Community Health Workers. Strengthening a proximity strategy in rural areas (PROXISANTE)

This three-year project in Côte d’Ivoire aims to strengthen rural healthcare access by training and supporting Community Health Workers to implement innovative community-based strategies for the prevention, screening, and management of HIV, malaria, and tuberculosis.

Côte d'Ivoire

Axis: Global Health inequities

Coordinating investigators:

– Raoul Moh, PACCI

Teams:

– PACCI, Abidjan, Côte d’Ivoire
– Ministère de la Santé et de l’Hygiène Publique (Direction de la Santé Communautaire et de la Promotion de la Santé, Programme National de Lutte contre le SIDA, Programme National de Lutte contre la Tuberculose, Programme National de Lutte contre le Paludisme), Abidjan, Côte d’Ivoire
– ONG Espoir Pour les Enfants Toumodi (EPE)

Funder: External (France Expertise)

Status: accepted

Background and rationale

In Côte d’Ivoire, the health system is not very accessible, especially in rural areas, and is not very efficient because it remains essentially the responsibility of households. Thus, in these areas, the three pandemics against which the Global Fund is mobilizing, malaria, tuberculosis and HIV, remain insufficiently covered.
The delegation of certain tasks to Community Health Workers (CHWs) in rural areas has been proposed to improve this coverage and has shown encouraging results. However, it has some limitations.
This current project, planned for a duration of three years including two years of field activities, wishes to rely on these CHWs in so-called “priority” rural areas by introducing innovations, which could then be integrated into the national system.

Objective

The general objective is to develop and implement innovative strategies aimed at improving the integration of prevention and management of HIV, malaria and tuberculosis into the health system at the community level thanks to CHWs.

Main methods

The project will take place in a health district, at the level of two neighborhoods of a sub-prefecture, two villages and two priority camps. The choice of these sites is supported by the fact that EPE, the partner NGO, intervenes in these areas and that these sites are priority sites because they house the largest active files of people living with HIV. These sites represent a population of approximately 60,000 inhabitants, half of whom are over 15 years old.
In these sites, the project will consist of: (i) Selecting and training CHWs to provide care for the three diseases through home visits (IEC/CCC, screening and management of simple malaria, referral of suspected cases of tuberculosis and DOTS, screening, counseling and distribution of ARVs to HIV-infected patients; screening) (ii) monthly animation of village health committees by target (women of childbearing age and children under 5, young adolescents); (III) use on tablets of a dedicated application for data collection.