| Selection process | | |
| Selected preferably by other women in the community | Selected by a panel of judges from the local PHC facility and municipal government | Self-selected with the approval of their superior |
| Selection criteria | | |
| Respected older woman with grown children | Female, literate, at least 5 years of prior CHW experience or auxiliary nurse training; ability to work half-time and travel between communities | Health professional; preferably woman who has a long-term contract in PHC facility |
| Workload | | |
| 1 CHW for every 30 families (on average, 2 or 3 pregnant women and 2 or 3 children aged 0–23 months) | 1 CS supports 10–15 female CHWs | 1 trainer per group of 10–25 CHWs and their respective CS |
| Key roles | | |
Attend monthly 1-day trainings at nearest PHC facility Meet monthly in small groups with her CS for reinforcement of training and practice with flip charts and monitoring formats Create a map of her 30 households, identifying pregnant women and children aged 0–23 months Visit each pregnant woman and child aged 0–23 months on a monthly basis Fill out simple monitoring checklists, referral slips, and monthly activity report checklists
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Ensure that her assigned CHWs attend month training sessions in the PHC facility Meet with her CHWs in small groups of 5–7 CHWs once or twice a month to review the training from the latest workshop in the PHC facility and to practice using flip charts to teach mothers Accompany CHWs on home visits until the CHW feels comfortable visiting alone Attend monthly training workshops along with CHWs in the PHC facility
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Organize and hold 1 monthly workshop for CHWs in their own PHC facility Train CHWs and CSs on how to educate and monitor mothers in the home using the flip chart series and monitoring tools, following a facilitator manual corresponding to each flip chart Receive training in how to utilize the facilitator manual that accompanies each of 7 flip charts Use the Sharing Histories teaching methodology as incorporated into each facilitator manual
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Key tasks during monthly home visits to pregnant women and children aged 0–23 months
Share histories and teach mothers using flip charts by stage of pregnancy or child age Monitor health practices and record on pictorial checklists by stage of pregnancy or child age Observe for danger signs using pictorial checklists by stage of pregnancy or child age Make referrals using pictorial referral slips for maternal-child preventive care and when danger signs are detected
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| Incentives | | |
In-kind from the health system: certificate of recognition, training, supervision visits by CSs In-kind from district government: clothing items identifying her as a CHW or CS with name of the district, a food basket and party for annual Health Promoters’ Day and Christmas
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Monthly stipend equivalent to about one-third the salary of an auxiliary nurse (To ensure accountability, monthly payment from district government was based on demonstrated completion of the 4 key roles) In-kind incentives from both the health sector and municipality, the same as for female CHWs
| Training and recognition |