NATIONAL LEVEL
MINISTRY OF HEALTH
Community Health Desk
NATIONAL LEVEL
MINISTRY OF HEALTH
Community Health Desk
DISTRICT HOSPITAL
•District Hygiene and Sanitation Officer
•Community Health Officer
DISTRICT HOSPITAL
•District Hygiene and Sanitation Officer
•Community Health Officer
DISTRICT ADMINISTRATION
District Health Supervisor
DISTRICT ADMINISTRATION
District Health Supervisor
CELL LEVEL
Binome Supervisor
(1 per cell, elected from among the binomes)
CELL LEVEL
Binome Supervisor
(1 per cell, elected from among the binomes)
UMUDUGUDU (VILLAGE) LEVEL
Community Health Workers
UMUDUGUDU (VILLAGE) LEVEL
Community Health Workers
Community Health Structure Community Health Structure
T
2011
2005
1995
Evolution of CHWs
•Selection and training of CHWscountrywide
•Linkage to a diversification ofstrategies
•to reduce child and maternalmortality
•community case management
•Initiated : 1995 ( after Genocide )Objective: first level of entry to thehealth system
•Operates at smallest administrativeunit of the country (villages)
•Includes a minimum package ofactivities focusing on primaryhealth care
BEGINNING OF CHW
Evolution
Strengthening health systems through communityhealthStrengthening health systems through communityhealth
Community Health WorkersCommunity Health Workers
1 Binome
female & male
1 CHSA (in charge ofsocial affairs)
1 Female
in charge of
maternal Health
4CHWs/village
Preventive Services
Curative Services
Promotion Services
C-HMIS & C-PBF
COOPERATIVES
CHW PROGRAMMES
•Communitysensitization onprevention ofcommon: diseases:malaria, diarrhoea,ARI, for preventionof sexual transmittedinfections,, healthcampaign on hygieneand sanitation,immunization etc.
•Educate communitieson use of watertreatment solutionsand distribute them
•Vaccination campaign
•Provision of familyplanning servicesincluding FP products
•Community MaternelNewborn Health (Rapid SMS)
•Community CaseManagement ofmalaria, ARI,diarrhoea,vaccination,malnutrition (e.g.CommunityIntegratedManagement ofChildhoodIllnesses/Community IMCI)
•MISO
•Engage incommunity DOTsfor tuberculosis,HIV
•Nutritioneducation tocommunities
•Growthmonitoringparticularlyamong childrenunder five yearsold
•Nutritionsurveillance
•Routine homevisits for activecase finding
•Hygiene Clubs
•C-HMIS:
•mUbuzima: all CHWreceivedthe mobilephone
•Monthlyreport : 40indicators
•Rapid SMS
•C-PBF:
•5 Maternaland ChildHealthIndicators
•2 TBindicators
•Report
•499 CHWscooperatives
•They helpCHWs to usethe PBFmoney tocollectivelyinvest it inprofitableventures
•They generateincome toallow CHW’s .
CHWs PACKAGESCHWs PACKAGES
Motivational mechanisms
•Community PBF
•Unplanned donations
•Community respect (they participate in all decisions in thevillage).
•Etc.
•Huge number of CHWs who need training and supportivesupervision;
• Low education level of CHWs call for demanding andfrequent training
•Weak financial management skills and systems hamperinginitial stages of business growth
•Logistical support to meet CHW need Strengthening thefunctionality of CHW Cooperatives (need for technicalsupport)
CHALLENGES
THANKSHE KAGAME PAUL WITH ALL CHWs
