203158 Contribution of Communication, Negotiation, community mobilization and Facilitation Skills and Tools to Improve Achievements of HEWs in Ethiopia

Tuesday, November 10, 2009

Samuel Yalew, MA , Last 10 Kilometers Project, JSI/The Last Ten Kilometers Project, Addis Ababa, Ethiopia
Wuteta Betemariam, MPH , JSI R@T Inc., Addis Ababa, Ethiopia
Hibret Alemu, MPH , JSI/The Last Ten Kilometers Project, Addis Ababa, Ethiopia
Ali Mehryar Karim, PhD , Last 10 Kilometers Project, JSI Research & Training Institute, Inc., Addis Ababa, Ethiopia
In 2005, Ethiopia launched the Health Extension Program (HEP) in order to significantly reduce child and maternal mortality rates (DHS 2005: 123/1,000 and 681/100,000 respectively). Two Health Extension Workers (HEW) per village (circa 5,000 people) engage the community in the delivery of Family and Community Packages that consists of disease prevention and control, family health, hygiene and environmental sanitation and health education. HEWs were trained for 9 months, with no or short practical attachment periods. The implementation style of the HEP includes: training of household to graduate as model families; reaching communities through outreach; training community volunteers; and providing services at health post. Although HEWs mainly focus on the provision of promotive, preventive and basic curative services, implementation was very challenging due to their limited or no practical exposure to basic communication, negotiation, counseling, community mobilization and facilitations skills.

The Bill and Melinda Gates Foundation funded JSI/The Last Ten Kilometers (JSI/L10K) Project is designed to bridge the gap between families, community and HEWs for improved Reproductive, Maternal, Newborn and Child Health Outcomes. Among other interventions, L10K adapted training guides to address the implementation challenges of HEWs to train volunteers and model families, mobilize communities and negotiate with clients. L10K developed simple, participatory and friendly guides to train volunteers and model families in a flexible manner. This paper will describe the content, approach, process and benefits of the training guides developed and skills introduced to improve achievements of HEWs.

Learning Objectives:
Describe the content, approach, process and benefits of the training guides developed to improve achievements of health extension workers

Keywords: Curricula, Community Health Promoters

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am experienced educator graduated from Kotebe College of Teacher Education, one of the oldest and well known teacher training colleges in the nation. I also have my second degree in literature from school of graduate studies in Addis Ababa University. I have worked as a teacher and teacher trainer for more than six years. My experience as BCC and community mobilization specialist working with various NGOs and projects gave me the chance to work with, learn from and support frontline health workers and community health volunteers in Ethiopia. My seven years experience working in the prevention and control of trachoma for the BCC World Service Trust Ethiopia communication campaign, child survival and system strengthening project for the USAID funded ESHE project as AED employee, and the community RMNCH intervention for JSI/The Last Ten Kilometers project paved the road for me to work with the HEWs in the four big regions of the country, Amhara, Oromia, SNNP and Tigray. My experience working with the HEP team at the ministry of health and the support I have been providing to the regional, district and project staff to strengthen the HEP have been the opportunities to understand the gaps, strategically think and provide solutions that help address challenges. I have been involved in the design, data collection and analysis of various studies and surveys conducted by the organizations I have been working with so far. Last year I presented the role of volunteers in improving health practices and health seeking behavior at the Global Health Council Conference 2008. I have a lot of experience in developing training guides, messages and tools for households, volunteers, peer educators, health workers and managers to promote health actions at various levels. In recognition to my hands on experience in the HEP, the ministry of health invited me to join the design of the newly developed and started urban HEP for the country.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: Learn about Community Health Worker Educational Curriculum, What’s Out There
See more of: Community Health Workers SPIG