HOUSE-TO-HOUSE COUNSELING, HEALTH

EDUCATION AND SERVICE PROVISION IN NAMIBIA

(Prepared by Airah T. Schikwambi, CBHC Programme Manager, MOHSS)

THE BACKGROUND INFORMATION OF THIS PROJECT

1.            INTRODUCTION

The health status of most Namibians at village level is poor. This can be attributed to the rural population not having adequate access to health care services, the attraction of urban areas as well as qualified health workers being concentrated in urban areas.

Outreach Programs were initiatedby Primary Health Care to bring health services to the rural communities but still the health care distribution is uneven.

2.             BACKGROUND AND RATIONALE

House to house counseling and service provision project Is intended to spread over a period of one year in its initial phase and to be piloted in throe of the most affected regions: Caprivi, Oshana and Ohangwena. This Initiative is being suggested with a focus on people affected by HlV/AlDS and other communicable diseases e.g. TB, Malaria in rural communities. The target of this project is the people at house hold level in the rural areas.

Emphasis is being put on improving health status for those suffering from HIV/AIDS, TB patients and Malaria patients and to identify orphans.

Poverty aggravated health situations like, Diarrhoea and Malnutrition will be part of this initiative This project intends to bring about a link between these rural communities and the available health services and other relevant agencies.

3.            IMPLEMENTATION PROCESS:

Identification of A category of people who can read and write as the implementers are the target to be incorporated in this initiative. They will be coordinated by the Ministry of Health and social services through the Regional AIDS Coordination Committee and Regional health team. The constituency councillors through the local communities will identify capable candidates as stipulated in the criteria below. Information collected will be linked to the District Health Information system through the Regional Health teams.

Each of the 13 Regions is presently divided into constituencies, which will then be divided into villages. The villages will be divided into homesteads of not more then 10 km radius. The Community Based Information Assistant& (CBIAs) will then be given basic training on data collection, documentation and reporting systems. This team will be tasked with the responsibility of distributing IEC material on prevention, collecting information during household visits to facilitate appropriate action at constituency and health district levels, identifying (AIDS) Orphans, HlV/AlDS I terminally ill patients, T13 patients, Malnourished children and people suffering from Malaria.

4.            SELECTION CRITERIA.

The candidate should:

1.             belong and be living in the village set up of that constituency;

2.             preferably have undergone training with “my future is my choice” and or home based cars;

3.          have an interest in the development of her/his community;

4.         be aged between 20 and 30 years, younger or older people will be accepted on their own merits

5.             normally completed grade 10 ‑ 12

6.          be able to communicate clearly in the predominant language of that constituency

An interview will be conducted for all the applicants as part of the selection process

5.          TRANSPORT

Each CBIA will be provided with a bicycle or scooter to facilitate prompt movement from house to house. Also, each CBIA will fully be responsible for maintaining the bicycle/scooter.

6.           SUSTENANCE OF THE PROJECT:

There is need to provide incentives to the CBIAs to keep them committed and motivated to the initiative. This should be according to their basic needs such as food: A bag of 50 Kg maize meal; 4 Kg beans; 2L cooking oil: 6 Kg Sugar‑ 10 tine of fish every 3 months and an allowance of N$200.00 per month. Stationery to be provided will be as follows: 1 hard cover ex book; 2 pens and a writing pad. Information, Education and Communication (IEC) material such as booklets of people living positively with HlV/AlDS; leaflets/booklets ‑how to prepare ORS; causes and mode of transmission of malaria, TB and HlV/AlDS; how to prevent malaria TB and HlV/AlDS.

7.             General Objective

The main emphasis of the programme is to ensure the continuum of care and to improve the health status of the communities in the rural areas.

8.                 SPECIFIC 0BJECTIVES

Communicable diseases mainly HIV/AIDS/STDs, Malaria and Tuberculosis will be the main focus for these objectives Therefore, by the and of the training the trainees should be able to:

1. Describe and explain basics and other fundamental issues and concepts related to these diseases

2. List and discuss the modes of transmission of these diseases

3. Describe the basic observable symptoms of these conditions

4. Understand the underlying dynamics of symptoms of these diseases

5. Discuss the basic prevention and management of these diseases

6. Describe and discuss basic principles and skills essential for counseling

7. Specify issues to consider when conducting counseling an different conditions

8. Advice on nutrition and healthy life style for any condition

9. Give guidance on basic caring skills to caregivers

10. Understand and apply the community dynamics

11. Refer the identified cases to available health services and other relevant agencies

9.             CURRICULUM CONTENT

The content of the curriculum shall cover five main units namely:

Community mobilization; basic knowledge an HlV/AlDS and other communicable diseases; counselling; care and support, supervision and evaluation.

A. COMMUNITY MOBILISATION

This unit aims to equip trainees with knowledge and skills on community dynamics

The Following will be covered:

B.    BASIC KNOWLEDGE ABOUT HIV/AIDS AND OTHER COMMUNICABLE DISEASES

In this unite the trainees will be equipped with the fundamentals on the most common diseases

The following will be covered:

C.    COUNSELING

This Unit shall equip the trainees with general counseling skills applicable for the managemtn and counseling of identified persons.

Acquisition of Basic knowledge of principles and skills in counseling:

D.    CARING AND SUPPORTING PERSONS LIVING WITH HIV/AIDS AND OTHER COMMUNICABLE DISEASES

This unit is focused on the family and the community as a whole.  It aims to equip trainers with skills and knowledge on giving guidance to caregivers.

This unit shall thus cover:

10.        MONITORING AND EVALUATION

The supervision for the CBIAs will be done by the health professional in charge of the nearest clinic and the regional councilor in the catchment’s area.

Regular feedback meetings between trainers and volunteers on a monthly basis and or when necessary will be hold.

Field visits by the trainers or nearest health facility health workers will be done on a monthly basis or when necessary.

Refresher courses will be provided to the volunteers on a six monthly basis or the improvement, of the project and strengthening their activities.

11.             ACTIVITIES OF THE VOLUNTEERS

Community Based Information Assistants will be required to do the following activities

1. Give health information on prevention and control of infectious diseases including HIV/AIDS

2. Distribute condoms and demonstrate how a condom should be used;

3. Identify orphans from their communities and register them;

4.  Identify HlV/AlDS and chronic terminally sick people at household level;

5. Establish whether home‑based care service is available for households with terminally persons;

6. Establish the frequency of available Home‑based care available for these people by the home-based caregivers;

7. Identify malnourished children, TO patients, and Malaria patients and refer them to health facilities for further treatment and care;

8. Report numbers of the registered HlV/AlDS persons, Orphans, TO and Malaria patients to the constituency Councillors and the Health Information system;

9. Distribute IEC material, and explain and discuss with the people the contents of such materials, particularly those pertaining to HIV, STD's, Malaria, TB, and Malnutrition;

10. Guide families inthe provision of home care;

11. Give reports to the constituency councillors on the progress made every month when they go to receive their allowance;

12. Refer all identified cases to the Health Information system of the Ministry of Health and Social Services (MOHSS) and other relevant agencies in their communities for further management.