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Table 2 CHA Work Package

From: The Tanzania Connect Project: a cluster-randomized trial of the child survival impact of adding paid community health workers to an existing facility-focused health system

Service Description
Health Promotion and Education
Behavior Change Communication • Delivered through household visits and mobilization of men’s and women’s groups
• Main topics are: family planning; antenatal care; delivery care; post-natal care; child health; HIV and STI prevention; water, sanitation and hygiene and environmental health.
Focused Counseling and Service Delivery in Households
Family Planning • Refer client to the nearest facility for family planning initiation
• Make household visits to refill methods and provide counseling and support
• Counsel and provide condoms and demonstrate their proper use
Antenatal Care Three households visits during pregnancy:
• Visit 1 at 12-16 weeks: counseling, promote early initiation of ANC within first 4 months, emergency referral in the case of complications; provision of condoms for HIV/STI prevention, monitor ITN use
• Visits 2 and 3 at 20 and 28 weeks: promote 4+ ANC visits, provide emergency referral for complications, continue monitoring ITN use, IPTp and PMTCT, develop birth preparedness plans, and counsel on danger signs, essential newborn care, post-partum family planning and HIV prevention/PMTCT
Delivery Care Emergency referral for obstetric and newborn complications:
• Call for advice and transport
• Mobilize community to create local solutions to the referral problem
Postnatal Care Four visits in the postnatal period:
• Visits 1 and 2 within 24 hours of delivery and 3 days after birth:
Intensified counseling on essential newborn care
Promotion of postpartum family planning
Refer for maternal and newborn complications
Measure the newborn’s foot size to detect low birth weight
Educate household on maternal and newborn postpartum danger signs
• Visits 3 and 4 at 7 and 28 days to promote immunization and exclusive breastfeeding and refer for complications
Under-five Health • Management of simple cases of diarrhea, pneumonia, malaria (pending RDT rollout), and helminthic infections; referral for severe cases of child illness
• Mobilize villages and coordinate immunization and Vitamin A outreach events with health facility staff
• Focused counseling on child nutrition, growth monitoring, and prevention and recognition of childhood illness
• Depending on mothers’ voluntary disclosure, encourage HIV diagnosis of the newborn and infants at 18 months.
HIV/STIs and TB • Provide HIV/STI prevention education and distribute condoms
• Encourage VCT
• Link PLWHA to support groups.
• Identify potential cases of TB and refer
First Aid • Perform first aid and refer
Vulnerability and Risk Protection
Disability • Identify individuals with disabilities
• Refer to appropriate services
Social Protections • Educate households on the Community Health Fund and encourage them to enroll
• Identify poor households that qualify for exemptions
Community Mobilization and Health Systems Strengthening
Mobilization and Outreach • Convene village groups to identify and discuss priority community health issues
• Mobilize community-based responses for emergency referrals and other priority issues
Health Information • Collect service statistics (CHA) and assist with vital registration at village level
• Manage and report community-based service information into broader HMIS
Governance and Leadership • Attend Village Health Committee, Health Facility Management Team and Health Facility Governing Committee meetings to articulate community health needs and priorities
• Support committees in coordinating events and activities as needed
  1. The below table provides an overview of the main tasks CHA are trained and authorized to provide.