month. 80% Percentage of Care Groups that held a meeting at least once per month. 80% Percentage of Care Group Volunteers that reported registration and C-HIS data to their supervising Promoter/CHW per month. 80% Percentage of CHWs that reported registration and C-HIS data to their associated Health Center per month. 80% Percentage of CHWs that attended at least one COSA meeting per month. 80% Percentage of Care Group Volunteers who received at least one visit from a Promoters/CHW per month. 80% Percentage of Care Group meetings that are conducted according to minimum standards of quality per month. 80% Percentage of Care Group registers that meet minimum standards of quality per month. 80% Percentage of CHW supervision visits to Care Group Volunteers conducted according to minimum standards of quality per month. 80%
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  • 19. Murakoze chane! (Thank you very much) Source: Alyssa L. Davis, Concern Worldwide Source: Philip Wegner, Concern Worldwide … et bonne chance!