{"id":21995,"date":"2020-08-12T11:43:59","date_gmt":"2020-08-12T10:43:59","guid":{"rendered":"https:\/\/blog.blueventures.org\/?p=21995"},"modified":"2020-08-13T11:25:28","modified_gmt":"2020-08-13T10:25:28","slug":"from-reproductive-health-to-covid-19-thirteen-years-of-responding-to-community-health-needs","status":"publish","type":"post","link":"https:\/\/blog.blueventures.org\/en\/from-reproductive-health-to-covid-19-thirteen-years-of-responding-to-community-health-needs\/","title":{"rendered":"From reproductive health to COVID-19: thirteen years of responding to community health needs"},"content":{"rendered":"

Next week our <\/span>community health<\/span><\/a> programme, Safidy, will be celebrating its thirteenth birthday. Back in 2007, as we worked alongside communities to rebuild fisheries, women shared horror stories of a lack of safe birthing facilities, no access to family planning services and no sexual health education.\u00a0<\/span><\/p>\n

Witnessing how these unmet health needs were impacting upon the wellbeing of the community \u2013 and how poor health was limiting their ability to engage in conservation \u2013 we felt compelled to respond. From a single weekly family planning clinic serving 2000 people in 2007, Safidy has expanded to provide maternal and child health care, sexual and reproductive health services and safe water initiatives for all of the 47,000 people living within Blue Ventures\u2019 five programme sites in Madagascar.<\/span><\/p>\n

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Safidy has been providing community healthcare for 13 years | Photo: Garth Cripps<\/div><\/div><\/div>
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The Safidy team have trained communities so that they can safeguard their own health | Photo: Garth Cripps<\/div><\/div><\/div><\/div><\/div>\n

Today we continue to respond to communities\u2019 most pressing health needs and this year, that has meant launching a <\/span>community health response<\/span><\/a> to the COVID-19 pandemic. Four months on from the launch, on the eve of Safidy\u2019s birthday, we reflect upon the different ways in which we are trying to reduce community transmission of the virus, protect the most vulnerable and strengthen health systems so they can better cope with the crisis.<\/span><\/p>\n

Training<\/span><\/h4>\n

Training of community representatives on COVID-19 awareness and in techniques to prevent transmission of the virus has been central to our response, and so far we\u2019ve supported training sessions for around 480 people across 80 villages in Madagascar.<\/span><\/p>\n

Komity Loharano <\/span><\/i>members are key participants in the training; these are village vigilance committees that mobilise during times of crisis, with each village having their own<\/span> Komity Loharano <\/span><\/i>composed of a range of community leaders. During the pandemic, they have been responsible for disseminating and collecting information about COVID-19 in their communities.<\/span><\/p>\n

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Community members in Besakoa, northwest Madagascar get a lesson in handwashing<\/div><\/div>
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The Komity Loharano in Belo-sur-Mer, northwest Madagascar, learn about COVID-19 prevention<\/div><\/div><\/div>
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Proper handwashing is one of the most effective ways to reduce the spread of the virus<\/div><\/div><\/div><\/div>
<\/a>
Informative posters are displayed in health and community centres<\/div><\/div><\/div><\/div><\/div>\n

In an effort to share information as widely as possible, and so that communities can continue to earn an income, fisheries and livelihoods representatives such as fisheries data collectors, aquaculture farmers and mangrove patrollers have also taken part in these training sessions.<\/span><\/p>\n

Crucially, all community health workers (CHWs) who lead healthcare efforts across Blue Ventures\u2019 field sites in Madagascar have attended COVID-19 training sessions. 83 CHWs have been trained in disease surveillance, symptom management, patient referral, contact tracing, and disinfection and cleaning of health clinics and materials. In doing this, CHWs are helping to build the capacity of the health system, so that it is better able to respond to the pandemic.<\/span><\/p>\n

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A CHW in Teariake, western Madagascar, teaches women to sneeze into their elbow<\/div><\/div><\/div>
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CHWs in Teariake gather outside a ‘Toby’ (community health hut)<\/div><\/div><\/div><\/div><\/div>\n

Collaborating<\/span><\/h4>\n

If there\u2019s one thing that this pandemic has taught us, it\u2019s that we are living in an increasingly interconnected world and that working together is the most effective way to combat the crisis. We will beat this together, or not at all!<\/span><\/p>\n

In Madagascar, we\u2019ve collaborated with authorities and health organisations in order to encourage a uniform response to COVID-19, including <\/span>Mahefa Miaraka<\/span><\/a>, USAID ACCESS, <\/span>PIVOT<\/span><\/a>, <\/span>Marie Stopes Madagascar<\/span><\/a>, <\/span>Wildlife Conservation Society (WCS)<\/span><\/a> and <\/span>PSI Madagascar<\/span><\/a>. Only through collaborating with our health partners can we ensure that our response effectively dovetails with that of the Ministry of Public Health, and that essential health services are maintained.<\/span><\/p>\n

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Community representatives and authorities present to communities in order to raise awareness<\/div><\/div><\/div>
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Blue Ventures’ Maintirano team partnered with health authorities on a community outreach tour in the Barren Isles<\/div><\/div><\/div><\/div><\/div>\n

To build the capacity of community health monitoring systems, with support from our partners and the Ministry of Public Health, we have supported regional and community trainers across our sites to roll out training in community health monitoring. There are currently twelve trainers in the southwest, seven in Belo-sur-Mer, eight in Ambanja, and four in Mahajamba, who are all responsible for training <\/span>Komity Loharano <\/span><\/i>members and other community representatives.<\/span><\/p>\n

These cascading training courses enable the application of preventive measures\u00a0 while strengthening everyone’s skills in the early detection and reporting of risks and events in public health\u201d – The Madagascar PHE Network<\/a><\/span><\/p><\/blockquote>\n

Distributing vital supplies<\/span><\/h4>\n

Like many organisations who support isolated communities, ensuring that they have the means to protect themselves from the spread of the virus has been an important focus for us. Across the 80 villages where we\u2019ve facilitated training, we have established water and handwashing stations and distributed soap to support regular handwashing and sanitation. We are also working to secure access to personal protective equipment (PPE) for all health staff working in our areas.<\/span><\/p>\n

As much as possible, we aim to enable communities to lead their own response efforts and harness existing local structures and skills. In Ambanja, northwest Madagascar, Mothers groups and Youth groups have been making reusable face masks for community birth attendants \u2013 local women who support the delivery of babies.<\/span><\/p>\n

Similarly, in southwest Madagascar, the local women\u2019s association in Andavadoaka have made over 5000 face masks to be distributed to a range of different groups, including aquaculture farmers, school students taking exams, beekeepers, mangrove patrollers, individual households, the mayoral offices and more.<\/span><\/p>\n

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The Mothers group in Ambanja making face masks<\/div><\/div><\/div>
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Distributing face masks during an outreach tour to a ‘Toby’ (health hut) in Ambanja, northwest Madagascar<\/div><\/div>
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Soap and handwashing stations have been distributed across 80 villages<\/div><\/div><\/div><\/div>
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The teams have distributed face masks to school students so that they can continue with their education<\/div><\/div><\/div><\/div><\/div>\n

Collecting data<\/span><\/h4>\n

For our teams, limiting the spread of the virus within communities is the absolute priority and one crucial way to do this is to ensure that cases can be tracked. In the villages where many of the communities we support live, this isn\u2019t always simple; communities live in close quarters and have to go out most days to busy markets to buy food and supplies, and whilst social distancing measures are in place, if the virus were to spread, it would be a challenge to identify the source.<\/span><\/p>\n

With support from the Safidy team, CHWs have developed new skills, learning to collect and manage data in order to track COVID-19 cases. They\u2019re using novel data collection systems, some of them using web based data management tools for the first time. This enables the inputting of information as simply and safely as possible, and means that CHWs can alert communities as soon as cases begin to increase.<\/span><\/p>\n

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CHWs are using novel ways to track symptoms and cases and support community monitoring of the virus<\/div><\/div><\/div>
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In Maintirano, CHWs gathered with other health representatives to track visitors coming into Port Maintirano<\/div><\/div><\/div><\/div><\/div>\n

Adapting ways of working<\/span><\/h4>\n

Around the world, all of our teams have had to adapt the ways we work, whether that\u2019s meant working from home, having regular <\/span>phone calls<\/span><\/a> with community partners rather than going out to the field, or setting up <\/span>online gatherings<\/span><\/a> for partner organisations.<\/span><\/p>\n

CHWs on the other hand, have no choice but to see patients face to face. In order to protect these front line workers when they come into contact with patients, we\u2019ve worked to train them to provide \u2018no touch\u2019 care to patients.\u00a0<\/span><\/p>\n

Despite our best efforts, PPE isn\u2019t always readily available, so developing these protocols is enabling health workers to continue to provide care, without putting themselves or their patients at risk. To complement \u2018no-touch\u2019 care, women are being taught to self-administer the contraceptive injection, or have been provided with larger supplies of the contraceptive pill in order to reduce clinic visits.<\/span><\/p>\n

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Where it is safe and possible, CHWs are continuing to deliver patient care<\/div><\/div><\/div>
<\/a>
Safe handwashing and sanitation has never been more crucial for CHWs<\/div><\/div><\/div><\/div><\/div>\n

Communicating<\/span><\/h4>\n

Another way in which we\u2019ve adapted the way we work is by producing community outreach media to raise awareness of the virus, without having to physically visit communities to spread the word. Across Madagascar, our creative colleagues have been harnessing the power of <\/span>music and film<\/span><\/a> to share public health messaging in a way that speaks to the needs and living context of coastal communities.<\/span><\/p>\n

However, as an organisation that has a long-established, strong presence within communities, safely visiting the areas where we work is one of the most effective ways to ensure that people have understood the message.\u00a0<\/span><\/p>\n

Where possible, our teams have visited vulnerable people to teach about shielding, and carried out community outreach tours to distribute supplies and share public health messaging. On market day in Mahajamba \u2013 the one day per week when everyone goes to the market to buy goods \u2013 the team uses the opportunity to spread the word about the pandemic and reinforce advice about social distancing.<\/span><\/p>\n

<\/a>
Microphones and loudspeaker systems are used during outreach tours<\/div><\/div><\/div>
<\/a>
Teams are visiting remote locations, such as Belo-sur-Mer, by boat<\/div><\/div><\/div><\/div>
<\/a>
Social distancing rules are reinforced during outreach tours<\/div><\/div><\/div>
<\/a>
During outreach tours, the teams visit schools and community centres to demonstrate handwashing<\/div><\/div>
<\/a>
The teams have translated books about COVID-19 into local dialects<\/div><\/div><\/div><\/div>
<\/a>
Posters are particularly effective in reminding communities about symptoms to watch out for and prevention techniques<\/div><\/div><\/div><\/div><\/div>\n

As a result of COVID-19, we are witnessing some of the world\u2019s most vulnerable communities being pushed deeper into poverty, with their limited access to basic services being reduced even further. As this pandemic continues to evolve, we will work with communities to minimise the impact of the pandemic on their health and on their livelihoods. Our expertise in both of these areas puts us in a unique position to respond to these interconnected challenges.<\/span><\/p>\n

As we approach Safidy\u2019s birthday in the midst of this global crisis, we are reminded of the overwhelming need to put communities first and help them to build the resilience they need to safeguard their health and the environment upon which they depend.<\/span><\/p>\n

\n

Learn more<\/span><\/a> about Safidy<\/span><\/p>\n

Support<\/span><\/a> our COVID-19 response<\/span><\/p>\n

Explore<\/span><\/a> our COVID-19 resource hub<\/span><\/p>\n

\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

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