Community Approaches to Child Health in Malawi: - CORE Group

Group model is more than most MOHs can afford to pay on top of their
responsibilities for curative care and the provision of essential preventative
services.
Establishing a C-IMCI program is affordable, however, when seen as a
one-time establishment cost rather than an annual operating expense.
Although it takes about six months to organize Care Groups and another
several years to conduct all the training and supervision, adding more topics
simply increases the cost-effectiveness and value of volunteers. As volunteers
develop their skills, they accomplish increasingly complicated tasks, such
as community-based rehabilitation of malnourished children, home-based
management of fever, growth monitoring, and insecticide-treated bed net
promotion and distribution.
The cost of maintaining the C-IMCI benefits of community-based models
also becomes increasingly affordable as village health committees or
other mediating groups are enabled to give continued encouragement to
volunteers. After outside funding ends, for example, Care Groups can be
supported by communities in various ways. In Rwanda, Care Groups were
sustained by the MOH, who hired some of the World Relief staff into the
MOH and through volunteer associations. In Malawi, Care Groups have
continued with support from village headmen, village health committees,
and HSAs in certain geographic areas. Even when Care Groups ceased
meeting formally, the volunteers remained a resource to families in their
communities.
Based on documented outcomes of C-IMCI projects worldwide, MOH
officials should be able to make a strong case for funding the initiation
of effective C-IMCI projects to bilateral and multilateral donors, private
donors and NGOs. MOH directors should then carefully examine which
districts would make good candidates for pilot C-IMCI programs, select
their NGO partners carefully, and choose local MOH officers who are
interested in C-IMCI programs.
26 Community Approaches to Child Health in Malawi