Table 4.
Basic Assumptions of a Classic CHC project compared to the intervention as performed in Rusizi District (2014–2015)
| Basic Assumptions of ‘classic’ (per-protocol) CHC | Score | cRCT intervention as implemented | Score |
|---|---|---|---|
| Training material | |||
| A customized CHC Training Manual | 4 | CBEHPP Manuals were available and used | 4 |
| Training manual developed/approved by MoH | 4 | Manual available and used | 4 |
| A tool kit of culturally appropriate visual aids | 4 | Appropriate visual aids available/well used | 4 |
| Sub total | 12 | 12 | |
| Trainers | |||
| Sufficient NGO Project staff to support EHOs | 4 | Not sufficient - only one dedicated PO for district | 2 |
| District leadership to ensure full local support | 4 | Mayor & District Health Officer removed from post | 1 |
| EHOs to mentor CHC Facilitators | 4 | Only 6 EHOs to supervise CHC facilitators | 2 |
| Politically enabling environment | 4 | Minister & Head MoH disabled CBEHPP | 0 |
| The CHC Facilitators are Village Health Workers | 4 | No public health personnel facilitated CHC | 2 |
| All CHC facilitators get a 5-day training | 4 | High turnover/30% had to be retrained in situ | 3 |
| Sub total | 24 | 10 | |
| Transport | |||
| EHOs to have motorbikes | 4 | Motorbikes provided but after the training in Year 2 | 1 |
| Project staff to have dedicated vehicle | 4 | No vehicle/motorbikes used on dangerous roads | 1 |
| VHWs to have bicycles | 4 | Supplied but not appropriate as hilly terrain | 4 |
| Sub total | 12 | 6 | |
| Training | |||
| Size of CHC: at least 70 members | 4 | 32 CHCs (64%) reached > 70 members | 3 |
| Coverage: 80% of village HHs in CHC in Y.1. | 4 | 12 CHCs (24%) reached 80% coverage in Y1 | 2 |
| All CHC sessions are participatory | 4 | Condensed sessions, so less participatory | 3 |
| Only one key message and one homework | 4 | Many messages and multiple homework | 3 |
| Model Home Competitions held end of training | 4 | Few competitions were held during intervention | 0 |
| CHC Membership Cards used / signed | 4 | CHC membership cards were used and signed | 4 |
| Certificates given at Graduation Ceremony | 4 | Only 50% of CHC held Graduations | 2 |
| Club venues permanent demonstration sites | 4 | Very few venues permanent or had demonstrations | 0 |
| Sub total | 32 | 17 | |
| Timing | |||
| Training is conducted during the dry season | 4 | All training conducted in the rainy season | 0 |
| Six months continuous weekly training | 4 | Only 4–5 months available for training | 2 |
| 24 health sessions meeting once a week | 4 | Only 4 CHC (8%) held > 20 sessions (mean of 15) | 2 |
| 2 h for each session provided | 4 | At least two hours if more than one topic was done | 3 |
| Only one topic is done per session | 4 | On average 2 topics done per session | 2 |
| Sub Total | 20 | 9 | |
| Total possible Score | 100 | Total Score | 54 |