Basic Assumptions of ‘classic’ (per-protocol) CHC | Score | cRCT intervention as implemented | Score |
---|---|---|---|
Training material | |||
A customized CHC Training Manual | 4 | CBEHPP Manuals were available and used | 4 |
Training manual developed/approved by MoH | 4 | Manual available and used | 4 |
A tool kit of culturally appropriate visual aids | 4 | Appropriate visual aids available/well used | 4 |
Sub total | 12 | 12 | |
Trainers | |||
Sufficient NGO Project staff to support EHOs | 4 | Not sufficient - only one dedicated PO for district | 2 |
District leadership to ensure full local support | 4 | Mayor & District Health Officer removed from post | 1 |
EHOs to mentor CHC Facilitators | 4 | Only 6 EHOs to supervise CHC facilitators | 2 |
Politically enabling environment | 4 | Minister & Head MoH disabled CBEHPP | 0 |
The CHC Facilitators are Village Health Workers | 4 | No public health personnel facilitated CHC | 2 |
All CHC facilitators get a 5-day training | 4 | High turnover/30% had to be retrained in situ | 3 |
Sub total | 24 | 10 | |
Transport | |||
EHOs to have motorbikes | 4 | Motorbikes provided but after the training in Year 2 | 1 |
Project staff to have dedicated vehicle | 4 | No vehicle/motorbikes used on dangerous roads | 1 |
VHWs to have bicycles | 4 | Supplied but not appropriate as hilly terrain | 4 |
Sub total | 12 | 6 | |
Training | |||
Size of CHC: at least 70 members | 4 | 32 CHCs (64%) reached > 70 members | 3 |
Coverage: 80% of village HHs in CHC in Y.1. | 4 | 12 CHCs (24%) reached 80% coverage in Y1 | 2 |
All CHC sessions are participatory | 4 | Condensed sessions, so less participatory | 3 |
Only one key message and one homework | 4 | Many messages and multiple homework | 3 |
Model Home Competitions held end of training | 4 | Few competitions were held during intervention | 0 |
CHC Membership Cards used / signed | 4 | CHC membership cards were used and signed | 4 |
Certificates given at Graduation Ceremony | 4 | Only 50% of CHC held Graduations | 2 |
Club venues permanent demonstration sites | 4 | Very few venues permanent or had demonstrations | 0 |
Sub total | 32 | 17 | |
Timing | |||
Training is conducted during the dry season | 4 | All training conducted in the rainy season | 0 |
Six months continuous weekly training | 4 | Only 4–5 months available for training | 2 |
24 health sessions meeting once a week | 4 | Only 4 CHC (8%) held > 20 sessions (mean of 15) | 2 |
2 h for each session provided | 4 | At least two hours if more than one topic was done | 3 |
Only one topic is done per session | 4 | On average 2 topics done per session | 2 |
Sub Total | 20 | 9 | |
Total possible Score | 100 | Total Score | 54 |