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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Melanie M. Morrow, MPH, Child Survival Specialist, World Relief, 7 East Baltimore St., Baltimore, MD 21202, 443-451-1900, mmorrow@wr.org, Pieter Ernst, MD, Vurhonga Child Survival Project, World Relief Mozambique, Rua Jose Mateus 274, Maputo, Mozambique, W. Meredith Long, DrPH, Director of International Health, World Relief Corporation, P.O. Box 868, Baltimore, MD 21203, and Adele Dick, HIV/AIDS Program Development, World Relief Corporation, P.O. Box 868, Baltimore, MD 21203.
Community health projects that depend on volunteers often suffer high attrition rates. In contrast, the care group structure promotes retention of volunteers. In a child survival project in Guija and Mabalane districts of Gaza Province, Mozambique, one volunteer was recruited for every ten households. Ten of these volunteers formed a care group. The care groups became the primary units for training, monitoring and the health information system. Over the four years of the program (1995-99), the volunteers enabled the project to exceed the project objectives in 16 key indicators of child survival, (i.e. the percentage of fully immunized children at twelve months climbed from 37% to 93%; women receiving at least one prenatal check climbed from 30% to 90%). Two years after project end, when care groups stopped receiving regular support from paid staff, 1361 (93.4%) of the original 1457 volunteers were still actively visiting their households and monitoring the health of the mothers and children. Of the original volunteers, 92 had dropped out, 44 had died, but the communities had selected and trained 40 substitutes. We attribute this high retention to the high level of social support within the care groups, the manageable level of work for each individual volunteer, and the establishment of a community-owned movement for health involving key leaders and enhanced by the fact that one in ten households had a fully trained volunteer.
Learning Objectives:
Keywords: Community Health Promoters, Sustainability
Presenting author's disclosure statement:
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.