Requirement for community based, CHW management of chronic disease | Kisoro VHW program responses |
---|---|
Early (preclinical) diagnosis through comprehensive community Screening | Biannual health Census by dedicated trained staff partnering with VHWs |
Diagnostic verification by a health professional | Supervisor verification during home visit of screen-positive people |
Follow-up of “borderline” cases below treatment thresholds | VHWs in the field, targeting specified clinical indices periodically and keeping track of patients via Family Health Sheets |
Community-based treatment: easy-access for high-risk patients who would not seek care otherwise, with referral/consultation when needed; | Chronic Disease in the Community (CDCom) program, ongoing 10 years; 39 monthly outdoor community clinic sites; referral pathways to district hospital established |
Geriatric treatment for common disabilities of aging: diagnosis and management | Elders program: VHW-mediated screening of sight, hearing, mobility, depression, and appropriate community-based therapies |
Malnutrition treatment: food supplementation when needed | Community nutrition program: VHW identification, supervisor verification, village-level food supplementation |
Use of health census and ongoing documentation of family observations to improve community health | Family Health Sheets and FHS binder |
Maintenance of VHW interest and investment over time: incentivize health actions financially, educationally, socially; prevent burnout | Stipends for health activities undertaken, regular meetings around educational topics, bi-monthly field supervision, community respect for achievements in providing health care |