Adapting HBLSS to Fit Your Program_DuBois_5.11.11
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Transcript of Adapting HBLSS to Fit Your Program_DuBois_5.11.11
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WellShare International
Diana DuBois, MPH, MIA
CORE Group Spring Meeting
11 May 2011
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HBLSS – Karatu District, Tanzania
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Tanzania Child Survival Project
• Karatu District, Arusha Region– Population ~250,000– 45+ villages
• USAID-funded• 5-year program
(2006-2011)• Intervention areas:
Maternal Newborn Care, Malaria, CDD, ARI, FP
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HBLSS Integration
• Initial/specified training cascade– Master training of trainers – 3 weeks
• (6 WellShare + 8 partner staff; ACNM consultants)
– HBLSS trainers • (14 local TBAs; ACNM consultants and
master trainers)
– HBLSS guides • (32 local health facility staff and TBAs)
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HBLSS Integration
• Integrated training activities (subsequent)– Maternal newborn care training for TBAs
• Integrated with MOH MNC curriculum for TBAs
• Additional 2 days HBLSS training for 36 TBAs
– HBLSS TOT training for TBAs• Equivalent to “HBLSS trainers” training• 84 TBAs trained over 5 days• Subsequent training of additional TBAs in
local villages by TOT TBAs– Health advocate training for
Hadzabe/Datoga• 15 trained using modified HBLSS materials
– MNC training for MAISHA taxi drivers• 45 trained using modified HBLSS materials
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HBLSS Integration
• Community level education to Survive & Thrive Groups– Home visits by TBAs– Village community meetings (TBAs
showed materials to men and village leaders
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Costs
• Initial master training– Approx. $30,000
• Consultants - $21,000
• TBA TOT training– Approx. $140 per person
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Adaptations
Other Adaptations• 2 sets of laminated teaching picture cards/teaching
models per village • Pictorial information on the “safe delivery kit” was
adapted to meet local standards and availability; also translated to Kiswahili and Kiiraqw
• Adapted materials for Hadzabe and Datoga health advocates and MAISHA drivers
• Adapted M & E materials into expanded Village Pregnancy Register (a WellShare tool) as M&E was too costly to implement
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Lessons Learned / Challenges
• Lessons Learned– HBLSS materials very well received by beneficiary
populations – HBLSS can effectively be used to provide MNC
training to male educators – Village leaders became proponents of HBLSS and
promoted it in their villages – HBLSS has been integrated into the body of
knowledge passed down from older to younger TBAs• Challenges
– Cost for total program is prohibitive (esp. M&E act.s)– Distance between households has affected training
and follow-up supervision
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Recommendations
• HBLSS should be more broadly implemented– Story format well-received by
communities – Effective even when modified
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Contact
WellShare International
122 West Franklin Avenue
Suite 510
Minneapolis, MN 55404
www.wellshareinternational.org