![Page 1: Community health systems strengthening in Petit-Goave, Haiti_Sankar](https://reader034.vdocument.in/reader034/viewer/2022051612/54c2f60a4a7959ec0f8b4583/html5/thumbnails/1.jpg)
Community health systems strengthening in Petit-Goave, Haiti
Girija Sankar
Associate Director
Global Health Action Atlanta GA, USA & Port-au-Prince, Haiti
![Page 2: Community health systems strengthening in Petit-Goave, Haiti_Sankar](https://reader034.vdocument.in/reader034/viewer/2022051612/54c2f60a4a7959ec0f8b4583/html5/thumbnails/2.jpg)
Objectives of Panel :
• Objective 1: By the end of this session, participants will have greater appreciation for the need to engage Ministries of Health, local NGOs, and Faith-based institutions in identifying innovative ways of expanding community volunteers as links to the formal health services
• Objective 2: By the end of this session, participants will have learned about efforts to repurpose existing cadres such as Traditional Birth Attendants to achieve greater community acceptance and use of health services.
• Objective 3: By the end of this session, participants will compiled a set of critical considerations for external organizations to draw upon when developing community based health volunteers.
![Page 3: Community health systems strengthening in Petit-Goave, Haiti_Sankar](https://reader034.vdocument.in/reader034/viewer/2022051612/54c2f60a4a7959ec0f8b4583/html5/thumbnails/3.jpg)
Presentation outline:
Background
Framework for a functioning health system
Working with Institutions
Working with community health providers
Critical considerations
![Page 4: Community health systems strengthening in Petit-Goave, Haiti_Sankar](https://reader034.vdocument.in/reader034/viewer/2022051612/54c2f60a4a7959ec0f8b4583/html5/thumbnails/4.jpg)
Background
2004-2010, USAID-funded maternal and child health project in partnership with faith-based organization and Ministry of Health.
Petit-Goâve commune
HAITI
Source: Google Maps
![Page 5: Community health systems strengthening in Petit-Goave, Haiti_Sankar](https://reader034.vdocument.in/reader034/viewer/2022051612/54c2f60a4a7959ec0f8b4583/html5/thumbnails/5.jpg)
Basic Indicators for Haiti Country Data
Population 10M
Birth Rate 26
NMR 25.5
Facility Birth 36%
Skilled Birth Attendants 37%
Source: UNICEF, WHO
![Page 6: Community health systems strengthening in Petit-Goave, Haiti_Sankar](https://reader034.vdocument.in/reader034/viewer/2022051612/54c2f60a4a7959ec0f8b4583/html5/thumbnails/6.jpg)
Program Area: Petit-Goave commune
• Total population of 157,296
• 68 km west of Port-au-Prince.
• 25% of women of reproductive age
![Page 7: Community health systems strengthening in Petit-Goave, Haiti_Sankar](https://reader034.vdocument.in/reader034/viewer/2022051612/54c2f60a4a7959ec0f8b4583/html5/thumbnails/7.jpg)
Child Survival Project, 2004-2010
MAIN OBJECTIVES:
• Improve the quality of pre- and post-natal/infant services.
• Improve access to pre- and post-natal/infant services.
• Establish a local network of referral services that provide quality maternal and neonatal care.
GOAL: Contribute to reduction of maternal and infant mortality in Petit-Goâve commune.
![Page 8: Community health systems strengthening in Petit-Goave, Haiti_Sankar](https://reader034.vdocument.in/reader034/viewer/2022051612/54c2f60a4a7959ec0f8b4583/html5/thumbnails/8.jpg)
Interventions • Health promotion by Community Health Workers (CHWs)
• Birth attendance by trained Traditional Birth Attendants (TBAs)
• Facility-based care (HIV testing & counseling; STI counseling)
• Mobile health services
![Page 9: Community health systems strengthening in Petit-Goave, Haiti_Sankar](https://reader034.vdocument.in/reader034/viewer/2022051612/54c2f60a4a7959ec0f8b4583/html5/thumbnails/9.jpg)
Positive Outcomes(highlights) • Trained network of community health providers
• Community health services complimented by facility-based services
• Community mobilization
![Page 10: Community health systems strengthening in Petit-Goave, Haiti_Sankar](https://reader034.vdocument.in/reader034/viewer/2022051612/54c2f60a4a7959ec0f8b4583/html5/thumbnails/10.jpg)
Challenges
• Resource-poor institutional mechanisms
• Vertical program not sustainable without strong foundations of a community health system
• CHWs integrated into project from past MOH initiatives
![Page 11: Community health systems strengthening in Petit-Goave, Haiti_Sankar](https://reader034.vdocument.in/reader034/viewer/2022051612/54c2f60a4a7959ec0f8b4583/html5/thumbnails/11.jpg)
Functioning Community Health System: A Framework
• Partnership between health facilities and the communities they serve
• Appropriate and accessible health care and information from community based providers
• Collaboration between state, facility, community-based providers and the communities through community associations
Ref: CORE group (http://coregroup.org)
![Page 12: Community health systems strengthening in Petit-Goave, Haiti_Sankar](https://reader034.vdocument.in/reader034/viewer/2022051612/54c2f60a4a7959ec0f8b4583/html5/thumbnails/12.jpg)
What’s different now? 2014-
![Page 13: Community health systems strengthening in Petit-Goave, Haiti_Sankar](https://reader034.vdocument.in/reader034/viewer/2022051612/54c2f60a4a7959ec0f8b4583/html5/thumbnails/13.jpg)
Working with Institutions
• Administration and infrastructure support for MOH
• Proactively seeking MOH input and feedback for program activities
• Working with village/community health committees
• Helping faith-based partner set up a health board to oversee and coordinate health activities
![Page 14: Community health systems strengthening in Petit-Goave, Haiti_Sankar](https://reader034.vdocument.in/reader034/viewer/2022051612/54c2f60a4a7959ec0f8b4583/html5/thumbnails/14.jpg)
Working with community providers
Traditional Birth Attendants:
• TBAs supported by community
• Open to training and skill building
• Challenge: not recognized by health system
![Page 15: Community health systems strengthening in Petit-Goave, Haiti_Sankar](https://reader034.vdocument.in/reader034/viewer/2022051612/54c2f60a4a7959ec0f8b4583/html5/thumbnails/15.jpg)
Working with community providers (cont.)
Community Health Workers:
• In many instances CHWs are not necessarily “chosen” by community
• Tend to be elected or nominated officials; representatives of municipal government; faith-based leaders; spiritual healers
![Page 16: Community health systems strengthening in Petit-Goave, Haiti_Sankar](https://reader034.vdocument.in/reader034/viewer/2022051612/54c2f60a4a7959ec0f8b4583/html5/thumbnails/16.jpg)
Critical considerations for developing community based health systems & providers:
• Long term support for health systems
• Innovative ways to support CHWs
• Greater engagement with/of TBAs
• Getting the community back in community-based
• Network at all levels of MOH
![Page 17: Community health systems strengthening in Petit-Goave, Haiti_Sankar](https://reader034.vdocument.in/reader034/viewer/2022051612/54c2f60a4a7959ec0f8b4583/html5/thumbnails/17.jpg)
Funding & Implementing Partners