The Regional Office has been carrying out work to increase access to quality child care through community health workers, to respond to a need expressed by a number of countries in the Region.
Initiative on caring for sick children in the community
Initiative on caring for sick children in the community
The first step of the regional initiative is about placing the community health worker-based child care approach within a supportive policy environment.
This is done by reviewing with interested countries and partners plans for the required health system and community support elements, which are considered essential for any community intervention of this type.
Issues include, among others:
policies on which services and medicines community health workers would be allowed to deliver;
criteria for selection of community health workers;
training standards for community health workers (objectives, duration, methodology, materials) and orientation of their supervisors (e.g. primary health care facility staff);
criteria for the selection of the trainers and plans to develop a core of trainers;
selection of areas for implementation (districts, villages);
availability of medicines and supplies (e.g. job aids, recording forms, registers);
links with the health system (reporting, follow-up, supervision, etc.);
feedback and motivation schemes by the health system and community;
mobilization and allocation of resources for the CHW-based initiative.
The second step is a training course for community health workers.
Regional training materials
The Child and Adolescent Health programme of the Regional Office has developed regional training materials on “Caring for sick children in the community” for community health workers.
Target audience and methodology
Health problems addressed
The course content addresses the main causes of death in children under five years of age, such as pneumonia, diarrhoea, malaria—where relevant—and malnutrition.
It describes action-oriented guidelines on identification of key health problems in this age group, their treatment and advice on home care, immunization and feeding practices.
Versions
The version of the training materials that has been developed is for countries with high under-5 mortality rate and malaria risk in which community health workers can dispense medicines and treat sick children. Other versions may be developed in the future, focusing on the healthy child for countries with lower under-5 mortality.
Materials
The training materials include:
a facilitator guide;
a set of facilitator aids, including also videos and games; and
a participant manual with a list of a few bulleted points per topic to act as key reminders.
The core of the course is the sick child recording form.
Language
The Regional set of materials has been developed in English, to serve as the basis for country adaptations.
Language adaptations tend to focus on facilitator aids and the participant manual, as facilitators are in many countries able to read English. If the facilitator guide can be kept in English, this reduces the amount of adaptation work, which can concentrate more on content and participant materials.
The first country adaptations have been made using the Arabic language. These versions can facilitate adaptation work for other Arabic-speaking countries.
Target audience and methodology
The materials and training methodology have been designed to target community health workers with low literacy levels and little or no health background, as recommended by countries in the Region.
Extensive use is made during training of interactive methods, games, videos and exercises with group and individual feedback requiring very minimal reading or writing skills and making participant learning an enjoyable experience.
Country adaptations
Content and language have been adapted in the following countries:
Country: Egypt
Language: Arabic
Date: July 2010 (field-test draft)
Country: Yemen
Language: Arabic
Date: November 2010
Country: Sudan
Language: Arabic
Date: November 2011
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