Posted by Jackline Oluoch | Sep 9, 2009 | Tinyhttp://2mp.tw/1r | Comments
Dertu, Kenya • Health • MDG Centres
Community Health Worker Training in Dertu, Kenya
CHWs weighing children
The Community Based Management for Health program, currently being implemented across the Millennium Villages in East and Southern Africa, stopped recently in the pastoralist village of Dertu, Kenya which has 850 households (350 sedentary and 500 migratory).
In this difficult, arid area where communities move in search of water and pasture, the role played by Community Health Workers (CHWs) is vital and helps save lives. Though Dertu has a dispensary with a functional six bed maternity ward, a laboratory and a two bed semi-permanent observation ward, the health outreach remains a major component of the Millennium Villages Project (MVP) health policy in the area. Of a population of 6,000, more than 1,000 pastoralists are treated and immunized every month by the mobile health outreach service. With the distribution of treated bed nets to the community, this service also focuses on malaria diagnosis and treatment, enabling the health team to keep the disease in check.
In August 2009, Dertu’s five CHWs received an eight day comprehensive training, jointly developed by the Program in Health systems at the Earth Institute, Columbia University, and the MVP health team in Dertu.
The training was conducted by the MVP health staff and Kenya’s Ministry of Health. Trainers covered topics such as antenatal care, maternal health, newborn care, family planning and management of diseases such as HIV/AIDS, TB and malaria. Additionally the CHWs received training in data management and use of information tools for monitoring and evaluation of the impact of their activities within the community.
Community health volunteers, such as the mobile teacher and two community animal health workers, also joined the sessions. The volunteers are recruited to work with the pastoral communities and assist the CHWs in collecting data on vital events such as births and deaths, as well as referring the sick to health facilities.
Learning to properly measure the children
Not only did the trainees attend in-class sessions, but they also underwent practical training held at the nearby Garissa Provincial Hospital. Here, they carried out child growth monitoring under the guidance of a clinician. They refreshed their knowledge and skills by performing Middle Upper Arm Circumference Measurements (MUAC) to children 6 – 60 months old, as well as proportioning and administering food rations of soy beans and vegetable oil to malnourished mothers and their babies. They also observed record taking and the identification of signs and symptoms of malnutrition in children under 5.
“I learnt many new and interesting things at the training, and the best part is receiving a reference manual that I can consult if I forget some facts when I am out with the community,” said Ahmed Abdinoor, one of the CHWs. ‘Now I look forward to the next monthly outreach session to implement what I learned,’ he added.
CHWs with their new certificates
The Dertu training is part of a series of trainings for the MVP sites that is supported by the program for health systems at the Earth Institute, and The MDG Centre, East and Southern Africa. Its main aim is to strengthen health systems through innovative initiatives that provide comprehensive trainings for the CHWs and the volunteers assisting them. The trainings also involve providing CHWs with tools for their work such as special bags to carry weighing scales, rapid diagnostic tests, ORS rehydration salts and manuals.
Jackline Oluoch is a Regional Community Health Worker Program Coordinator. She is based in Nairobi, Kenya.
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For the need of community health worker, can a social worker working with HIV AIDS issues and concern apply?
Thank you for your comment concerning Community Health Workers (CHWs) in Dertu, Kenya.
The CWHs in Dertu, and across the Millennium Villages, are recruited locally from within the community. They have a variety of backgrounds and are provided with training for their roles as CHWs. To answer your question, therefore, a social worker with experience on HIV/AIDS would be welcome as long as she was from the community. If this is the case, I would be happy to connect this individual—whether it be yourself or another person—to the local team in Dertu.
Having been to Kenya on 2 occasions, I am interested in helping to set up a comprehensive community-based health clinic in Kenya. I understand that CHWs, as well as a network of local providers is essential before embarking on such a plan. Do you have any recommendations re. contacts within the MOH to help facilitate such a project and/or training programs within Kenya for local CHWs?
There are two bits to this: process of approval and construction of a health facility (Level 2 or 3 of the healthcare hierarchy in Kenya) and the process of setting up a community health unit (Level 1).If it is a small health facility- outpatient with HIV/TB, Maternal and Child Health, and General Outpatient, and small inpatient catering mostly for maternity with a small observation room for other patients who need a few hours of observation- then it is called a health centre and will require liaison with the district medical office and the district development office and also the community members and the local leadership (which the district people can help with). The community will moot the idea in their Sub-district Development Committee and take it further on to the District Development Committee- essentially telling these people that they want a new health facility and have found a partner with whom to build it. The architectural plans will require advise from the district medical office which often has (or will refer you to the district architect for) stock plans for standard health facilities- the rule here is that the stock plan has the minimum number of rooms required but by no means restricts what additional facilities you can have.
The Community Health Unit consists of about 1000 households or about 5000 people in what is called a ‘sub-location’. Depending on the size of the health facility, a number of these may form the primary catchment area of the health facility. Each community health unit should have a committee called a village health committee which is elected from the different smaller units within the sub-location- there is a guide called the Community Strategy of the Ministry of Health which is also available at the district medical office. This committee selects Community Health Workers based on certain criteria. The current strategy recommends that a CHW support 20 households. The experiences of the Millennium Villages Project suggests that this number of CHWs may be too large for effective training and puts the ideal number at about 100-150 households depending on the population density. There is a national curriculum for training CHWs but which may need to be enriched a little. The government is very welcoming to partners who want to set up these units but some things need to be agreed, especially deviations from the guidelines, before implementation.
Dr. James Wariero
Health Coordinator
Millennium Villages of Sauri, Kenya
Scott,
We have around four units where i am based(Embu-Eastern province)in operation. There is need for more but due to some shortcomings we have not been able to retain the original ones. Any assistance is welcome.
thanks for showing interest in supporting projects and training programs within kenya for local CHWS. there are sixty university students willing to be trained as CHWS how.
Kindly advise how to go about it.
contact person
Lucy gakuya
Cl. Psychologist
am appealing for any organization willing to train sixty youth peer educator on alcohol/drug abuse, child sexual abuse and hiv/aids preventions