Baselinesurvey2008
- 1. Project Outline • Project Period： Apr. 2008～Mar. 2011 • Project Area：Catchment areas of 6 health centers in Prey Veng Operational District, Prey Veng Province • Target group：Health center staff and Community Health Workers（VHSG and TBA）of the target area, approximately 300 in total. 1) VHSG :Village Health Support Group
- 2. Project purpose：6 target Health Centers provide Integrated ANC/PNC and Growth Monitoring services through collaboration with Community Health Workers. *Integrated services include measuring weight/height, history taking and physical check-up, early detection of problems , immunization, micro-nutrient, and health education. Objective of the survey To identify activities by VHSG and collaboration between HC staff and VHSG at the time of starting the project.
- 3. Survey method • Target：18 Health Center staff and 97 VHSG who were randomly selected. • Target area：Catchment areas of the 6 target HC • Method：Face-to-face interview by using questionnaire • Period：June - July, 2008 • Contents：VHSG activities (selection process, motivation, contents of activities), collaboration between VHSG and HC (including management by HC), contributing factors for VHSG to continue their activities. • Analysis：Comparing answers by HC staff and VHSG for the same question. • Ethical consideration：The interviewers explained the purpose of the survey and confidentiality to interviewees.
- 4. Results Main Activities done by VHSG (Answers by HC staff and VHSG） 100 90 80 70 60 50 HC staff 40 VHSG 30 20 10 0 Collect Collect and inform Disseminate Detect TB Conduct HE Inform Refer patients children/women health data information about suspect/Supprot community's for outreach HC service TB DOTS complain/request activity about HC service
- 5. Results (continued) Request/consulation HC Difficulties in VHSG staff have received from activities （N=36) VHSG （N=18) 45 40 60 35 50 30 25 40 20 30 15 20 10 10 5 0 Nomeans of No collaboration Too much work Lack of health No financial 0 Request for Request for Health Difficult to get transportation from villagers knowledge benefits financial material education in collboration incentive incentive community from villagers Main difficulties raised by VHSG raised were; collecting mothers and children for outreach services(61.1%) ; and conducting health education(27.8%).
- 6. Results (continued) Factors for VHSG to continue their activities Answers by VHSG（N=93） Answers by HC staff （N=18) 90 90 80 80 70 70 60 60 50 50 40 40 30 30 20 20 10 10 0 Satisfaction as HV Material and financial Increase health Others 0 Financial Technical Material support Emorional/moral Others benefits knowledge support support support
- 7. Main findings • Main activities by VHSG were supporting HC’s outreach services. • Health Center did not pay much recognition to some VHSG activities such as health education, referral of patients and sending voices of community people to Health Center. • While majority of VHSG chose moral/emotional support as the most important factor for them to continue their activities, HC staff considered providing financial benefits was more important.
- 8. Conclusion • Health Center staff were rather negative towards collaboration with VHSG which supposed to be essential for HC to provide quality services to community members. Many HC staff were hesitant to collaborate with VHSG without providing financial benefits. • Such attitudes of HC staff were largely influenced by the situation where many aid agencies (especially NGOs) actually provided financial incentives to VHSG, much more than HC could afford to do so. As VHSG became ‘paid-volunteers’ , which was actually opposite to their expected roles under the national policy, a big challenge arose in promoting VHSG’s activities with their own initiative. • There is a necessity to strengthen collaboration among community members, CHWs, and HC staff in more sustainable way, such as providing technical support and creating opportunity for mutual communication; this is a core element of our approach to implement project activities.