1. CORE Group Spring Meeting
CHS Benin OR Presentation
Partnership for Community Management of Child
Health (PRISE-C)
Chief of Party: Mme Marthe Akogbeto
Technical Backstop: Sara Riese, MA, MPH

2. Project background
• 22nd out of 193 countries
in under-5 mortality
• Maternal mortality ratio
of 410/100000
• Poor accessibility and quality
of health services for women
and children
CHS Benin’s PRISE-C project
aims to improve maternal
and child health outcomes
in three health intervention
areas of SAO, DAGLA and
AZT

3. To improve maternal and child health
Goal/Impact outcomes in the 3 health intervention areas
Strategic To accelerate the delivery of proven, low cost
Objective maternal and child health interventions by
strengthening community health delivery system
Intermediate Increased Increased Strengthened
Results community demand for performance and
engagement community sustainability of
with community preventive and the community
health delivery curative health delivery
system services system
Create a Improve Improve support to
conducive knowledge, attitu CHWs by the
Strategies
environment for des and practices Health Facility
the promotion of towards maternal Workers
community and child health
maternal and Reinforce the
child health Promote uptake knowledge and
of mutuelle skills of CHWs
membership

4. Where we started
• Original OR idea: to test different
motivation strategies (financial, non-
financial)
• New MOH CHW policy in May 2010
required projects to provide financial
incentives
• Suggestion to use mHealth but we decided
to choose an innovation to increase
community engagement with CHWs
• Together with MOH stakeholders we
decided to test community collaborative
approach to improve CHWs performance
and retention

5. What is the collaborative
approach?
• The collaborative approach is an experience
sharing process between a network of teams for
quality improvement (32 villages with their
Quality Improvement Teams in our case)
• QITs identify context-specific methods to
implement a model of specific interventions to
resolve their priority problems, and obtain
meaningful results at low cost and in a short time
• Best practices are identified through this process
and then scaled up in other villages

6. Where we started (2)
Why did we choose the collaborative approach?
• Linked with overall project strategy
• URC-CHS area of expertise
• We thought that the community-level collaborative
approach would improve community participation
leading to improved CHWs performance and
retention
• The collaborative approach has not been
rigorously tested at the community level
• We worked with our in-house research expert on
the concept paper and in September 2011 it was
approved

7. Where we are now
• Formative research completed in Dec 2011:
– Reorganized QIT membership
– Recognized the need to ensure adequate female
representation, all QITs are now 50% female
• Formative research results will be disseminated
during meetings with MOH staff and in the project
report

8. Where we are now

9. Challenges
• Harmonizing DIP and OR development
with MOH policies, project and USAID
objectives and project budget
• Lack of French guidance documents
• Motivation of non-CHW QIT members,
who do not receive financial incentives
• Baseline indicators level is higher in
control area than intervention area
• How to minimize bias between control
and intervention areas

10. Lessons learned
• When all the partners participate in
DIP and OR development, the
implementation is easy
• QIT members need close coaching to
better understand their roles and
continuous quality improvement
• Need to be creative to modify tools for
the community level

11. Thank you for your attention
Any questions?