Community Based Health Care National Coordinator, Ministry of Public Health, Afghanistan
Received date: December 24, 2015 Accepted date: December 26, 2015 Published date: December 28, 2015
2007-2009 a best practice of Women Action Group was piloted in two provinces of Afghanistan Ggazni and Bamin, by Future Generations Afghanistan one of the US NGOs and Community Based Health Care Department Ministry of Public Health Afghanistan under direct leadership of mine. Dr. Said Habib Arwal, aim of the project was women empowerment and enhancing community Health Care in community level .
Me, Professor Carl Taylor, Professor Daniel Taylor Founders of the Future Generations United Stat my close friends and professors of Master program in USA, Future Generations Afghan staff Dr. Shukria and Dr. Permohamad Paya , coordinately have been worked for implementation of the pilot project which was funded by USAID.
After ending the pilot phase we have had presented the result of the project to the Technical Advisory Group TAG Ministry of Public Health, it was accepted and approved by them, finally I as head of Community Based Health Care convince leadership of the Ministry of Public Health to includes women Action Group by the name of Family Health Action Group as a national elements of MoPH - CBHC program. Now we have 6500 Family Health Action Groups , each group have 12 members (mothers who have breast feeding child).
The Community-Based Health Care Department for strengthening of health by systems has moved forward with the decision to establish Family Health Action Group.
The Family Health Action Group (FHA Group) is a support group for female CHWs whose aim is to improve the life style of and appropriate use of health services by mothers and children with a view to reducing mortality rates. With the formation of these groups from the community members services are utilized for spreading health awareness and key health messages among mothers. This will result in healthy homes and healthy lifestyles and will increase the use of available health services. It will build a strong information and referral system within the community that will help CHWs attend to pregnancies, births, and other cases of illness.
A major responsibility of the FHA group is to encourage health seeking behavior among households at the community health center level which will lead to the provision of more health services and thereby lower morbidity and mortality rates for remote communities.
The FHA model is distinguished by its embedment in the community which means that good their work is under community control, is completely local eliminating the need for travel to other villages. This group does not affect the role of community health workers but serves as a support mechanism to strengthen the existing health system FHA groups extend the reach of Community Health workers and the health system as they visit remote areas where the community health workers are not able to visit.
Female CHWs select a group of 10-15 women as activists/ volunteers with young children, respected within their community, and improve their knowledge about health related actions. These women activists/volunteers in turn promote adoption of healthy behaviors among the families in their neighboring households. It is expected that this will make the work of the CHWs more effective and more efficient, even reducing their current workload.
Community based treatment centers and Family health action groups have been integrated in Basic package of Health services. Family health action groups will be evaluated for effectiveness in improving health utilization compared with the existing system. Results from the evaluation will guide the determination to implement and scale up family health action groups throughout the country.
Community collaboration and health development.Active works with mothers and family health action groups for health development of families, mothers and children. Also Family health action group is a supportive mechanism for community health workers, to improve health seeking behavior among households in remote areas with the expectation that it will lead to appropriate use of health services by communities, with the ultimate goal of decreasing the maternal and newborn mortality rate [2,3].
We establish FHAGs to follow objectives of CBHC department as; Assist community health worker (especially female) in family health activities. Improve family’s health behavior. Increase provision of health services. Inform community health workers about the need of pregnant women, children and patients.
Selection criteria for member of family health action group are as follow: Mothers with children less than five years old. Respectful women in the community. Reliable women for community health workers. And preferably literate groups, but literacy is not required.
Establishment of family health action group with 10-15 members at the level of health post and every member will be representation of 10-15 household into the area. Community health workers with consultation of community SHURA are selecting the members of family health action group.
Community based health care is a successful program in Afghanistan, which provide primary health care services as close as to the people homes through health posts by two male and female community health worker.
For now in Afghanistan, it is the best way to reach to the people homes, so it needs to be more strengthened and expanded. Also we should more focus on quality of health care services which provided by health posts.
After implementation of pilot FHAG project, result was presented to the Technical Advisory Group TAG Ministry of Public Health Afghanistan , result was accepted and decided, this innovation of women action Group change the name to Family Health action Group and include in National Package of the CBHC and Health Service.