Adherence & Retention

Welcome to the community Ailis!

Thank you for sharing with us the great work you and your colleagues at TTL are doing.

Working with CHW and integrating them in your program will have tremendous impact on your work especially that outreach activities are a major component of your program. CHW can act as a vital link between your organization and the community and they can contribute immensely to health care delivery.

As you know, the CHW network already exists in Lesotho, they are referred to as village health workers. They are trusted members of the community , usually appointed by the chief of the village. The majority of the VHW are women, they know how to write and read and the training they received before PIH set their program was minimal. After launching the Know Your Status campaign, some of the VHW received training in counseling and HIV testing.

Your should try to define the role of the CHW in your program and the tasks you expect them to perform. Your program should consider providing training for the CHW on regular basis, PIH curriculum for CHW (available on PIH website) can be very useful in this regard. Also, it will be ...

Welcome to the community Ailis!

Thank you for sharing with us the great work you and your colleagues at TTL are doing.

Working with CHW and integrating them in your program will have tremendous impact on your work especially that outreach activities are a major component of your program. CHW can act as a vital link between your organization and the community and they can contribute immensely to health care delivery.

As you know, the CHW network already exists in Lesotho, they are referred to as village health workers. They are trusted members of the community , usually appointed by the chief of the village. The majority of the VHW are women, they know how to write and read and the training they received before PIH set their program was minimal. After launching the Know Your Status campaign, some of the VHW received training in counseling and HIV testing.

Your should try to define the role of the CHW in your program and the tasks you expect them to perform. Your program should consider providing training for the CHW on regular basis, PIH curriculum for CHW (available on PIH website) can be very useful in this regard. Also, it will be great if TTL is able to provide regular salaries for CHW. Training and paying CHW are crucial for the success of the program.

Since your program focuses on VOC, CHW can actively identify these children in the community, refer them to you and accompany them afterwards throughout their care. They can screen children in the community for malnutrition (using MUAC or based on clinical signs and symptoms) and refer malnourished ones to care. Also they can help the family in the preparation of safe formula at home. These are few examples of some of the tasks CHW can do ..I was wondering about HIV positive children in your program, who follows them and where? CHW can play a great role in the care of these children.

I was in Lesotho last year, working with PIH .There was around 150 CHW working with us (in one clinic), each of them accompanied 5 patients ( Patients choose their CHW).They were very motivated, worked very hard and felt very happy that they are contributing to the well being of their community.

I had the chance to meet Dan Block from TTL when I was in Lesotho and we started to think together how we can coordinate our outreach programs, I believe this is an issue worth exploring. Also CRS (catholic relief services) have a program for VOC in the rural areas, it will be useful if your organization can coordinate with them.

I hope this is helpful, please don’t hesitate to post more questions/comments.

Good luck, we are eager to hear more about your work!

Hi Ailis, thank you for posing this question: i can answer a few of your PIH specific questions: there are no "most important factors" in choosing a community--we have found that this approach works throughout diverse communities. We definitely do NOT do an initial community survey in the formal sense we do however, meet with groups of community health workers and patients informally to discuss the work. How many families per community health worker?--usually about 5 but depends heavily on how far away the families are.
There are some great materials in the community under the "Community Health Workers" topic (on the right) and we also have some great PIH training materials:
- Partners in Health Accompagnateur Curriculum: http://www.ghdonline.org/adherence/resource/pih-accompagnateur-curriculum/
- Partners in Health Community Health Worker Program: http://www.ghdonline.org/adherence/resource/partners-in-health-community-heal...

Jill Hackett can provide you more info on these as needed (she is a member of the community) and already her team has been requesting feedback on the PIH Model Online Community Health Worker Curriculum so if you happen to use this resource, please follow-up in this discussion:
http://www.ghdonline.org/adherence/discussion/feedback-on-pih-model-online-co....

i just included the link to the accompagnateurs guide..
http://model.pih.org/accompagnateurs_curriculum
under resources and have it here

Hi Ailis,

How many of this children are HIV positive or if there is any co-infection?

Thanks,Sthe

Hi! Thank you for all of your responses. I know that we have served children with HIV and with HIV and TB. I'll get back to you with more specific numbers once the TTL director responds. Thanks again.

Hi Ailis --

It's wonderful to read about your efforts in Lesotho. I help direct Tiyatien Health (http://www.tiyatienhealth.org), a community-based, social justice organization that has adapted some of PIH CHW models to provide DOT-HAART and accompaniment in rural Liberia. We've been working with the Government of Liberia to rollout its first rural public ART program, the HIV Equity Initiative, at a district hospital in Zwedru.

I'll echo responses from Mona and Joia: we've found employing community health workers and pairing them with socioeconomic support to have a tremendous impact on not only health and socioeconomic outcomes among our patients and communities in rural Liberia. So, we're thrilled to hear you are considering them in your own program.

Our programs are designed and run by Liberian community members and health professionals. We find the attached form, describing our CHWs (called "accompaniers") roles and responsibilites, to be helpful in presenting some of the "nuts and bolts" of the interventions we use. As you can tell, these were also shaped based on PIH's experiences in Rwanda and Haiti.

Hope this helps! Happy to chat more.

good luck!