Role of FBOs In Improving Maternal, newborn

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Role of FBOsInImproving Maternal, newborn
Womens health

• Sarla Chand
• Women Deliver Conference
• October 19, 2007

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Objectives

• To inform about the extent and the reach of FBOs
  and their contribution to improving maternal,
  newborn womens health.
• To lift up a few successful, varied and
  replicable FBO health care models.

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Faith-Based Organizations Any group working
in the name of faith

• Christian
• Most extensive
• Over a century old
• Islamic
• Agha Khan Development Network
• Health, Education
• Islamic Supreme Councils national
  organizations, e.g. Uganda Muslim Medical Bureau
  Bakawata, Tanzania
• Hindu
• Hindu Mandal, Tanzania
• Rama Krishna Mission, India
• Budhist
• Thailand, India, etc.
• Bahai
• Tanzania, India, etc.

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Faith-Based Organizations What added value
do FBOs offer?

• ACCESS extensive networks of hospitals, health
  centers, dispensaries, pre-service training
  institutions congregation-based health programs
  a permanent sustainable national resource
• SUSTAINABILITY FBOs have staying power
  provide good infrastructure for health have
  access to resources not available to MOH
• SERVICE high quality, compassionate service to
  all, especially the poor and marginalized
  effective in community mobilization
• TRUST long-term presence strong community
  ties have good management systems are willing
  to integrate into the public health system

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Successful FBO Models

• FBO Health Networks
• Congregation-based health programs
• Community health programs focusing on behavior
  change
• Comprehensive and Integrated healthcare models

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Faith-Based Healthcare Networks
What do we know about FBO healthcare networks?
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Faith-Based Organizations Complex
Interlinked Christian Health Networks

• International (US)
• Ecumenical, e.g. I.M.A., Church World Service
• Denominational, e.g. Lutheran World Relief,
  Catholic Relief Services
• Non-Denominational, e.g. World Vision, World
  Relief, Samaritans Purse, Balm of Gilead
• Regional (Africa)
• Ecumenical, e.g. PACANet (HIV/AIDS)
• National (Africa, Asia)
• Ecumenical, e.g. CSSC, CHAM, CMAI
• Denominational, e.g. ELCT, TEC, KEC
• Local
• Community, congregational (church, mosque,
  temple, etc.)

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Make up of National Health Sector in Select
African countries
FBOs are a diverse group representing different
religious affiliations. The graph illustrates
data from a variety of sources to depict the role
that the FBO Christian Health Associations
(CHAs)a network of Christian health
facilitiesplay in the national health sector in
select African countries. In addition to the
CHAs, smaller networks e.g. Agha Khan network,
Bakawata, Hindu Mandal and Ahamadiya are
also contributing to the NHS but since their
numbers are not available, they are not
included in this graph
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Christian Health Networks

• DRCongo FBOs provide 50 of health services
  with 180 hospitals several thousand HCs
• Kenya CHAK provides 40 of health services with
  24 hospitals, 341 HC/disp. 51 church programs
• Lesotho CHAL provides 40 of health services
  with 8 hospitals 75 HCs
• Malawi CHAM provides 37 of health services
  with 28 hospitals 125 HCs
• Uganda UCMB, UPMB UMMB provide over 55 of
  health services. 75 of pre-service training
  institutions are faith-based
• India Christians make up 2.3 of the
  population, but provide over 25 of health
  services

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• Comprehensive Primary Health Care Systems There
  are numerous examples of FBOs that have
  successfully implemented variations of a
  comprehensive primary health care model in
  different parts of the world.
• Examples Jamkhed
• SANRU/AXxes

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CRHP Jamkhed Referral Model
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• The following componentsin addition to the
  comprehensive and integrated approach to
  healthhave made the CRHP a success
• The VHW is a volunteer, selected by her
  community, and acts as a local agent to promote
  positive health and social change. She is trained
  in basic health issues, community development and
  organization, communication skills and personal
  development by the CRHP training team. Many VHWs
  are also trained as skilled birth attendants.
• The mobile health team (MHT) is composed of a
  nurse, social worker, doctor and paramedical
  workers. The team visits the project villages
  periodically to provide support and facilitate
  development activities. The MHT also serves as
  the liaison between the village and health
  center.
• Jamkhed Hospital is a secondary care facility. It
  provides low-cost, high-quality emergency,
  medical, surgical and outpatient care for the 1.5
  million people in the surrounding area. Each year
  at the hospital, about 20,000 outpatients receive
  treatment, 250 deliveries take place (high-risk
  referrals) and 400 surgical procedures are
  performed. The hospital acts as a referral center
  for health problems that cannot be handled by
  VHWs (Arole et al. 2005).
• The Institute for Training and Research in
  Community Health and Population by 2005 had
  trained more than 2,000 international
  (representing nearly 100 countries) and 5,000
  national health and development workers from the
  government, nongovernmental organizations (NGOs)
  and FBOs. The training institute continues to
  train both domestic and international health and
  development workers, and is affiliated with
  public health schools in England and Australia.
• The project recognizes the importance of a
  multi-sectoral approach to improving health and
  provides support to the communities on
  agriculture, infrastructure, education, and
  micro-finance, as well as other areas.
• The project has enabled close cooperation among
  community members from different castes,
  religions and economic backgrounds, and led to
  improved services and ability to access services
  in the project villages.

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Successful FBO Models Contd.

• Congregation-Based Health Programs Local
  congregations (churches and/or mosques) promote
• Women and childrens health through womens
  groups.
• Youth groups are an effective channel for
  promoting appropriate reproductive health
  messages.
• The U.S.-based model of having a parish nurse or
  congregational health leader within congregations
  has taken root in several developing countries.
• All use behavior change messages to promote
  healthy living

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Successful FBO Models Contd.

• Community Health Programs - Focusing on Behavior
  Change World Relief Care GroupMozambique
  (multiple communities). World Relief (WR)
  developed the Care Group Model in rural
  communities of Mozambique to address some of the
  gaps in achieving sustainable impact by engaging
  a network of community volunteers, and training
  them in care groups as behavior change agents.
• The health volunteers implement culturally
  relevant approaches
• Each volunteer then shares her newly acquired
  knowledge with at least 10 of her neighbors.
• With this approach, the volunteers are spreading
  life-transforming information in one of the most
  effective ways possiblemother to mother.

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World Relief Care Group Model Contd
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Faith-Based Organizations Why one should
work with FBOs?

• Because FBOs
• Provide significantly large proportion of
  healthcare
• services, especially in Africa Asia
• Are deeply integrated into communities
• Have history of sustained, long-term presence
  despite
• natural disasters political unrest
• Are experienced at maximizing use of available
  resources
• Have established effective channels of
  communication in
• the communities they serve
• Are able to mobilize volunteers
• Provide high-quality compassionate care
• Have committed service-oriented personnel

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How ACCESS is working with FBO Healthcare
Networks in Africa?
working with Christian and Islamic healthcare
networks, providers, religious leaders by
Training Providers in FANC, MIP, and PMTCT
Strengthening TOT Disseminating
Resources Networking Advocacy workshops
FBO Health Assets Mapping - Tanzania (2006)
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Recommendations for strengthening partnerships

• For Faith-Based Organizations
• Document and disseminate .
• Strengthen partnerships among FBOs of all faiths
  and with other stakeholders.
• Participate actively in national and global
  policy development and mechanisms for resource
  allocation and decision-making.
• Strengthen capacity in management and leadership
  development.
• Advocate for improved health care services for
  all.
• Advocate for equitable HR recruitment and
  retention policies.
• Strengthen values of justice, equity, medical
  ethics, care and compassion in the FBO health
  care system and infuse them in the countrys
  health care system, while providing leadership in
  research and practice of the spiritual dimensions
  to health.
• Develop a resource base so that the poor and
  marginalized are not turned away because of an
  inability to pay for services.

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Recommendations for strengthening partnerships
Contd

• For Policymakers
• Incorporate strengths of FBOs in national health
  system at the country, regional, district or
  local level.
• Engage FBOsthrough a participatory
  decision-making processin policy development
  identification and distribution of resources
  co-management of health districts
• Promote development of a national behavior change
  strategic plan to promote healthy behaviors
  utilizing the reach, holistic service,
  compassionate care, trust and sustainability of
  FBOs.
• Endorse a joint decision-making process that
  strengthens all pre-service training
  institutions.
• Develop a national HR plan that implements human
  resources reforms that do not undermine the FBO
  health care networks, but strengthens the entire
  national health sector.

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Recommendations for strengthening partnerships
Contd

• For Donors
• Support MOHs to build capacity of national
  faith-based health networks (e.g., Christian
  Health Associations and various Islamic health
  networks) and help strengthen collaboration in
  the co-development and co-management of an
  integrated health system.
• Increase funding for integrated MNH programs.
• Support training, recruitment and retention of
  health professionals equally for governments and
  FBOsthereby strengthening health care for all.
• Advocate with governments around the world on
  equitable recruitment policies that do not drain
  national assets from developing countries.
• Support MOH and FBO health networks to promote
  and deliver the holistic and integrated programs
  that are their strengths.

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Thank You!
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