IFGH 2012: Effectiveness and Sustainability of an Integrated Care Group Model in Delivering Community Health Services

Authors:Cotes G., Davis A., Weiss J., Tamming R.


Author Affiliations:Concern Worldwide Ireland, USA, Burundi and Ireland respectively

Option 2– Lessons from the field; project and programme evaluations; and syntheses or analyses Presented as – Oral Presentation

Issues:

Community-based behaviour change communication (BCC) is key to improving household health practices. The Care Group model is an effective method of delivering BCC, resulting in improved health behaviours. The traditional Care Group model requires significant external support, traditionally provided by paid NGO staff.

Description:

A Care Group is a group of 10-15 community health volunteers. Each volunteer goes out at least monthly to conduct health promotion with a small cohort of caregivers. Concern designed a two-pronged study in Burundi to compare a new integrated Care Group model with the traditional model in terms of 1) improving household knowledge and practices, and 2) functionality and sustainability. The integrated Care Group model adapts the traditional model by using Ministry of Health (MOH) staff to implement and manage Care Groups. The project targets caregivers of approximately 7,594 children aged 0-23 months through 305 Care Groups. A Community Health Information System (C-HIS) and reporting forms have been piloted to monitor service delivery.

Results:

Initial household coverage is high, reaching 74% of households monthly with BCC messages. Coverage and functionality of integrated Care Groups is similar to that of the higher-input traditional model. C-HIS reporting requires supervision and quality assurance, but reporting is high, with 90% of Community Health Workers (CHW) submitting monthly reports.

Lessons:

It is possible to integrate Care Groups into MoH human resource systems, particularly if CHW are in place. The model shows promise for scale-up within other contexts.

C-HIS systems are important for monitoring community service delivery and may potentially be integrated into HMIS and performance-based financing systems.

Integrated Care Groups may provide a more cost-effective model for supervision, peer support, and health service delivery in communities. The Integrated Care Group Model has been identified in Burundi MOH discussions as a promising model for implementing a realistic community health strategy.