COMMUNITY HEALTH LEVEL 5

COMMUNITY HEALTH SERVICES STRATEGIES

Learning Outcome No 3: Manage Community Health

Volunteers and CHCs committees

TRAINER: Victor Wasilwa

January - April 2024

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Introduction

• This learning outcome covers establishment of the community health

annual work plan as per standard community health requirements,
filling and updating Community Health Volunteers and CHCs register
according to community health guidelines, facilitation of Community
Health Workers and CHCs according to community health guidelines,
evaluation and reporting of CHV and CHCs performance according to
community health guidelines.

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Definition of Key Terms

• Evaluation: This is the act of determination of value, nature, character,

or quality of someone or something. In health care, a critical
assessment of the phenomenon being evaluated is done through
rigorous processes with the objective of fulfilling the desired
objectives.
• Importance of evaluation
•  Problem solving.
•  To inform in decision making.
•  To build knowledge.
•  To develop a deeper understanding on how to improve health care.

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• Reporting: This is a written or spoken account of something after
observing, hearing, doing or researching it.

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3.1 Community health annual work plan is
established as per standard community
health requirements
Work plan is an outline of a given set of goals and processes by which a
team/a person can use in order to accomplish those goals. It can also be
defined as a schedule or strategy that enables a particular person to stay
focused throughout the project.
Importance of a work plan
a) It gives a sense of direction – it helps one to avoid drifting into short-
term solutions by focusing on the future goals.
b) Focuses attention on objectives and goals – it ensures that people stay
focused and anticipates results.
c) Establishes a basis for team work -through coordination of the project,
diverse groups of people are able to effectively cooperate and work
together.

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• d) Helps anticipate problems and cope with change – problems that
are likely to arise as the project is being carried out are anticipated
earlier and therefore the management is able to make future plans or
changes in order to avoid them.
• e) Provides guidelines for decision making – if an organization uses a
work plan, it is able to make decisions based on future plans of the
company.
• f) Serves as a prerequisite to employ other functions of management.
These include staffing, organizing and leading and controlling.

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3.2 Community Health Volunteers and
CHCs register is filled and updated
according to community health guidelines
• Community health volunteers (CHVs) form a part of an important
network who are working to provide improved health services and health
education to people who may otherwise not have access to care.
• They act as a link between the community and the health care system.
• CHVs are selected by their neighbors (or otherwise members of the
community) and they serve in areas where they live. Many countries
recognize the benefits of linking communities to health facilities.

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• Register definition
• This is a written record containing regular entries of items or details.
• Table 35. A register depicting list of pregnant women

No. Name of Address Expected Pregnancy Place of Status of

Pregnant date of outcome birth Mother
woman birth after birth

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• The register depicting the list of pregnant women is filled by
community health volunteers.
• It is a way of ensuring that these women are well taken care of and
that all the outcomes of the pregnancy are recorded.
• For instance, pregnancy outcome may be live birth, still birth or
miscarriage.
• It is therefore vital for CHVs to maintain a record or a register to ensure
they follow up.

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Table 36. A work plan
Actions Responsibilities Budget Estimated completion
date

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• Actions
• This indicates the steps and procedures that a person or a team
should follow in order to achieve a specified goal or target.
• Responsibilities
• The duties that are assigned and should be carried out. A team
leader is usually held accountable or responsible of ensuring that the
action required has been carried out.
• Budget
• This gives an estimate of the amount of money or products that is
required in order to complete the task.

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• Estimated completed date
• It gives a rough estimate of the time that is required to have
completed the action.
• Methods of creating registers
• Registers are created mainly based on the members of the
community that are being offered the service. Some of the areas to
consider include:
• i. Amount or number of people.
• ii. The uniting factor e.g. pregnant women, infant babies.

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3.3 Facilitation of Community Health
Workers and CHCs is done according to
community health guidelines
• Facilitation – this is the act of helping a person or a group of
people to understand their common objectives and assist
them to plan on ways of achieving these objectives.
• In order to facilitate CHWs and CHCs, it is paramount that a
person understands their objectives in the community.
• Responsibilities of community health workers and CHCs
• a) Helping communities, groups and families to develop their
capacity and access to resources including quality care,
health insurance and health information.
• b) Helping to build understanding and social capital to
support healthier behaviors and lifestyle choices

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• c) Helping people understand their health condition(s) and develop
strategies to improve their health and well-being.
• d) Helping health care and social service systems to become culturally
relevant and responsible to their service population
• e) Linking people to health care or social service resources
• f) Advocating for local health needs
• g) Making home visits to pregnant mothers, chronically ill patients,
nursing mothers and the elderly
• h) Providing health care services such as monitoring blood and first aid
• i) Providing informal counseling, support and follow up
• j) Delivery of health information using terms and concepts which are
culturally appropriate

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Methods of facilitating CHWs and CHCs

• 1. Setting up community health worker training programs

• 2. Creating an open process of selecting and employment that is free
from corruption
• 3. Defining the roles of CHWs and CHCs well to ensure that members
of the community are catered for properly
• 4. Ensuring that they receive stipends to enable them to work
• 5. Educate the communities on the importance of CHWs and CHCs for
instance, communities that rely on native healers
• 6. Creating conducive environments for them since they live in the
community they serve
• 7. Provision of enough materials for them to distribute when they go
about educating the people e.g. flyers.

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• 8. Ensuring security of the areas or localities so that the CHWs and
CHCs can work in conducive environments.

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Figure 39. Health care tiers in Kenya
•

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3.4 CHV and CHCs performance is
evaluation
• Performance evaluation – is a formal and productive procedure used to
measure the work and results of an employee based on their job
responsibilities.
• Goals of employee performance evaluation
• 1. It ensures that the CHVs understand their goals, required outcomes or
outputs and how they will be assessed.
• 2. Performance evaluation also ensure that the development of CHVs is
monitored.
• 3. It provides legal, ethical and visible evidence that they were actively
involved in their jobs.
• 4. It enables CHCs to get the relevant feedback regarding the overall
health of the community.
• 5. Numeric rankings can be used to compare performances among CHVs.

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• 6. It provides a channel for recognition and even promotions.
• 7. It gives a clear understanding on how effective the training process
of CHVs is through their application in real life.

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Procedure for performance evaluation

• The following steps should be followed in order to create an

effective evaluation system:
•  Develop an evaluation form.
•  Identify performance measures.
•  Set guidelines for feedback.
•  Create disciplinary and termination procedures.
•  Set an evaluation schedule.

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• 1. Developing an evaluation form
• Evaluations should be conducted fairly, consistently and objectively so as
to protect the interest of employees and also protect yourself from legal
liability. Ensuring that a standard evaluation form is used is a way to
make sure there is consistency.
• The evaluation form should only focus on the essential job performance
areas. This allows addressing of issues that matter the most.
• 2. Identifying performance measures
• This can be one of the most time-consuming parts of creating a
performance evaluation system.
• One of the performance measures is the job description. This helps to
evaluate whether the employee’s skills match the requirements of the
position.

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• 3. Setting guidelines for feedback
• It is paramount to ensure those conducting the evaluations knows what
kind of feedback to give, how to give it, and how to get it from the
employee in return.
• i. Giving balanced feedback – do not gross over an employee’s deficiencies
by focusing only on his/her strengths. Ensure that they understand their
weakness in order for them to take ownership of their performance.
• ii. Outline expectations for improvement – ensure that you address areas
where employee need to improve and outline your expectations for
improvement. Also address how you intend to help the employee meet
your expectation.
• iii. Encourage feedback from the employee – after discussing the
evaluation results, encourage the employee to give some non-defensive
feedback. It is important to ask if he/she agrees with your assessment.

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• 4. Creating disciplinary and termination procedures
• It is important to be prepared to handle a disciplinary and/or
termination procedure.These procedures give an outline of actions to
be taken when performance deteriorates
• e.g. a verbal warning, a written warning and termination if there is no
improvement.
• Care should be taken when creating disciplinary and termination
procedures and one should ensure that it is in accordance with the
law.

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• 5. Setting an evaluation schedule
• Some of the common ways of evaluating is within 30 days of an
employee’s anniversary or performing evaluation for all the employees
at the same time.
• Ensure that all the employees are evaluated as not evaluating some
employees may hurt their morale and make them feel devalued.

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Conclusion

• This learning outcome covered Management of community health

volunteers and CHCs through various aspects such as having the
community health annual work plan, CHCs and CHVs register,
evaluation and reporting of performance according to the community
health guidelines.

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Written Assessment

• 1. Name the 3 tiers of health care in the country.

• 2. List 3 methods of facilitating CHWs and CHCs.
• 3. Name 4 goals of performance evaluation.
• 4. Define the following terms
• i. Performance evaluation.
• ii. Reporting.
• iii. Work plan.
• 5. Differentiate between a procedure and a method.
• 6. What is the definition of a register?

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