SPF Project



SAVING LIVES AT BIRTH .

Funded by: One to One Children’s Fund

Project Coordinator: Khuzwayo August

Sector: Health

The Early Infant Diagnosis Treatment and Care (EIDTC) programme supports programming in maternal, new-born and child health, immunization, family planning and reproductive health, nutrition, health systems strengthening, water/sanitation/hygiene, prevention of mother-to-child transmission(PMTCT) of HIV, and pediatric HIV care and treatment. Access of mothers and children to medical services and health care during the first 1000 days of life became an important area for SPF to focus on to develop a systematic care and support strategy that responds to the needs of children under 3 years to ensure their survival and development. The project will create systems that will address and prevent child mortality. The project name is Saving Lives at Birth Programme.

Objective:

The programme will strengthen HIV/AIDS care in the Nyandeni Municipal area for 3 of the 13 Clinics:

 

·         Improving community responsiveness to Maternal and Child Health (MCH) and PMTCT through Community  Score Cards (CSC) workshops in all three clinic catchment  areas.

·         Improving clinic responsiveness to MCH and PMTCT through developing Balanced Score Cards (BSC) which identify and address service quality improvements in paediatric and maternal care.

·         Training of Clinic Committees on their roles and responsibilities and induction to Clinic Committee Policy, to strengthen clinic committee accountability to communities.

·         Involving of men and male partners in the PMTCT process to support their partners and children and offer HIV counselling and testing (HCT). 

·         Continuation of defaulter tracing (SMS Life-line) communication between Community Health Workers (CHWs), clinics and PMTCT/ART clients to support defaulter tracing, improve EIDTC and ensure adherence to PMTCT and ART regimes.

·         Support of mobile outreach teams (Department of Health Ward based outreach programme).

·         Capacity building of 30 Community Health Workers through the Skills to Care (Perinatal Education Trust) Modules as a training method.

·         Systematic replication of the programme model into the DOH beyond the 3 clinics.

·         Focussed home visits by CHW’s on a daily basis to assigned pregnant women and mothers and babies.

 

Activities:

Activity DescriptionInputsResult
Ward based (per clinic catchment area) community and stakeholder mobilisation and planning

o    Ward and village stakeholders

o    Community members

o    EC DOH Nyandeni Sub District and Ngqeleni Cluster

o    Community based organisations (CBOs)

o    Programme promoted to communities

o    Mentor mothers per village identified

o    Training of Mentor Mothers.

o    CBOs per village identified for collaboration.

o    PLA workshops and community score cards agreed upon; and have taken place.

Engagements with 3 clinics namely Ngqeleni Buntingville and Canzibe

o    Clinic Committee Members

o    Clinic Managers

o    Clinic CHWs

o    WBOTs

o    Database of clinic committee members per clinic collated.

o    New Clinic Committees nomination for 2017/18.

o    Clinic Committees will be training. (Database of CHWs and their skills levels per clinic obtained.

o    Training schedule confirmed

o    Schedule of clinic score card intervention confirmed and actioned upon.

o    Training of 30 CHWs, WBOTs Team Members.

Clinic File Audits

o    Audit of clinic files

o    Allocation of defaulters to CHWs

o    Patient file management system fully functional.

o    Provision of weekly defaulter list in place.

o    Identified defaulters followed up and returned to care.

Focussed home visits by CHW’s on a daily basis to assigned pregnant women and mothers and babies.o    6 CHWs providing a range of services through home visits

o    Comprehensive education sessions held per clinic.

o    All assigned defaulters traced.

Men spousal support and testingo    Encouraging more men to test for HIV /AIDS and to support their spouses to ANC and PNC.o    HCT campaigns continues to attract male testing in the villages, but fewer men still visits clinic to support their women and for HIV testing.

Mentor Mom Programme:

Since October 2017 the mentor mom programme has gained momentum, in grouping new moms and pregnant women to attend antenatal and post-natal education sessions conducted by Community Health Workers at village level. Small Projects Foundation champions mentor mother programme to increase the number of pregnant women and new moms to attend antenatal and postnatal sessions that are provided by Community Health Workers at a village level. A number of sessions are covered from this programme, and expert moms are then identified during these sessions to become expert mentor moms, and to run wellness clubs with fellow villagers for the continuation of the programme forward.

These sessions has been very motivational and interesting for new moms and pregnant women as they provide an incentive for those that attend these session in a form of a tray of eggs, to boost their nutrition and improve health and prevent and address nutritional stunting among infants and young children. This programme empowering pregnant women early in gestation through antenatal classes (ANC) and post-natal clases (PNC) and continued support up to 24 months after delivery.

Small Projects Foundation has extended its MOU with the Department of Health, to provide multi-vitamin to pregnant women and new moms, through the partnership with Vitamin Angels. Pregnant women have an increased need for vitamins and minerals throughout pregnancy. Providing supplemental nutrition in the form of a daily multi-vitamin is an excellent way to meet this increased need by ensuring adequate nutrition and improve the pregnancy outcome. The dispensary platform of the multivitamin supplements will be through the mentor mom village based classes that are held every month in the village where this programme takes place.

 

SMSLifeline solution (Dimagi):

Small Projects Foundation has in a month of February made fresh contact with the Dimagi team in Cape Town, where Dr Paul Cromhout and Khuzwayo August met with Carlos Yerena and his team. The meeting was about the resuscitation of the Dimagi mobile defaulter tracing in all three clinics funded by One to One. This is a new deliberation from the first attempt that did not work according to the expectation. This time SPF is looking for a working system as a response to defaulter tracking and tracing, to bring patients back to care.

The meeting agreed that Dimagi will be developing a new CommCare application whose primary focus will be to manage the follow up and tracking of patients in the Early Infant Diagnosis, Treatment and Care (EIDTC) and Prevention of Mother to Child Transmission (PMTCT) project, to ensure women are adhering to clinic visits while pregnant and supporting mothers and babies after birth for 18 months. The main goal of the application will be to develop a simple system which will:

 

v  Create and store information on new registered patients on a weekly basis that are part of the EIDTC and PMTCT project listed in the paper-based form.

v  Have an accurate record of patients defaulting on clinic visits

v  Provide quick and efficient communication to Community Health Workers (CHW) when follow ups are required

v  Ensure actions are being taken to return patients to care

 

Recommendations:

The recommendations were that , there has to a person employed to steer this programme in the form of a regional mHealth Coordinator, SPF needs a champion solely dedicated to this project, to guarantee rapid responses and reliability on SPF’s side. It is crucial to have this resource within SPF.

The Organisation has since employed Miss Nomfundiso Joseph as a regional Coordinator who is based in Ngqeleni. She has started to engage Clinic Operation Managers and Data Capturers. We have received and approve the proposal. The capacity building on the new app development and the training for Nomfundiso and Community Health Care workers, will commence shortly. Currently Small Projects Foundation has introduced Miss Joseph to SPF Nursing Coordinators Miss Makhalima and Mrs. Mapeyi and she has spent some time with the Community Health Workers. We have introduced her to the Nyandeni IT Manager Miss Nangamso Simouse, and to Miss Ndwandwa, who is currently a sub District Manage.  We are due to send her to Cape Town for training on the app with Dimagi.

 

Challenges:

A challenges facing the project is still the need to increase the number of males coming forward to test for HIV/AIDS, and spousal support to partners. A second one is the delay in resuscitating the Dimagi app. Carlos Yerena of Dimagi has responded back to us on the training and the app development and we are now making progress.

Results:

Small Projects Foundation presented the results on the Skills to Care and Mentor Mom Support Group Programme at the South African National Best Practices workshop in Pretoria, on the 16th May 2018. This was well received with much interest shown by the National Department of Health and international Non –Governmental Organisations. The selection of SPF to present this model as best practice is a great honour for the organisation and the project.

Acknowledgements:

Small Projects Foundation, welcomes the continued support and funding of this wonderful programme by One to One Children’s Fund and Positive Action for Children’s Fund (PACF) in the Ngqeleni cluster clinics under the Nyandeni Sub-District and the OR Tambo District. Our grateful thanks for wonderful support, funding and encouragement. Without your funding and support this programme would not have been possible.

We acknowledge the Eastern Cape Department of Health, Nyandeni Sub-district, Health Staff, clinic staff, community health workers, and other partners for their hard work, support, inspiration and commitment.

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