Guide for Developing Community Health Action Plans (CHAPs)

Introduction:

This guide is to support you to systematically guide CHMC workshop for implementing the CE4HW and the
development of community health action plans in your CHPS zone. The workshop shall be a two-day event. Kindly
follow through on how to go about the workshop and CHAPs development below.

Day one: CHOs shall train and guide CHMCs and Volunteers on the following.

1. Basic planning, community engagement and mobilization

2. Identifying and prioritizing community health needs using both facility data and community perspectives
of their health needs.
3. Identifying causes/ behaviors that cause these health problems under each of the technical areas
prioritized.
Day Two: CHOs shall support CHMCs and Volunteers to draft CHAPs for validation with community members
based on barriers to behavior change to prioritized health needs identified in day one.

Before the workshop

1. Hold a meeting with CHMCs and volunteers to brief them about the CE4HW. Ask traditional leaders in the
CHMCs to help in engaging leaders on the CE4HW.
2. Plan with them to conduct community entry and engage with Traditional and opinion leaders in each of
the communities forming the CHPS zone to introduce the CE4HW
3. Agree with them on the time and venue and communicate to all expected participants
4. Make sure you have seating arrangements done
5. Assign roles to team members at the facility ie, who takes note, who engages,
6. Before the orientation, collect facility data under each technical area below to help communities
understand their health situation.
7. Once you have determined the burden of health issues in the technical areas below from facility data,
note them down before the orientation (using graphs will be good)

COMMUNITY ENGAGEMENT FOR HEALTH AND WELLBEING(CE4HW) INITIATIVE USAID-ASBC Activity

 a. Malaria (IPTp uptake and regular ANC attendance, LLINs use and care, and Case management
(Test, treat and track)
b. Maternal, Newborn and Child Health (Cord care, Neonatal jaundice, Early care seeking for small
and sick children and Maternal nutrition)
c. Nutrition (Early initiation of breastfeeding, Exclusive breastfeeding, Complementary feeding, Growth
monitoring, Community management of acute malnutrition (CMAM), Micronutrient
supplementation (Vitamin A and iron)
d. Family Planning (Access and use of FP products, Birth spacing)
e. SRH (Menstrual hygiene management, Safety net (ANC, counselling, family planning,) Screening for
anemia, STI and treatment)
f. Wash
Behaviors to be promoted under the CE4HW: They include use of health services and products, timely care
seeking for the prevention and treatment of adverse health conditions, delivering babies in a facility with a
skilled birth attendant, completing at least four antenatal visits during pregnancy, using modern
contraceptives, exclusive breastfeeding, sleeping under insecticide treated bed-nets (ITNs), wearing a face
mask to reduce COVID-19 infection and seeking timely vaccination and additional behaviors within malaria,
FP, RMNCH, nutrition, COVID-19.

During the workshop.

Day one: Basic planning, community engagement, mobilization, prioritization of community health needs, and
the identification of barriers to behavior change across prioritized areas

1. Meet with the CHMCs and brief them about the Community engagement for health and wellbeing and
introduce them to the recommended behaviors being promoted.
2. Outline the engagement and mobilization techniques that the initiative will rely on for implementation
using the CHMC training guide.
3. Explain each focus area under each technical area, one by one as above and discuss the health issues
faced by communities

COMMUNITY ENGAGEMENT FOR HEALTH AND WELLBEING(CE4HW) INITIATIVE USAID-ASBC Activity

 i. Use facility data to show how community members are affected under each of the focus
areas.
ii. Support communities to identify the health issues affecting them
iii. Help community members to compare the facility data to what they feel are their problems
iv. Support community members to use PLA tools to prioritize their health needs under each of
the technical areas
v. Under each technical sub focus area of the prioritized technical area, guide community
members to identify the barriers/factors/things they do or do not do, that cause community
members to be affected by these health issues one by one, considering the following
1. Individual factors including their knowledge, motivation, attitudes, prior experiences,
ability to engage in desired behavior etc., that limit communities to practice the
desired behavior
2. Social factors including support systems available, social and gender norms, social
practices, and sanctions in the community etc., that limit communities to practice the
desired behavior
3. Structural factors including access, availability, affordability, convenience, conflict,
religion, and economy
Day two: Development of CHAPs for validation

1. Guide them to develop a goal and objectives under each of the prioritized areas (see example below)
2. Guide community members to come up with main activities/strategies to solve the problems (it can be
developed using the objectives)
3. Support communities to break each activity down into sub activities and writing down channels through
which they will be conducted
4. Support them to identify audiences to whom the activities should target
5. Allow community members to write down the time an activity will be implemented and what they want
to achieve afterwards.
6. Guide them to list resources needed that they, can provide for the implementation of the proposed
activities and identify those they need to mobilize from the larger community/stakeholders

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 7. Assign roles to community members as leads for the specific activity implementation
8. Support communities to complete the CHAPs template for CHMCs Chair to sign.
9. Submit copy of the draft CHAPs to the sub district head for onward submission to the district team.
Developing goals and objectives

▪ The goal of the initiative: this will help you to assist community members to know how to focus or
determine the goal of the CHAPs they will be developing based on their situations. The goal of the
CE4HW is to reduce disease burden across multiple health areas, generate demand for, increase
uptake of services, and promote measurable behavior change across the 17 priority districts by 12
% across all technical areas.

For example, your CHPS communities may decide to have improve maternal, newborn and child health
outcomes in Gruba CHPS as its goal under MNCH.

The accelerating behaviors being promoted will guide community members to come up with good objectives.

▪ Recommended behaviors for cord care and prevention of neonatal jaundice under the MNCH
focus area of the CE4HW include:
a. Use of chlorhexidine gel for cord care
b. Regular attendance of child welfare clinics for child assessment
c. Early care seeking for small and sick newborns

Communities may want to align or develop their objectives in line with the recommended behaviors.

For example.

a. To increase child welfare clinics attendance by care givers for growth monitoring of infants
b. To increase the use of CHX for cord care among caregivers of newborns from
c. To increase early care seeking for small and sick children
COMMUNITY ENGAGEMENT FOR HEALTH AND WELLBEING(CE4HW) INITIATIVE USAID-ASBC Activity
 d. Increase adherence and compliance to the management and prevention of neonatal jaundice
1. Developing activities: activities should be action oriented. In those activities show what you want to do or
strategies to achieve your objectives. Developing activities can follow on the objectives broadly or
specifically aligned to the objective. Using the objectives in the example above under point 2, you can
develop activities from them as can be seen below. First recall from the training that these activities should
be directed at overcoming barriers to the adoption of the recommended behaviors being promoted.
For example:
a. Educate community members on the benefits of using CHX for cord care
b. Sensitize pregnant women and women in their reproductive age on the symptoms of neonatal
jaundice
c. Educate nursing mothers on the need for early care seeking and regular visits to child welfare
clinics
d. Educate community members on the myths and misconceptions of neonatal jaundice
e. Sensitize community members on the merits of adherence and compliance with malaria treatment

2. Developing sub-activities: sub activities are other activities that collectively fall under main activities. They
form strategies through which the main activity can be achieved and are specific. For each sub activity,
community members should focus it on a channel and state how it intends to help them conclude the
main activity (find example below). Guide community members to develop sub-activities that can be
focused under the following illustrative activities/channels: door to door/ home visits, night screening/ video
shows at night, school-based activities, discussions with community groups, discussions, and broadcast on
community information centers, bimonthly CHAPs reviews, and other activities that community members

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 may come up with. These should not leave out services provided at the health facilities or outreach points.
For example:
a. Conduct door to door/ home visits to encourage educate pregnant women and caregivers of
infants aged 0-28 days on the importance of cord care using CHX
b. Educate pregnant women and caregivers during ANC and CWC on the myths and
misconceptions of neonatal jaundice
3. Targeting audiences: in doing this, guide community members to identify those that are most affected
by malaria/nutrition/MNCH etc. Do not forget that the recommended behavior an activity is promoting,
determines the audience to which it is focused. Target audiences are grouped into three levels (see
table below).
Priority (primary) Secondary Tertiary Audience

• Pregnant • In-laws • Traditional

women • Friends or peers leaders
• Caregivers of • Spouses • Assembly
children under • Siblings members
5 • Relatives • Religious
• Basic school • Health workers leaders
pupils • Community • Opinion leaders
• Women in their Health
• School health
reproductive Volunteers
teams
age • Teachers
•
• Nursing mothers • Traditional
• Adolescent girls healers
• Traditional birth
attendants

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 4. Timelines: signify the duration an activity will be implemented. It has to be realistic to be achieved.
5. Resources needed: these are materials or logistics you will need to ensure that the activities are
implemented. Sources of these resource are in two folds. Some of these resources are found in the
communities and others are found in the health facilities. Those in the communities require stakeholders to
make them available. As such, community members should identify them and should be able to provide
them when needed. Those in the health facilities includes flip charts and others. Mapping out resources in
the communities is essential for community ownership of the initiative.
6. Lead person (s): Allow community members to identify individuals whom they believe can lead an activity.
However, CHOs must play supervisory role while allowing community members to lead in some of the
activities. Building capacity of CHMC and CHVs may help them to adequately lead activities.
7. Expected outcomes: answers the questions what do we aim to achieve after implementing a set of
activities?
8. Guide community members to link it to the main activities which further leads to the attainment of the set
objectives and finally the goal set. Support communities to complete the CHAPs template for CHMCs Chair
to sign as per the example below
9. Submit copy of the draft CHAPs to the sub district head for onward submission the district team.

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Community Health Action Plan Technical area MNCH

Name of CHPS Zone: Gruba CHPS Subdistrict: Anoola District: Karbene

Goal: Improve maternal, newborn and child health outcomes in Gruba CHPS

Objectives: 1. To increase uptake of chlorhexidine (CHX) for cord care by nursing mothers from 7 % to 27 % by December 2022

2. To reduce maternal anemia from 35% to 15 % by December 2022

3. To increase child welfare clinics attendance for growth monitoring of infants from 30% to 50% by December 2022

4. To increase early health seeking for children at the health facility from 28% to 48 % by December 2022

Main Activity Sub-activity Target Timelines Resources Person(s) Expected

Audience Needed responsible outcome (s)
(Weeks)

1 2 3 4 5

Educate and sensitize Intensify education Pregnant CHX, GoodLife CHMC,

community members on during ANC, women and Cue cards/flip Champion,
the benefits of CHX for pregnancy schools nursing charts, CHO, and
cord care and CWC on benefits mothers, in Volunteers
of CHX for cord care laws, spouses, (state their Increased and
and make it part of TBA, and names) regular use
the birth relatives
CHX for cord
preparedness kit for
pregnant women care

COMMUNITY ENGAGEMENT FOR HEALTH AND WELLBEING(CE4HW) INITIATIVE USAID-ASBC Activity

 Organize discussions Nursing Flip chart, CHX CHMC,
with mother-to-mother mothers, for Champion,
support groups and to demonstration, CHO, and
pregnant
demonstrate to them Volunteers
how to use CHX women, in- (state their
laws, spouses, names)

TBAs,

Organize discussions Pregnant Flip chart, CHX CHMC,

with 10 community women for Champion,
Organize education and groups on good demonstration, CHO, and
Caregivers of
sensitization on maternal feeding practices for Volunteers
pregnant women and newborns Tables, chair, (state their
nutrition venue
caregivers of children Spouses, names)
under 5 to address relatives and
myths and friends,
misconceptions in traditional
consumption of some and religious
food items. leaders

Intensify education at
ANC, CWC,
Educate community pregnancy schools women, in Flip charts, CHMC, Increased early
members on the signs and outreach points their maternal Champion, health seeking
on symptoms of reproductive health record CHO and for newborns
and dangers of neonatal
age book Volunteers
jaundice neonatal jaundice
(state their
names)

Conduct home visits Pregnant GoodLife Cue CHMC,

to educate and women, cards, CHVs,
sensitize pregnant women in maternal Champion,
women and women their
in their reproductive
COMMUNITY ENGAGEMENT FOR HEALTH AND WELLBEING(CE4HW) INITIATIVE USAID-ASBC Activity
 age, households on reproductive health record CHO(state
the signs and dangers age book their names)
of neonatal jaundice
relatives and
friends

opinion
leaders

Broadcast GoodLife Pregnant GoodLife radio CHMC,

radio spots on women, Spots, airtime Champion,
neonatal jaundice on women in on CiC CHO(state
CiCs/community radio their their names)
reproductive
age

relatives and
friends

opinion
leaders

Promotion and Household Pledge cards, CHMC,

distribution of MNCH heads, CE4HW stickers, CHVs,
pledge cards and spouses, ink pads, and Champion,
stickers to get relatives, ink, CHO(state
religious
households to their names)
leaders,
commit seeking
opinion
MNCH services and
leaders
taking the
recommended
practices

COMMUNITY ENGAGEMENT FOR HEALTH AND WELLBEING(CE4HW) INITIATIVE USAID-ASBC Activity

 Pregnant Airtime on CHO,
Sensitize community
women CiC/Mosque, CHMC,
members on the Hold counselling Increased
resource CHVs,
sessions for nursing Caregivers for persons, testing for
importance of early care mothers on early care newborns Champion, malaria
refreshment,
seeking for infants and seeking for newborns (state their
Spouses, names)
children relatives and
friends,
traditional
and religious
leaders

Conduct video show Pregnant GoodLife CHMC,

to educate women, Video spots, CHVs,
community members caregivers, projector and Increased
Champion,
adherence
on the need to newborns, screen, CHO
register on NHIS to spouses, generator, fuel, and
compliance
seek care at the relatives and and a laptop,
facility friends, chairs, and with malaria
religious table treatment
leaders and
opinion
leaders

CHAPs review CHMCs CHVs, Venue, chair, CHMC chair, Improved

meeting opinion table, CHO CHAPs
Review meeting leaders, assessment implementation
subdistrict sheet, review
staff , form
community

CHMC Chair’s name: ………………………………………… CHO’s name: ……………………………………………………………..

Sign: …………………………………… Sign: …………………………………………………… date:………..
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