I think your program’s commitment to empowering mothers and caretakers to educate their communities is an important one. One question I had relates to how your program anticipates effectuating and measuring this program goal. Will lessons on preventing, responding to, and treating diarrhea be given verbally? Will there be takeaways for the women and caretakers to memorize and communicate to their friends and neighbors? For instance, could an acronym that condenses the information for ease of memorization and communication be used?
Thanks so much for your message and for your terrific questions.
Regarding measuring program goals:
Collected indicators will include:
• Percentage of CHW-referred children who are brought to the diarrhea treatment center;
• Percentage of admitted children who are successfully rehabilitated without use of intravenous saline;
• Prevalence of diarrhea (within the previous two weeks) among children aged 0-24 months within CK’s catchment area (currently being collected monthly as part of the GMP program).
• Prevalence of malnutrition (weight/age z scores > -2SD) among children aged 0-24 months within CK’s catchment area (also currently collected monthly).
Indicators indicating success:
• A statistically significant reduction in growth faltering and in the percentage of 0-24 month old children with weight/age z scores > -2SD, within 9 months of project initiation, compared with existing baseline data from the CK catchment area;
• 60% of successfully rehabilitated children have no severe diarrhea relapse within the following six months;
• From a sample of mothers/caretakers of children aged 0-24 months who have attended information dissemination sessions with a new change agent, the percentage scoring at least a 7 on a 10 point child feeding/care and diarrhea prevention/treatment scale.
HOW DATA WILL BE COLLECTED:
An integral component of Calcutta Kids’ already existing programs in maternal and child health and micro health insurance (MHI) is CHW home visits to beneficiaries. Each registered pregnant woman is visited at least once a month to monitor the progress of her pregnancy, identify potential problems, and provide counseling on subsequent infant feeding and care. For children who are malnourished or growth faltering, home visits seek to identify and address constraints to adequate growth. In the MHI program, each hospitalization case is followed up with a home visit to ensure that discharge instructions are being followed. CHWs understand the importance of accuracy in the collection of both the quantitative and qualitative data collected during home visits, are aware of regular spot checking by supervisors, and receive performance bonuses in cases of superior data collection.
CHWs, regularly visiting slum households with pregnant women or young children will be referring children with severe or potentially severe diarrhea to the diarrhea treatment center and will maintain a record of those children who are, in fact, brought to the center. CHWs also will make follow-up visits to the homes of rehabilitated children within one week and again within six months after release from the center, and will collect data on these children plus a sample of those of neighbors and friends recruited by the mothers of treated children. Monthly growth monitoring will continue along with the collection of data on diarrhea prevalence.
Meanwhile, data on the progress of each child brought to the diarrhea clinic will be maintained at the diarrhea treatment center itself in a custom built MIS which will be compatible with the already existing Calcutta Kids database. The CKDTC trained health workers will be given weekly quantitative progress reports and the CKDTC manager will ensure that data is properly and regularly collected.
Regarding your second question on the medium used for communicating information to the mothers and caretakers: Within hours of treatment, patients are likely to feel and look better, and fears of the mother/caretaker will be reduced. At this point, intensive education will be initiated using a variety of media including flip charts, photographs, film, animation and personal counseling.
• Within one week of discharge, and again within 6 months, the child will be visited by a CK CHW to insure full recovery and to continue promoting and evaluating the impact of the BCC messages provided.
• If the mother/caretaker chooses to serve as a change agent, the mother/caretaker and a CHW will plan, at the one week visit, for a dissemination session to take place in which the mother/caretaker can share with a minimum of 5 friends and neighbors (either pregnant or with children under the age of 2), what was learned at the CKDTC. Upon completion of the meeting, 50% of the cost of treatment paid at discharge will be refunded to the mother/caretaker.
• Additional incentive awards (i.e. CK health camp coupons) will be made available to particularly motivated change agents based on the number of subsequent information dissemination sessions held in the presence of a CHW.
So essentially most of the BCC will be done verbally (in an interactive way) and visually. But I LOVE your idea of the acronym! I'll speak with my team about this immediately and we'll see what we can come up with.
Comments
Hello Noah,
I think your program’s commitment to empowering mothers and caretakers to educate their communities is an important one. One question I had relates to how your program anticipates effectuating and measuring this program goal. Will lessons on preventing, responding to, and treating diarrhea be given verbally? Will there be takeaways for the women and caretakers to memorize and communicate to their friends and neighbors? For instance, could an acronym that condenses the information for ease of memorization and communication be used?
Best of luck in your important work,
Cecelia Tanaka
Dear Cecelia,
Thanks so much for your message and for your terrific questions.
Regarding measuring program goals:
Collected indicators will include:
• Percentage of CHW-referred children who are brought to the diarrhea treatment center;
• Percentage of admitted children who are successfully rehabilitated without use of intravenous saline;
• Prevalence of diarrhea (within the previous two weeks) among children aged 0-24 months within CK’s catchment area (currently being collected monthly as part of the GMP program).
• Prevalence of malnutrition (weight/age z scores > -2SD) among children aged 0-24 months within CK’s catchment area (also currently collected monthly).
Indicators indicating success:
• A statistically significant reduction in growth faltering and in the percentage of 0-24 month old children with weight/age z scores > -2SD, within 9 months of project initiation, compared with existing baseline data from the CK catchment area;
• 60% of successfully rehabilitated children have no severe diarrhea relapse within the following six months;
• From a sample of mothers/caretakers of children aged 0-24 months who have attended information dissemination sessions with a new change agent, the percentage scoring at least a 7 on a 10 point child feeding/care and diarrhea prevention/treatment scale.
HOW DATA WILL BE COLLECTED:
An integral component of Calcutta Kids’ already existing programs in maternal and child health and micro health insurance (MHI) is CHW home visits to beneficiaries. Each registered pregnant woman is visited at least once a month to monitor the progress of her pregnancy, identify potential problems, and provide counseling on subsequent infant feeding and care. For children who are malnourished or growth faltering, home visits seek to identify and address constraints to adequate growth. In the MHI program, each hospitalization case is followed up with a home visit to ensure that discharge instructions are being followed. CHWs understand the importance of accuracy in the collection of both the quantitative and qualitative data collected during home visits, are aware of regular spot checking by supervisors, and receive performance bonuses in cases of superior data collection.
CHWs, regularly visiting slum households with pregnant women or young children will be referring children with severe or potentially severe diarrhea to the diarrhea treatment center and will maintain a record of those children who are, in fact, brought to the center. CHWs also will make follow-up visits to the homes of rehabilitated children within one week and again within six months after release from the center, and will collect data on these children plus a sample of those of neighbors and friends recruited by the mothers of treated children. Monthly growth monitoring will continue along with the collection of data on diarrhea prevalence.
Meanwhile, data on the progress of each child brought to the diarrhea clinic will be maintained at the diarrhea treatment center itself in a custom built MIS which will be compatible with the already existing Calcutta Kids database. The CKDTC trained health workers will be given weekly quantitative progress reports and the CKDTC manager will ensure that data is properly and regularly collected.
Regarding your second question on the medium used for communicating information to the mothers and caretakers: Within hours of treatment, patients are likely to feel and look better, and fears of the mother/caretaker will be reduced. At this point, intensive education will be initiated using a variety of media including flip charts, photographs, film, animation and personal counseling.
• Within one week of discharge, and again within 6 months, the child will be visited by a CK CHW to insure full recovery and to continue promoting and evaluating the impact of the BCC messages provided.
• If the mother/caretaker chooses to serve as a change agent, the mother/caretaker and a CHW will plan, at the one week visit, for a dissemination session to take place in which the mother/caretaker can share with a minimum of 5 friends and neighbors (either pregnant or with children under the age of 2), what was learned at the CKDTC. Upon completion of the meeting, 50% of the cost of treatment paid at discharge will be refunded to the mother/caretaker.
• Additional incentive awards (i.e. CK health camp coupons) will be made available to particularly motivated change agents based on the number of subsequent information dissemination sessions held in the presence of a CHW.
So essentially most of the BCC will be done verbally (in an interactive way) and visually. But I LOVE your idea of the acronym! I'll speak with my team about this immediately and we'll see what we can come up with.
Many thanks,
Noah