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Project Outline

 • Project Period:
   Apr. 2008~Mar. 2011
 • Project Area:Catchment
   areas of 6 health centers in
   Prey Veng Operational
   District, Prey Veng Province
 • Target group:Health center
   staff and Community Health
   Workers(VHSG and TBA)of
   the target area,
   approximately 300 in total.


1) VHSG :Village Health Support Group
Project purpose:6 target Health Centers provide
Integrated ANC/PNC and Growth Monitoring services
through collaboration with Community Health
Workers.
*Integrated services include measuring weight/height, history taking
and physical check-up, early detection of problems , immunization,
micro-nutrient, and health education.



             Objective of the survey
To identify activities by VHSG and collaboration
between HC staff and VHSG at the time of
starting the project.
Survey method

• Target:18 Health Center staff and 97 VHSG who were
  randomly selected.
• Target area:Catchment areas of the 6 target HC
• Method:Face-to-face interview by using questionnaire
• Period:June - July, 2008
• Contents:VHSG activities (selection process, motivation,
  contents of activities), collaboration between VHSG and
  HC (including management by HC), contributing factors
  for VHSG to continue their activities.
• Analysis:Comparing answers by HC staff and VHSG for
  the same question.
• Ethical consideration:The interviewers explained the
  purpose of the survey and confidentiality to interviewees.
Results
                      Main Activities done by VHSG
                    (Answers by HC staff and VHSG)

100

 90

 80

 70

 60

 50
                                                                                                                                         HC staff
 40                                                                                                                                      VHSG

 30

 20

 10

  0
             Collect       Collect and inform      Disseminate         Detect TB      Conduct HE   Inform community's   Refer patients
      children/women for       health data      information about   suspect/Supprot                 complain/request
       outreach activity                            HC service         TB DOTS                      about HC service
Results (continued)                                                                                 Request/consulation HC staff
                Difficulties in VHSG                                                                     have received from VHSG
                 activities (N=36)                                                                                              (N=18)
45

40                                                                                        60
35
                                                                                          50
30
                                                                                          40
25

20                                                                                        30

15                                                                                        20
10
                                                                                          10
 5

 0                                                                                        0
       Nomeans of      No collaboration   Too much work   Lack of health   No financial            Request for         Request for        Health education    Difficult to get
      transportation    from villagers                      knowledge       benefits           financial incentive   material incentive    in community      collboration from
                                                                                                                                                                  villagers




     Main difficulties raised by VHSG raised were; collecting mothers and
     children for outreach services(61.1%) ; and conducting health
     education(27.8%).
Results (continued)

     Factors for VHSG to continue their activities
                Answers by VHSG(N=93)                                                         Answers by HC staff (N=18)




90                                                                            90

80                                                                            80

70                                                                            70

60                                                                            60

50                                                                            50

40                                                                            40

30                                                                            30

20                                                                            20

10                                                                            10

0                                                                              0
     Satisfaction as HV   Material and financial   Increase health   Others        Financial support echnical support aterial support
                                                                                                   T                M            Emorional/moral support Others
                                benefits              knowledge
Main findings
• Main activities by VHSG were supporting HC’s
  outreach services.
• Health Center did not pay much recognition to
  some VHSG activities such as health education,
  referral of patients and sending voices of
  community people to Health Center.
• While majority of VHSG chose moral/emotional
  support as the most important factor for them to
  continue their activities, HC staff considered
  providing financial benefits was more important.
Conclusion
• Health Center staff were rather negative towards collaboration
  with VHSG which supposed to be essential for HC to provide
  quality services to community members. Many HC staff were
  hesitant to collaborate with VHSG without providing financial
  benefits.
• Such attitudes of HC staff were largely influenced by the
  situation where many aid agencies (especially NGOs) actually
  provided financial incentives to VHSG, much more than HC
  could afford to do so. As VHSG became ‘paid-volunteers’ ,
  which was actually opposite to their expected roles under the
  national policy, a big challenge arose in promoting VHSG’s
  activities with their own initiative.
• There is a necessity to strengthen collaboration among
  community members, CHWs, and HC staff in more sustainable
  way, such as providing technical support and creating
  opportunity for mutual communication; this is a core element of
  our approach to implement project activities.

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En baseline survey 2008

  • 1. Project Outline • Project Period: Apr. 2008~Mar. 2011 • Project Area:Catchment areas of 6 health centers in Prey Veng Operational District, Prey Veng Province • Target group:Health center staff and Community Health Workers(VHSG and TBA)of the target area, approximately 300 in total. 1) VHSG :Village Health Support Group
  • 2. Project purpose:6 target Health Centers provide Integrated ANC/PNC and Growth Monitoring services through collaboration with Community Health Workers. *Integrated services include measuring weight/height, history taking and physical check-up, early detection of problems , immunization, micro-nutrient, and health education. Objective of the survey To identify activities by VHSG and collaboration between HC staff and VHSG at the time of starting the project.
  • 3. Survey method • Target:18 Health Center staff and 97 VHSG who were randomly selected. • Target area:Catchment areas of the 6 target HC • Method:Face-to-face interview by using questionnaire • Period:June - July, 2008 • Contents:VHSG activities (selection process, motivation, contents of activities), collaboration between VHSG and HC (including management by HC), contributing factors for VHSG to continue their activities. • Analysis:Comparing answers by HC staff and VHSG for the same question. • Ethical consideration:The interviewers explained the purpose of the survey and confidentiality to interviewees.
  • 4. Results Main Activities done by VHSG (Answers by HC staff and VHSG) 100 90 80 70 60 50 HC staff 40 VHSG 30 20 10 0 Collect Collect and inform Disseminate Detect TB Conduct HE Inform community's Refer patients children/women for health data information about suspect/Supprot complain/request outreach activity HC service TB DOTS about HC service
  • 5. Results (continued) Request/consulation HC staff Difficulties in VHSG have received from VHSG activities (N=36) (N=18) 45 40 60 35 50 30 40 25 20 30 15 20 10 10 5 0 0 Nomeans of No collaboration Too much work Lack of health No financial Request for Request for Health education Difficult to get transportation from villagers knowledge benefits financial incentive material incentive in community collboration from villagers Main difficulties raised by VHSG raised were; collecting mothers and children for outreach services(61.1%) ; and conducting health education(27.8%).
  • 6. Results (continued) Factors for VHSG to continue their activities Answers by VHSG(N=93) Answers by HC staff (N=18) 90 90 80 80 70 70 60 60 50 50 40 40 30 30 20 20 10 10 0 0 Satisfaction as HV Material and financial Increase health Others Financial support echnical support aterial support T M Emorional/moral support Others benefits knowledge
  • 7. Main findings • Main activities by VHSG were supporting HC’s outreach services. • Health Center did not pay much recognition to some VHSG activities such as health education, referral of patients and sending voices of community people to Health Center. • While majority of VHSG chose moral/emotional support as the most important factor for them to continue their activities, HC staff considered providing financial benefits was more important.
  • 8. Conclusion • Health Center staff were rather negative towards collaboration with VHSG which supposed to be essential for HC to provide quality services to community members. Many HC staff were hesitant to collaborate with VHSG without providing financial benefits. • Such attitudes of HC staff were largely influenced by the situation where many aid agencies (especially NGOs) actually provided financial incentives to VHSG, much more than HC could afford to do so. As VHSG became ‘paid-volunteers’ , which was actually opposite to their expected roles under the national policy, a big challenge arose in promoting VHSG’s activities with their own initiative. • There is a necessity to strengthen collaboration among community members, CHWs, and HC staff in more sustainable way, such as providing technical support and creating opportunity for mutual communication; this is a core element of our approach to implement project activities.