| (i) Political mobilization by Manicoré
City |
Manicoré City (city mayor and health
director) was supportive of CHW refresher training and their activities,
although there was local political change during the period of the project. |
Manicoré City established a supportive supervisory
system for CHWs. |
Manicoré City agreed to continue the CHW support
system, including supervision, as part of the role of the health division. |
|
|---|
| (ii) Degree of
community participation |
Community organizations and people welcomed
working together. |
People within the community organized a
community-based institution to supervise CHWs, especially for CHWs in remote
communities, because the division of Manicoré City cannot constantly supervise
all CHWs. |
There is confidence among community organizations,
people within the community, and CHWs regarding continuous collaboration. |
|
|---|
| (iii) Increased awareness of CHW
performance |
People within the community appreciated CHWs’
activities. |
People within the community came to understand that
the roles of CHWs involved disease prevention and promotion of health, not only
giving medicine and performing clinical treatment. |
People within the community have learned that
“health can be obtained by ourselves, not by someone else.” People within the
community and CHWs stimulate each other to maintain a good level of motivation
for self-management. |
|
|---|
| (iv) Capacity to manage CHW refresher
training |
People within the community became more
supportive of CHWs and their training, especially in the latter period of the
project. |
People within the community voluntarily participated
in CHW training. |
The project directly addressed CHWs and people
within the community, and they were in charge of decision-making and management
at the local level from the beginning of the project. Thus, they obtained a
sufficient capacity to manage the CHW system. |
|
|---|
| (v) Partnerships established among Manicoré
City, the state hospital and health centers, and CHW |
CHWs and health personnel of the
hospital/health center did not have collaborative relationships at the beginning
of the project, but after beginning to work together, they established more
supportive relationships. |
Manicoré City integrated a CHW support system as
part of the role of the health division with the hospital and health
centers. |
CHWs’ activities are part of the national health
strategies; stakeholders at all levels, including the local government (Manicoré
City), local health sector (hospital/health centers), community organizations,
and people within the community, recognize their responsibilities and
harmonization of each role. |
