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Welcome to the CHW Web Conference

Welcome to the CHW Web Conference. We will begin in a moment. If you have not already done so, please call the number listed in the info tab on your screen. While we wait… play! Try out your marker tool… type a comment… say hello in the chat box. Get to know the WebEx interface.

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Welcome to the CHW Web Conference

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  1. Welcome to the CHW Web Conference We will begin in a moment. If you have not already done so, please call the number listed in the info tab on your screen. While we wait… play! Try out your marker tool… type a comment… say hello in the chat box. Get to know the WebEx interface.

  2. Community Health Care Workers’ Manual Design In collaboration with DesignInKind and the UN Millennium Village Project/Earth Institute Kick-Off Meeting Thursday August 7, 2008

  3. Meeting Overview • Introductions • Project Overview • The books • The CHW Manual • Goals • The Blog • Who is Who • Design Process • First Versions of Style guide • Comments and Questions

  4. Introductions Below are the names of all of the participants thus far. If you are present, make a marker line over your name. Use this color to make marks and comments during the rest of the meeting. If your name is not there, please type it in at this time. Amita Makdani Ryan Nussbacher Craig Provost Russell Robertson Carolyn Schaeberle Jaime Stein Kenzan Tsutakawa-Chinn Tucker Viemeister

  5. Project Overview: The Books Indicates Person Indicates Manual Millennium Development Goals (MDG) Trainers 2 individuals based at the “Millennium Development Centers” in East and West Africa who will train the CHW Coordinators. Trainer of Trainer Manual (TOT) Community Health Workers (CHW) Coordinators 14 individuals who will have been taught how to use the TOT Manual to teach the CHWs (10 per site) Trainer of Trainer Manual (TOT) Community Health Workers (CHW) The CHWs will carry the CHW Manual on their household visits. Each CHW is responsible for about 150 households (roughly 750 people). CHW Manual

  6. Project Overview: The Books MDG Trainers TOT Manual CHW Coordinators CHW Coordinators CHW Manual CHWs CHWs CHW Manual/Household Cards Households

  7. Project Overview: The CHW Manual MDG Trainers TOT Manual CHW Coordinators CHW Coordinators CHW Manual CHWs CHWs CHW Manual/Household Cards Households

  8. Project Overview: Goals • The Project’s main objective is to create a new training model for Community Health Care Workers (CHW) that is efficient, accessible, and graphical. • This design team will suggest layouts, information algorithms, and organization structure that highlights the practical utility of the guide for users with a wide range of educational backgrounds and culture. • Together we have the opportunity to create and enact, with feedback, a unique resource for facilitating life-saving health care in the parts of the world that have the least means and access.

  9. Blog • The Blog will be our offline dialogue that will document the process and allow people to review the project’s progress. • We will post the agenda for the WebEx meeting prior to our meeting. • We will post material from previous WebEx meetings including powerpoint and feedback • Please add any comments, design ideas, or critiques of the templates to the blog after this meeting.

  10. Blog: Key Features Templates and Examples: Content, Examples, Initial Templates Participants: Get to know the group Project Statement: More details about the project Working Design: The most current version of the template and older versions Home: Updates, news, WebEx announcements

  11. Who is Who Design Advisors The group surrounding the home team that offers comments, Suggestions, sketches, etc. on the blog.  Home Team Clients: Jot, Anne, Simone and others from Earth Institute Guidance on content and field feedback Local Team Deb, Carolyn, Mary and Ryan Consider and integrate changes into master document design

  12. Design Process Design Advisors Home Team Local Team • The Home Team provides the reduced content and required information to Local Team. Also provides opinions of style of illustrations desired. • Local Team provides necessary info to Design Advisors via Blog and WebEx conferences. • Local Team develops initial template concepts. • Design Advisors discuss initial concepts and give feedback via the Blog and WebEx conferences. • Local Team incorporates feedback and creates new iterations of templates. • Home Team gives feedback about direction of new templates. Also seeks feedback from the field. Rinse… Repeat…

  13. Template Design: Overview • Original, text-based content • Move to graphical algorithm format • Basic structure: required information • Initial Templates • Template 1 • Template 2 • Template 3 • Comparison of templates • Comments and Questions

  14. Content: No Design FAQ about Zinc and ORS Q: Should I give less ORS since I am giving zinc? A: No, you should continue to give plenty of ORS, as recommended, even though you are giving zinc. ORS will help to replace fluids lost during diarroea. Zinc will speed up recovery, and will help the child fight off new episodes of diarroea in the 2-3 months following treatment. Zinc will also improve appetite and growth. Q: Why do I give zinc after my child is better? A: Zinc is good for your sick child, but it is important to give to your child after he is better too. The zinc will help your child grow and will improve his appetite. Remember, even though your child does not have loose stools, he will still need to continue to take the zinc AND eat and drink more than usual for 2 weeks after the diarrhoea, all of this will help replace lost nutrients. Zinc will help your child not get diarrhoea again soon. Q: If my child vomits the zinc should I give another one? A: Yes, try to give the child one more tablet. Wait until he/ she is calm again and vomiting stops. Make sure your child is keeping down ORS. When he/she takes ORS with no problems, give the next zinc tablet. If he/she vomits after the second tablet do not give anymore on that day, wait to give the next tablet until the next day. Give zinc again the next day and daily until there are no more tablets in the pack. Q: If my child is vomiting other things, like ORS, should I try to give the child zinc? A: No, if your child is vomiting ORS and all food and other liquids you should bring him/her to the health centre. Q: Can zinc have any bad side effects? A: The only side effect of zinc supplementation is sometimes vomiting. You should not expect any other side effects. As always, you should come back to the health centre if your child has any danger signs with or without the zinc supplements. Q: I think tablets are bad for babies, what do I do? A: This tablet should be dissolved in breastmilk, ORS, or clean water. When you do that you will make a syrup to give to your baby. Babies like this very much, especially in breastmilk. Q: What if my child takes more than one tablet? A: You should keep the tablets away from any children in the house to prevent this from happening. If your child takes too many tablets she will probably vomit them up. Your child should take 1 per day. One or two extra taken by mistake will likely not hurt your child, but you should come to the clinic and discuss what happened with a healthcare worker, just to be safe. Q: Are vitamins/minerals harmful for my child who has a bad stomach? A: No, vitamins and minerals are very important while your child is sick and will help your child get better faster. You should give the zinc to your child even though his stomach is bad. Q: I give a multivitamin to my child; can I give zinc on top of that? A: Yes, your child is losing a lot of zinc in his stools right now, so giving more than usual zinc is good while he/she is sick. After the diarrhoea is over it will help replace lost nutrients. You can continue to give the multivitamin and give the zinc as diarrhoea treatment for the full 10/14 days. This will not harm your child. TEXT-BASED CONTENT

  15. Content: No Design Diarrhea Diarrhea kills over 2 million children every year through dehydration and malnutrition. Children are in greater danger than adult to die from diarrhea because they become dehydrated more quickly. Diarrhea is preventable by good hygiene and good food. Diarrhea + any of the danger signs Refer urgently to health center and advise the mother to give frequent sips of ORS on the way (or continue breastfeeding) Loose or watery stools. More stools than normal. Ask the mother: How many Days? Less than 2 weeks More than 2 weeks Is there Blood in the stool? No Blood Blood Refer urgently. Called Dysentery Advise the mother to give frequent sips of ORS on the way (or continue breastfeeding) on the way to the nearest clinic for IV or NG treatment. If the child does not receive treatment, s/he will die. Treat Dehydration!

  16. Example of Manual Below are pages of an existing manual about TB. It is an example that the client feels is successful in terms of it being more illustrative. There are still too many pages.

  17. Template Design: Basic Structure Category Information Fact Area Symptom Area Diagnosis Treatment Page Number 17

  18. Template Design: Initial Versions The in-house designers created three different templates as a starting point Template 2 Template 3 Template 1

  19. Template Design: Template 1

  20. Template Design: Template 1 Basic Structure Symptom Area Category Information Fact Area Diagnosis Page Number Treatment

  21. Template Design: Template 1 Category Information Page Number

  22. Template Design: Template 1 Fact Area

  23. Template Design: Template 1 Symptom Area

  24. Template Design: Template 1 Symptom Area

  25. Template Design: Template 1 Diagnosis

  26. Template Design: Template 1 Diagnosis and Treatment Area

  27. Template Design: Template 1 Treatment Treatment

  28. Template Design: Template 1 Treatment Icons

  29. Questions: Template 1 Please Comment on the following: 1. Overall Set up. 2. Manner in which the category is indicated on the side tab. 3. Type of image for warning signs. 3. Levels of Urgency. This is an area where icons need to be developed. 4. Diagnosis and treatment setup. 5. Icons used to indicate treatment. 6. Colors, borders, and shapes used.

  30. Template Design: Template 2 Basic Structure

  31. Template Design: Template 2 Basic Structure Fact Area Category Information Symptom Area Diagnosis Treatment Treatment Page Number

  32. Template Design: Template 2 Fact Area Category Information Page Number

  33. Template Design: Template 2 Category Information Page Number

  34. Template Design: Template 2 Symptom Area

  35. Template Design: Template 2 Symptom Location Image Symptom Severity Description

  36. Template Design: Template 2 Basic Structure Diagnosis

  37. Template Design: Template 2 Diagnosis Algorithm

  38. Template Design: Template 2 Treatment Treatment

  39. Template Design: Template 2 Treatment

  40. Template Design: Template 2 Treatment Algorithm

  41. Questions: Template 2 Please Comment on the following: 1. Overall Set up. 2. Manner in which the category is indicated (DIARRHA and Icons). 3. Type of image for area of concern. 3. Symptoms and Diagnosis flow chart. 4. Icons, colors and shapes used in flow chart. 5. Treatment Information layout. 5. Skills area set-up and icons. 6. Overall colors, borders, and shapes used.

  42. Template Design: Template 3 Basic Structure

  43. Template Design: Template 3 Basic Structure Category Information Fact Area Symptom Area Symptom Area Diagnosis Treatment Treatment Page Number

  44. Template Design: Template 3 Category Information Fact Area Page Number

  45. Template Design: Template 3 Symptom Area Symptom Area

  46. Template Design: Template 3 Basic Structure Diagnosis

  47. Template Design: Template 3 Treatment Treatment

  48. Template Design: Initial Versions Now compare the three. What features do you like or dislike? What is missing from one that you like in the other? What could you not live without? What do you never want to see again? Template 2 Template 3 Template 1

  49. Template Design: Template 1

  50. Template Design: Template 2 Basic Structure

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