The Neighbourhood Health Committee (NHC) Strengthening Package

Project dates: 1999 - present

Themes: Capacity Building, Community Mobilization, Gender & Sexuality, Child Health/IMCI, Family Planning and Maternal Health, Malaria, HIV/AIDS/Youth

• Overview
• Objectives
• Activities
• Outputs
• Impact
• Unique Features
• Future Plans
• Partners

Overview

The process of empowering the communities to take responsibility for their own health began with the involvement of community members in identifying and prioritizing their health problems and developing strategies to mobilize local resources to solve these problems. Building the capacity of NHCs to better coordinate population, health, and nutrition (PHN) interventions at the community level is a critical focus area of Zambian Integrated Health Programme Communication and Community Partnerships) ZIHPCOMM; it is a participatory process that allows all stake holders to gain an appreciation of the need to work together. Training of trainers was conducted by ZIHPCOMM, helping NHC members to mobilize their communities, identify and prioritize their problems, and work towards solutions.

Objectives

To improve the skills and capacity of NHC members to be well informed and skilled health promoters in their communities.

Activities

Training of Trainers (TOT) and Roll Out of the NHC Strengthening Package
Participants from districts and health centers were trained in the PLA approach for community mobilization skills and the Employee Health Care Package (EHCP) to enhance knowledge in disease prevention.

Building Community Mobilization Skills at Scale: The Radio Distance Education Course Model in Zambia (1.2 MB)

Distance Education Radio Program
The NHC Distance Education Radio Program for service providers was launched in January 2001 after determining the scope, content and details through a design workshop. The NHC Distance Education Radio Program, seen as the glue for the whole NHC component, supported NHC members as they moved from the training into roles as community mobilizers. The Distance Education Radio Program for NHC members, entitled "Our Neighbourhood," is a 6-month, 30 minute per week, repeatable course. The program provided technical updates on both health interventions and community mobilization techniques, and provided on-going support and encouragement, filling some of the gap in supportive supervision. The Central Board of Health endorses the program as an official distance learning program, certifying graduates as qualified in community mobilization. A follow-up radio program was launched, entitled "Community Health with Sister Evelina". This program was a follow-up to those NHC members who already completed the formal distance learning course. This 15-minute program gave NHC members additional health and technical updates, community mobilization tips, and information on current health events. More than 5,000 listeners register per 6 month period. Programs are produced in English and three Zambian languages: Bemba, Nyanga, and Tonga. To date 26 Distance Education Radio Program episodes have aired. Thirteen episodes of "Community Health with Sister Evelina" aired per quarter. Lozi (Zambian dialogue) was introduced in January 2002.

Health Information Cards
NHC Health Information Cards were developed as a supplement to those NHC members who registered for the distance education course. The cards are print materials that an NHC member can use for technical updates and for providing ideas on community mobilization around a specific health topic. NHC Information cards have been printed and distributed to new NHC listeners on HIV/AIDS, STDs, TB, Birth Preparedness, Family Planning, Danger Signs in Pregnancy, Malaria in Pregnancy, Mother to Child Transmission of HIV/AIDS, Community Drama, and Health Care Financing. Cards are also being developed on VCT, community mobilization, accessing resources, and peer education.

Supervisory/Field Visits
Support visits for technical assistance and onsite checks were regularly conducted.

NHC Rapid Assessment
A rapid assessment exercise was conducted to track the achievements of the NHCs in relation to their planned activities. Data is available for five districts.

Operations Research
Operations research activities are conducted to guide and inform the NHC strengthening package. The main objective of the research was to determine which approach is most effective in terms of cost and impact for NHC strengthening and community action for the promotion of health and prevention of diseases.

Distribution of registered NHC members.

Outputs

• NHCs formed in 12 districts
• 5,394 participants trained in community partnerships building and PLA approach
• 1,460 NHC Action Plans developed
• Catchment populations of about 2.9 million people reached (about 30% of Zambia's population)
  

Impact

The action plans formulated by the NHC were elevated to form part of the health center and district action plans. Preliminary findings from supervisory/field visits show positive changes have taken place. Additional NHCs have been formed, more community members are willing to join, neighborhoods are cleaner, and the demand for CLORIN (water purification product promoted by NHCs) has increased. People are seeking information on the benefits of living healthier.

Unique Features

The NHC consists of community volunteers and is designated as the grassroots unit in the health structure, providing the link between health centers and the community level.

Future Plans

• Expansion of operations outside of ZIHP supported districts.
• ZIHP is working with Action Computers and the DHMTs to create a database at the district level for compiling community level activities. This will help determine which NHCs are active, what activities they are doing, and what levels of training they have achieved in the Essential Health Care Package and Participatory Learning and Action (PLA) techniques.
  

Partners

Central Board of Health
Government of the Republic of Zambia
CARE
Africare

Previous Project | Next Project