1. Community Approaches to Child Health

2. Why Community Approaches? To reach unreached families To mobilize additional resources and partners (including communities and families themselves) To especially strengthen preventive approaches

3. Careseeking And Sources of Care - Bangladesh, 2000 Source: IMCI Multi-Country Evaluation Bangladesh, 2000 1 st source of care sought

4. Home Treatment and Proportion of Children with Severe Dehydration - Haiti, 1983

5. Examples - Community Approaches at Scale Indonesia - Posyandus Bangladesh - BRAC ORT Nepal - Vitamin A & pneumonia treatment Madagascar - Immunization, Nutrition, Safe Water, “Community IMCI” Bamako Initiative

6. Global Programming Efforts for Community Approaches at Scale Community Based Delivery of family planning “Community IMCI” Roll Back Malaria (“the home is the first hospital”) Child Health Days (vitamin A plus) “Sustainable Outreach” (immunization)

7. WELL Promotion/Prevention Behaviors Feeding Hygiene Bednets, etc. Support Groups (Women’s, schools, religious, etc.) Information Resources Support for key inputs (Bednet redipping, water, etc.) Organization for outreach (Immunization, micronutrients, etc.) Outreach Assessment (Nutrition status) Information & counselling Immunization, micronutrients ILL Recognition Home care Care seeking Continued care Referral acceptance Information Support for referral (Transport, emergency funds, etc.) Drugs and supplies (Community Pharmacies, private sector, CHWs, etc.) Treatment Referral Counselling (continued care) “Counter-referral” HOME COMMUNITY FACILITY

9. Taking Community Approaches to Scale Focus on key outcomes (not prescribed processes) Build on what’s there - NGOs, community- based programs Engage partners Develop policy and resource commitment (part of national strategy)

10. Country Program Examples - Key Questions Why a community approach? How does the program work? What is the role of government (national, district, local), NGOs, others? What have been key challenges and constraints? Is it working?

13. Key Behaviors Related to Major Causes of Infant and Child Mortality Newborn care Breastfeeding Appropriate feeding Micronutrient intake Immunization Handwashing & Hygiene Bednets Recognizing illness Appropriate home care Danger signs & indications for care seeking Seeking appropriate care (including care delivered in the community) Accepting referral Promotion of Health/ Prevention of Illness Illness Recognition, Home Care & Care Seeking