WellShare International

Diana DuBois, MPH, MIA

CORE Group Spring Meeting

11 May 2011

HBLSS – Karatu District, Tanzania

Tanzania Child Survival Project

• Karatu District, Arusha Region– Population ~250,000– 45+ villages

• USAID-funded• 5-year program

(2006-2011)• Intervention areas:

Maternal Newborn Care, Malaria, CDD, ARI, FP

HBLSS Integration

• Initial/specified training cascade– Master training of trainers – 3 weeks

• (6 WellShare + 8 partner staff; ACNM consultants)

– HBLSS trainers • (14 local TBAs; ACNM consultants and

master trainers)

– HBLSS guides • (32 local health facility staff and TBAs)

HBLSS Integration

• Integrated training activities (subsequent)– Maternal newborn care training for TBAs

• Integrated with MOH MNC curriculum for TBAs

• Additional 2 days HBLSS training for 36 TBAs

– HBLSS TOT training for TBAs• Equivalent to “HBLSS trainers” training• 84 TBAs trained over 5 days• Subsequent training of additional TBAs in

local villages by TOT TBAs– Health advocate training for

Hadzabe/Datoga• 15 trained using modified HBLSS materials

– MNC training for MAISHA taxi drivers• 45 trained using modified HBLSS materials

HBLSS Integration

• Community level education to Survive & Thrive Groups– Home visits by TBAs– Village community meetings (TBAs

showed materials to men and village leaders

Costs

• Initial master training– Approx. $30,000

• Consultants - $21,000

• TBA TOT training– Approx. $140 per person

Adaptations

Other Adaptations• 2 sets of laminated teaching picture cards/teaching

models per village • Pictorial information on the “safe delivery kit” was

adapted to meet local standards and availability; also translated to Kiswahili and Kiiraqw

• Adapted materials for Hadzabe and Datoga health advocates and MAISHA drivers

• Adapted M & E materials into expanded Village Pregnancy Register (a WellShare tool) as M&E was too costly to implement

Lessons Learned / Challenges

• Lessons Learned– HBLSS materials very well received by beneficiary

populations – HBLSS can effectively be used to provide MNC

training to male educators – Village leaders became proponents of HBLSS and

promoted it in their villages – HBLSS has been integrated into the body of

knowledge passed down from older to younger TBAs• Challenges

– Cost for total program is prohibitive (esp. M&E act.s)– Distance between households has affected training

and follow-up supervision

Recommendations

• HBLSS should be more broadly implemented– Story format well-received by

communities – Effective even when modified

Contact

WellShare International

122 West Franklin Avenue

Suite 510

Minneapolis, MN 55404

www.wellshareinternational.org