Activities held in NOVEMBER 2017

Picture: Some Kayayei in a group photo after their start-up training to become family planning peer educators and distributors of health protection products (Credit HealthKeepers Network)
                                                                                                                                                                                                                                                                     

SIGNIFICANT ACCOMPLISHMENTS in November 2017

Key activities implemented by HealthKeepers Network (HKN) in November 2017 are outlined below. The report has been organized under the headings: Recruitment, Training, Supervision, Outreaches, and Supplies. It also includes some other activities that were undertaken during the reporting month.

1. RECRUITMENT

In November, HKN held three recruitment sessions to select HealthKeepers in the North Tongu and Mion Districts and Kayayei in the La-Nkwanang District and the Accra Metro Area.  During recruitment, participants were briefed on the HKN program, its benefits to them, their families and their community when they join the program; and what would be expected of them. In all, 79 CBDs were recruited in the four 4 districts visited as shown in detail in Table 1 below.

Table 1: Category of CBDs recruited, their numbers and their districts

2. TRAINING

Six (6) start-up training was held in November. One of the training was organized for HealthKeepers, four for Youths-in-School and one for Kayayei (Youth-out-of-School) as shown in Table 2 below. Of this number of training, two were held in the Savelugu-Nanton District and one in the Mion District both in the Northern region. And in the Volta region, one training was held in Akatsi South district, one in North Tongu district and one in Central Tongu. A total of 264 participants were trained.

Table 2: Number of CBDs Trained

1. HEALTHKEEPERS

The training for HealthKeepers in November was held in the Savelugu Nanton District for 22 participants made up of eight (8) females and fourteen (14) males. The participants who were recruited from existing Health volunteer groups were drawn from thirteen (13) communities under the Pong-Tamale and Diare sub-districts. The communities are Nakpanzoo, Nabugu, Ying, Pong-Tamale, Tibali, Tunaayili, Pigu, Kukuobila, Kpalung, Diare, Disiga, Dipali, and Adaayili.

The training was also attended by three (3) Community Health Nurse from two Health Centers where the volunteers work. These Community Health Nurses are expected to assist HKN in supervising the activities of the volunteers since they are in the communities with them and report any challenges to HKN.

1. YOUTH IN SCHOOL

In collaboration with the District Health Directorate and District Education Services, HKN successfully undertook five (5) Youth Peer-Educators training in November as shown in Table 3 below.

Table 3: Youth Peer Educators training in November by HKN

Most of the students who participated in the training were recruited from existing but dormant Adolescent School Clubs.  Their training was attended by District Public Health Nurses, District School Health Education Promotion (SHEP) Coordinators and Girls Education Officers. Also in attendance during the training were teachers, one each from a school where the students were selected from. The teachers are expected to organize and monitor activities of the peer educators in their school to sustain interest.

Photos 1a &1b: left – training of some students and (right) some newly trained Youth Peer Educators

• KAYAYEI

Start-up training for the first batch of Kayayei HealthKeepers began in November 2017. It was held for two (2) days at the Ghana Registered Nurses Association Guest House in Accra. Participants were from Mallam Atta, Old Fadama, Agbogbloshie Zongo, Darkuman, and Madina. In all forty -two (42) Kayayei whose ages ranged from 15 to 28 years participated in the training.

Also in attendance were Executives from the Kayayei Youth Association and leaders of the Kayayei communities. They took turns to talk to the Kayayei about the benefits of the Kayayei HealthKeeper program and encouraged them to give it their best shot. One of the leaders informed them that they should not listen to ridicule from their peers and other people in their communities as the program could be the start of great things for them.

A pre-test was administered to ascertain the participants’ knowledge before the training. Some of the topics discussed during the training, included Adolescence and the changes that occur during that period, Menstruation, Pregnancy, consequences of Teenage Pregnancy, STIs, Abstinence, Family Planning, and its benefits, Available methods in Ghana with emphasis on the Oral contraceptive pills and condoms and USAID Family Planning Compliance.

Use was made of group exercises and presentations to build participant’s capacity to educate their peers effectively. The facilitator also used demonstrations and contextual illustrations to ensure a deeper understanding of the topics discussed. Notably, almost all participants admitted it will be difficult to abstain and thus were more interested in the family planning methods. Facilitators took time to clarify a number of misconceptions, particularly about the long-term methods. Participants were implored to always talk about the benefits of family planning and how it affects their immediate community and the nation at large.

Photo 2a & 2b: Kayayei listening to their facilitator during their training

Participants were also then taken through HKN’s reporting and referral forms. They were grouped according to their communities and given case studies to practice.  A post-test administered after the training showed there was knowledge transfer.

Photos 3a &3b: Some Kayayei in group discussions during their training

The last activity on the agenda was the supply and supervision of the products. The facilitator for this session explained HKN’s policies on product supply and distribution. She stressed on proper handling and storage of the products and also their appearance when they go out to sell. Together with participants, they cross-checked their initial products supplied against their invoices to ensure that everything was correct and in good order before taken custody. They were also taken through how to pay their product loans using mobile money. Some questions asked by the Kayayei during their training are listed below:

• Why do some women cease menstruating when they are on the injectable?
• Why do some people become infertile after they stop using family planning?
• Is it okay when one reaches adolescence and does not have sex?
• Why is it that some women experience painful menstruation in older age relative to when they are young?

3. SUPERVISION

The field supervision team of HKN scheduled and visited seventeen (17) Districts/Municipalities across all the five project regions during the month under review. Overall the team visited sixteen (16) HealthKeepers groups, nine (9) OTCMS groups, two (2) StationGuard/Barber groups and one (1) Youth Peer Educator group. Table 4 below is a table with details of the monitoring visits.

Table 4: HKN monitoring visits in November

The field team inspected the baskets/bags of CBDs to ascertain at first-hand the situation on the ground. It is refreshing to note that all the agents visited had their baskets in good conditions and the commodities also well kept. All CBDs were reminded about the USAID family planning compliance.

They were also given onsite refresher education on some of the major topics taught during the training period. Topics such as how Secure® oral contraceptive pills are used, which clients should not be given the Secure® pill, what to do if one misses a pill, benefits of family planning and how to wear male condom, etc. are usually discussed during such field trips.

Outcomes of the supervisions

• HealthKeepers in the Mion and Karaga districts have made a great start in their community-based family planning programming. During the supervision visit, it was noticed that most of them had sold their commodities and were also educating people.
• The majority of them also completed and submitted their reporting M&E and referral forms.
  • Out of 28 HealthKeepers trained in the Mion district, the team visited 24 of them in 11 communities in the district. All the 24 visited submitted their M&E forms. Half of the number visited bought commodities like CD condoms, Secure® pills, ORS and Zinc tablets.
  • In the Karaga district, HKN trained 24 HealthKeepers. During the field visit, 21 of them were met. All 21 HealthKeepers submitted their M&E forms and 9 referral forms. All the referrals were for the injectable method.
• The youth peer educators visited in Adaklu were taken through HKN’s reporting forms and encouraged to continue the adolescent education with their peers and document their activities on the HKN reporting form.

4. COMMUNITY OUTREACH

Two community outreaches were organized in November in the Central Tongu and Sagnerigu districts. Both outreaches were organized in collaboration with the District Health Directorates, Chief, Elders, Assemblymen and other identifiable and influential groups in the host community.

Outcome from Central Tongu Outreach

• The outreach in the Central Tongu District was held at Mafi Zongo. It was attended by One hundred and seventy-four (174) community members made up of one hundred and twenty-three (123) females and fifty-one (51) males.
• The services offered at the outreach included but not limited to family planning education and counseling, HIV testing and counseling, Blood pressure and body mass index measurements
• One hundred and forty-three (143) community members made up of thirty (30) males and one hundred and thirteen (113) females were counseled on family planning during the outreach.
• One hundred and fifty-nine (159) persons took the voluntary HIV test. Three (3) persons i.e. a male and two females tested positive. They were referred to the Adidome Hospital.
• Twenty-one (21) trained HealthKeepers were present to receive their certificates.

Outcome of the Sagnerigu Outreach

• The outreach in Sagnerugu Districts was held at Gurugu in front of the Chief’s palace. Amongst the invited guests was the Gurugu Chief Naa Issaka Neidow and eight of his elders and Mrs. Augustine Maami the in charge at the Choggu Health Center.
• Seventy-five (75) community people made up of 25 males and 53 females and fifteen (15) HealthKeepers from the district attended the program.
• Fifty-five (55) people (10 males and 45 females) accessed family planning counseling.
• Seventy (70) people did the HIV test and counseling. No positive case was recorded at the outreach.

Some questions asked during the outreach

• Why do some people experience itches when they use a condom?
• Can the male condom get stuck inside the vagina?
• Can pre- ejaculation impregnate a woman?
• Can the implants get lost in the arm?

5. RESUPPLIES VISITS & CYP CONTRIBUTION

Resupply of commodities to CBDs continued in November 2017. The supply team visited 27 districts/municipalities. A total CYP contribution of 4,442.33 was made from the condom and oral contraceptive pills distribution in November. Tables 5 and 6 below provide a breakdown in CYP contributions and the places visited for resupplies in the month.

Table 5:  HKN CYP Contributions

Table 6: Details of resupply visits in November 2017

6. OTHER ACTIVITIES HELD IN NOVEMBER

• 1st and 2^nd November: HKN participated in USAID HPNO and its IP meeting
• 13^th November: HKN participated in a meeting between USAID/Washington, USAID Ghana, PSI and HKN on FP commodities supply chain issues.

7. CONCLUSION

HealthKeepers Network community-based family planning and HIV prevention project is going according to the work plan and on track to achieving its overall goal. HKN greatly values the management and technical assistance it is obtaining from JSI-RTI and USAID-Ghana as well as the funding support of USAID, its partnerships with the various MMDAs, MoH/GHS, Ghana Education Services, GAC and others which has made such progress possible. Thank you.