258960 Community health workers as change agents for improved newborn care

Monday, October 29, 2012 : 9:00 AM - 9:15 AM

Elizabeth Fischer, MCRP , IntraHealth International, Chapel Hill, NC
Dharmendra Panwar, MBBS, Community Medicine , IntraHealth International, Lucknow - 226010, India
     
Purpose: Evidence reviews of home-based newborn care show that improvements in newborn outcomes are achievable through home-based counseling by community health workers (CHWs). Evidence reviews also demonstrate that effective use of CHWs requires strong systems for continued capacity building, supervision, and mentoring. In India, ASHAs (Accredited Social Health Activists) are a new voluntary cadre recruited from the communities in which they live who receive training and performance-based incentives to provide counseling and support to pregnant women and newborns. Performance assessments, however, indicated significant deficiencies in ASHAs' ability to be effective change agents.

Data/information used: Baseline data indicated that only 3% of women considered ASHAs to be a primary source of advice during pregnancy.

Methods: IntraHealth, through the USAID-funded Vistaar Project, worked with district officials in Uttar Pradesh to use monthly meetings as a platform for continuing education and problem-solving. We also activated support for ASHAs through engaging auxiliary nurse midwives as supervisors and mentors. To sustain this new model, the government appointed a technical resource group to carry forward the continuing education process.

Results: The intervention achieved significant improvements in the numbers of women counseled on essential newborn care during home visits and adoption of improved care practices. ASHAs' home visits to pregnant/recently delivered women increased from 0.6% at baseline to 41% in July 2010.

Recommendations: This intervention shows that better utilizing existing platforms can improve overall CHW performance at minimal cost to the government system.

Learning Areas:
Administer health education strategies, interventions and programs
Assessment of individual and community needs for health education
Planning of health education strategies, interventions, and programs
Public health or related education
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
1. Explain how innovative training and mentoring approaches were used to improve the performance of community health volunteers in India 2. Describe the outcomes achieved from strengthening government processes to improve community health worker performance 3. Discuss lessons learned and implications for other contexts

Keywords: Child Health, Community-Based Health Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been involved in the project design,providing technical assitance to the government,periodic monitoring and evaluation of the project in the capacity of technical advisor to the project. I have first hand experience of observing the change that happened over time.I have been working on community based newborn care since the last 9 years and it is an area of interest to me.
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.

Back to: 3047.0: Community Based Primary Health Care