Community health information system in action in Ethiopia
When Aragash started working as an HEW, people in the kebele had no latrines and were not using family planning methods. In the beginning, they collected baseline data and implemented the sixteen packages of the Health Extension Program (HEP) with particular emphasis on sanitation, family planning, immunization and maternal health. Aragash is trained to provide Rapid Diagnostic Tests for malaria and received refresher training in safe delivery for one month last summer at Butajira Hospital. She says, “Now people are more aware about their health and even go to Butajira Hospital if I am not around.”
The family data were later used to prepare the Master Family Index, a village-wide list of the names of household heads arranged in alphabetical order used to retrieve the Family Folder, which is filed serially by household and village number. Aragash has observed that by using the Family Folder the quality of work has improved. She thinks that the Family Folder is “family-centered” where all the services given to the family are registered. “If I go out in the village for educational activities, in my absence any one of us can know the status of the individual coming to the Health Post for service,” said Aragash.
Aragash and Zulfah use the household numbers to plan for their field visits. They pick the Family Folders of the eight to ten households they plan to visit in a day. The Family Folder “helps us to know such details as the latrine status or water source of the household so that we can give them health education accordingly.”
Aragash likes the tickler file system because it helps her to identify defaulters and have quick follow-up. She puts the health cards of the mothers who need follow-up care in the boxes arranged according to the month when the follow-up should be done. In the tickler boxes, she puts the health cards of women receiving family planning services or antenatal care and of children getting their vaccines. Later every day, they review the health cards in the current month’s box and plan follow-up accordingly.
However, the case was serious and the baby was transferred to the Butajira Hospital. Tigist kept the health card she prepared for the infant in the tickler box. Every day when she came to the Health Post and looked at the health cards in the tickler box, the health card of the infant reminded her about the baby. She waited a day or two to get some feedback on the status of the baby, but didn’t get any. She then went to the family who informed her that ht echild was admitted in Butajira Hospital. She wnet there and inquired about the well-bing of the child. It was because of the health card lying in front of her that she was proactive in enquiring about the baby. The mother of the baby told other mothers in her neighborhood the story of Tigist giving them support when their child was sick. This has “helped build trust in me,” said Tigist.
Tigist is so impressed with the Family Folder and tickler file system that she offered to train other HEWs on how to use them. In fact, during a training of trainers on Family Folder-centered Community Health Information System conducted by the USAID-funded MEASURE Evaluation HMIS Scale-up project, the participants from the other ten regions visited the Health Posts where Tigist and Aragash work, and they were highly impressed by the work they are doing.
|Related Project: MEASURE Evaluation (1997-2014)|