Pneumonia is the leading cause of death in young children worldwide and the second leading cause of death in children under five in Haiti. To decrease pneumonia mortality, WHO developed a case management approach for children suffering from acute respiratory infection (ARI)which uses simple clinical signs that have been shown to predict pneumonia.
Since 1988 the Haitian Health Foundation (HHF) has been conducting child survival activities in remote Haitian villages using resident health agents with a seventh grade education on average and LPN supervisors. HHF adapted and implemented the WHO protocol in 1993, when all the health agents had 4 years of experience. Despite that fact that health agents had intense supervision, HHF found that it took about a year before most of these health agents became really good at applying the protocol. When HHF expanded its zone and trained brand new health agents, it took them even longer.
During 1993 through 1999, HHF field staff applied the protocol 17,000 times and computerized each case record. When the intervention was evaluated by the U.S. Centers for Disease Control in 1997, the evaluators determined that HHF had reduced the pneumonia-specific mortality rate in children under five by 50%.
This presentation will describe the implementation of the intervention in some detail, including how the health agents were trained and supervised, and discuss lessons learned.
Learning Objectives: At the conclusion of this session the participant will be able to describe multiple strategies for training and managing health agents in applying the WHO protocol for ARI in developing country settings
Keywords: Child Health,
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.