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NUR CENTER FOR RESEARCH AND POLICY

ONE DAY NATIONAL LEVEL WORKSHOP ON CHBC GUIDELINES FOR NGOS AND CBOS A Joint Collaborative Project of the Fatima Memorial Hospital and the Association of People Living with HIV Dr. Shabnum Sarfraz Chief Operating Officer, Nur Center for Research and Policy February, 2013


ONE DAY WORKSHOP ON CHBC GUIDELINES FOR NGOS AND CBOS

Contents Contents ...................................................................................................................... 2 Introduction ................................................................................................................. 3 Objective of training................................................................................................... 3 To orient participants from NGOS and CBOs working for PLHIV, on the CHBC Guidelines, also developed by Nur Center for Research and Policy .................................................. 3 Scope ....................................................................................................................... 3 Facilitator’s Profile...................................................................................................... 3 Training Methodology................................................................................................. 4 Agenda ........................................................................................................................ 5 Workshop evaluation.................................................................................................. 6 Feedback .................................................................................................................. 6 Trainer’s Feedback: ................................................................................................ 6 Participants’ Feedback: ........................................................................................... 6 Annex 1- Registration Sheet ( 1 of 2) ............................................................. A Annex 1- Registration Sheet ( 2 of 2) ............................................................. B Annex 2- Trainer Evaluation Form .................................................................. C Annex 3- Training Evaluation Form................................................................. D Annex 4- Participants Evaluation of the Facilitators .......................................... E Annex 5- Pictures from the Workshop............................................................. F Annex 5- Pictures from the Workshop............................................................. G Annex 5- Pictures from the Workshop............................................................. H

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ONE DAY WORKSHOP ON CHBC GUIDELINES FOR NGOS AND CBOS

Introduction The one-day national level workshop for NGOs and CBOs was a project of Global Fund Round 9 organized by the Association of People Living with HIV. The technical assistance for the project was provided by the Nur Center for Research and Policy, the technical arm of the Fatima Memorial Hospital. Both Fatima Memorial Hospital and the Association of People Living with HIV are both sub recipients of the Global Fund Round 9 and the present workshop was a joint collaborative project of both the SRs for which they worked closely together.

Objective of training To orient participants from NGOS and CBOs working for PLHIV, on the CHBC Guidelines, also developed by Nur Center for Research and Policy

Scope The aim of the training was to orient the staff of different NGOs in understanding the need of standardized guidelines and learning the use of CHBC Guidelines. The topics covered in this workshop included: 1. Introduction to CHBCs and the Rationale for Guidelines 2. Using the CHBC Guidelines 3. Monitoring and Evaluation

Participant Profile The workshop was designed for middle and lower level staff of NGOs and CSOs working for PLHIV and they were selected in consultation with PR, UNAIDS, SRs and the association. Participants included program managers, M&E managers, field officers, health care providers, outreach workers and administrative staff from NGOs, CHBCs, COPCs from all over the country.

Facilitator’s Profile Keeping in view the need of the content, the workshop was designed to be interactive so that participants participate fully in the activities and learn about the guidelines. The module on need of guidelines and standardization was led by Prof. Dr. Aman Ullah Khan, Dean Faculty Fatima Memorial Hospital Medical and Dental College, Supervisor for FCPS Community Medicine and Senior Technical Advisor to Nur Center for Research and Policy. He is a senior academician in public health with numerous publications and trainings to his credit. The directions to the actual guidelines and activity sessions were taken up by Dr. Roomi Aziz. She is the Senior Manager Strategy and Planning at Fatima Memorial Hospital, working as one of the lead trainers at Nur Foundation. Dr. Aziz is an MBBS Doctor with an MBA from LUMS. She has in-country and international experience in trainings on leadership development, governance and planning in

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ONE DAY WORKSHOP ON CHBC GUIDELINES FOR NGOS AND CBOS

social and corporate sector. She has done a leadership development for social sector module from LUMS-REDC Hewlett & Packard Foundation.

Training Methodology Design and delivery of the training was via powerpoint presentations with aim of strengthening civil society and foster institutional capacity building on care and support for PLHIV. The training followed the following protocol: a. Participants were registered as they come in and seated. b. At 9:15 am, registration was closed and there was recitation of Holy Quran, followed by a short welcome speech by the keynote speaker. c. Moderator introduced the participants to the main objective of the training, the stakeholders, set the ground rules and the expected outcome of the trainings. d. This was followed by the first session on introduction to the workshop. e. The senior trainer began with the objectives of the workshop, followed by various sessions on different topics. f.

The sessions were also accompanied by activities to improve the understanding of participants. At the end of training, evaluations were collected and after that the participants were asked to share their experiences with the rest of the group.

g. The workshop ended at 4pm with certificate distribution and a group photograph, followed by message dedication. h. The training methodology included: i.

Illustrated lectures, visual aids in addition to verbal explanation

ii.

Discussion/ Brainstorming to share views and problems using reasoning power, to get all possible ideas from the group members

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iii.

Group work, to interact with each other and learn together

iv.

Self study, to gain deeper insight and more profound knowledge

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ONE DAY WORKSHOP ON CHBC GUIDELINES FOR NGOS AND CBOS

Agenda

Workshop Program

Instructor Name: Prof. Dr. Amanullah Khan, Dr. Roomi Aziz Date: 19th February 2013 Venue: Beach Luxury Hotel, Karachi, Session Name

Time

Registration

9:00 –9:15 am

Orientation to Workshop

9:15 –10: 15 am

Session #1: Introduction to CHBCs and Rationale for Guidelines

10: 15 –11:00 am

Objectives

o o

Introduction of participants Pre-workshop assessment

o o

Overview of CHBCs Orientation to the Global Fund R-9 CHBC Component Why do we need guidelines?

o Tea/Coffee Break

10:30 –10:45 am 10:45 –11:00 am

Activity#1: Making signboards Session #2: Using the CHBC Guidelines- The Text

11:00 –12:00 noon

Session #3: Using the CHBC Guidelines- The Study Aid Material

12:00 – 12:30 pm

Activity # 2: What do you see?

12:30 –12:50 noon

Session #4: Monitoring and Evaluation

12:50 –01:30 noon

o o o o

o o

Lunch & Prayer Break

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Understanding the structure of the guidelines How to use the CHBC Guidelines How to use the study aid material SOPs for CHBC

Difference between Monitoring & Evaluation M&E at the CHBC

01:00 – 02:00 pm

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ONE DAY WORKSHOP ON CHBC GUIDELINES FOR NGOS AND CBOS

Workshop evaluation

Workshop Evaluation 15

10 Strongly agreed 5

Agree Disagree Strongly disagree

0 The training The The training The content The The activities The duration met my knowledge objectives for of the was presentations were expectations. acquired is each topic organized were easy to educative and workshop practical for were and easy to follow useful was enough my present identified and follow. for the professional followed content of role the workshop

Workshop evaluation forms were filled and collected from the participants at the end of the day. This was done in order to gain better insight about the different aspects of the workshop. All participants showed satisfaction with the achievements of the program objectives stating that the training met their expectations. They also believed that the acquired knowledge would help them in their professional fields in future. The objectives of the each session were clearly explained and stated to the participants with the content being easy to follow. However they did suggest adding more field base work along with theory. The participants showed satisfactions with the trainer and stated that they had full command of the subject. The group activities were appreciated as well by the participants.

Feedback Trainer’s Feedback: The trainers believed that the participants were eager to learn and share the knowledge. Their backgrounds were relevant to the scope of the program and hence not only were the participants better informed but also stood at gaining the most out of this workshop. The participants should have been provided with the actual guidelines so that the workshop could have rendered more utility to them and they could have asked questions in real time, as opposed to seeing screenshots of the guidelines on the screen. Participants’ Feedback: The participants insisted on provision of CHBC guidelines before the beginning of the workshop. Budgetary allowance for provision of support material needs to be made.

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ONE DAY WORKSHOP CHBC GUIDELINES FOR NGOS AND CBOS ANNEXURE

Annex 1- Registration Sheet ( 1 of 2)

A

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ONE DAY WORKSHOP CHBC GUIDELINES FOR NGOS AND CBOS ANNEXURE

Annex 1- Registration Sheet ( 2 of 2)

B

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ONE DAY WORKSHOP CHBC GUIDELINES FOR NGOS AND CBOS ANNEXURE

Annex 2- Trainer Evaluation Form

C

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Annex 3- Training Evaluation Form TRAINING EVALUATION FORM Please check against the box which states the extent of your agreement to the following statements about this training program:

STRONGLY AGREED

AGREE DISAGREE

STRONGLY DISAGREE

1. The training met my expectations. 2. The knowledge acquired is practical for my present professional role 3. The training objectives for each topic were identified and followed. 4. The content was organized and easy to follow. 5. The handouts and readings were given to me before the sessions began. 6. The material distributed was easy to follow and useful 7. The presentations were easy to follow 8. The activities were educative and useful 9. The video was educative and useful 10. The duration of the workshop was enough for the content of the workshop

D

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ONE DAY WORKSHOP CHBC GUIDELINES FOR NGOS AND CBOS ANNEXURE

Annex 4- Participants Evaluation of the Facilitators

PROF. DR. AMANULLAH KHAN

Prof. Amanullah 25 20 15 10 Strongly agreed 5

Agree

0

Disagree Trainer’s Trainer was well- Trainer made use Trainer has good Trainer has an understanding of prepared and of the handouts presentation interactive concepts was answered to the given to the skill/style, teaching style, thorough questions raised participant to knowledge and involving by participants explain things in command over participants in appropriately a better way the subject discussion.

Strongly disagree

DR. ROOMI AZIZ

Dr. Roomi Aziz 25

Strongly agreed

20

Agree

15

Disagree

10

Strongly disagree

5 0 Trainer’s Trainer was well- Trainer made use Trainer has good understanding of prepared and of the handouts presentation concepts was answered to the given to the skill/style, thorough questions raised participant to knowledge and by participants explain things in a command over appropriately better way the subject

E

Trainer has an interactive teaching style, involving participants in discussion.

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ONE DAY WORKSHOP CHBC GUIDELINES FOR NGOS AND CBOS ANNEXURE

Annex 5- Pictures from the Workshop

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ONE DAY WORKSHOP CHBC GUIDELINES FOR NGOS AND CBOS ANNEXURE

Annex 5- Pictures from the Workshop

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ONE DAY WORKSHOP CHBC GUIDELINES FOR NGOS AND CBOS ANNEXURE

Annex 5- Pictures from the Workshop

H

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UNDERSTANDING THE NATIONAL CHBC GUIDELINES 19th February, 2013 Beach Luxury Hotel, Karachi

Participants

Agenda To understand the need of CHBC Guidelines

Why are we here today?

Going through the guidelines step by step and using different sections

Understanding the Guidelines

Simple measures and approaches

Need of Monitoring and Evaluation

PARTICIPANTS

ORGANIZATION

AIM

Irshad Ahmed Khan Abdul Latif Sheikh Farooq

Bridge

Stop HIV/AIDS totally

APLHIV- Karachi

To work for PLHIVs

Bridge

Serve the humanity, specifically PLHIVs

Shezad Sheikh

Bridge

Kashif

Gender and HIV Prevention- FSWs Reproductive Health Forum

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Participants PARTICIPANTS

ORGANIZATION

Hina Feroz

GRFH

Zeba Ramzan

GRFH

Raheela

GRFH

Masooma

GRFH

AIM

FSWs focussed- highly successful

Participants PARTICIPANTS

ORGANIZATION

Syeda Almas

Bridge

Ursila Zafar

Bridge

Lubna Rubab

Bridge

Muneer Jabbar

Sukkur SKR1 CHBC site Pakistan Society

Rubina Iqbal

Pak Positive Welfare Organization

Dr. Ashraf

Indus Hospital

To serve humanity/ Camps/fundraising

Saliha

Mohammad Amir

Indus Hospital

370 pts registered

Mukhtiyar Ali Mughal

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AIM

Counselling of PLHIVs

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Participants PARTICIPANTS

ORGANIZATION

Muhammad Iqbal

Pak Positive Society

Shahnawaz Sheikh

CHBC Site Larkana

Ameer Ali Abro

CHBC Site Larkana

Dr. Nayab Tarique

Bridge- CHBC Site Karachi

Agenda AIM Introduction to CHBCs and rationale for guidelines

Using the CHBC Guidelines

Monitoring and Evaluation

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Why need a guideline?

Reading the guidelines

Understanding M&E for CHBCs

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Why need guidelines? • How to behave with PLHIVs • How to deal • To achieve standardization- Why?

WHY ARE WE HERE TODAY?

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– Same PLHIVs, deserving same level of care ��� To achieve quality in services – Same services!!!!

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Objective • To follow comprehensive guidelines for the Community Home Based Care Centres that include: 1. Standards for Case Management 2. Formats for monitoring, evaluation and reporting 3. Training requirements for CHBC Staff

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WHAT ARE CHBCS?

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Challenges of Community Home Based Care

Defining CHBC • ‘Any form of care given to ill people in their homes.’ • (WHO, 2011)

• • • • • • • • • • •

• • • • • • •

Stigma Trust Economic Status Awareness De-motivation Drug Addiction Accountability

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Challenges of Community Home Based Care

7 Essential Elements of CHBC

Child care and HIV Confidentiality Economic distress Lack of awareness about CHBC programs Access to CHBC programs Stigma associated with HIV/AIDS High illiteracy rate Care for the caregiver Limited resources Tb/HIV co-infection Geographic scatter of the patients

1. Provision of care- includes assessment and entry criteria, care plan and exit strategy 2. Continuum of care 3. Education 4. Supplies and equipment 5. Staffing 6. Finance and sustainability 7. Monitoring and evaluation 8. Effective governance and management structures Source : WHO

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CATEGORY 1. PROVISION OF CARE

2.

CONTINUUM OF CARE

3.

EDUCATION

4.

SUPPLIES & EQUIPMENT

5.

STAFFING

6.

FINANCING AND SUSTAINABILITY

7.

MONITORING AND EVALUATION

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SUBCATEGORY                                      

Basic Physical care Palliative care Psycho-social support & counselling Care of affected & infected children Accessibility Continuity of care Knowledge of Community resources Accessing other forms of community care Community coordination Record-keeping for PLHIV Case- finding Case management Curriculum development Education management & curricular delivery Outreach Education to reduce stigma Mass media involvement Evaluation of education Location of CHBC team Health center supplies Management, monitoring &record keeping Home-based care kits Recruitment Supervising and coordinating CHBC Retaining staff Budget and finance management Technical support Community funding Encouraging volunteers Pooling resources Out-of-Pocket payments Free services Quality assurance Quality of care indicators Monitoring and supervision Copyright 2013- Intellectual Property of Informal evaluation Formal evaluation Nur Center for Research and Policy Flexibility

SIGNBOARDS

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Abbreviations and Acronyms

USING THE CHBC GUIDELINES

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Table of Contents Glossary of Items

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Section 1: Background and Introduction

Privacy is a practice

CONFIDENTIALITY IS A PROMISE

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Section 2: Standards for Community and Home Based Care

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Section 3: Standards services

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Section 5: Referral Support Services

Section 4: Standards services

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Section 6: Establishing and Maintaining CHBC

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Section 8: Financing and Sustainability of the CHBC

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Section 10: Standard Operating Procedures

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Section 7: Staffing and Training at CHBC

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Section 9: Monitoring and Evaluation at the CHBC

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Section 10: Standard Operating Procedurescontd.

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Dancing elephant Try to count the number of his legs

MONITORING AND EVALUATION AT CHBC

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Difference Between Monitoring and Evaluation

Feedback

Evaluation Periodic: At important milestones In-depth analysis of Documents progress achievements and gaps Focuses on inputs and Focuses on outcomes and impacts outputs Alerts managers to Provides managers with strategy and problems policy options Copyright 2013-External Intellectual Propertyanalysis of Self-assessment Nur Center for Research and Policy Monitoring Continuous: day-to-day

• Awareness of CHBCs and their work • Standards- Services • Knowledge of an existing guideline

• Less Duration • • • • • • • •

Knowledge sharing Networking/ Collaboration Confidentiality/ Trust! Empowerment Accountability/ Responsibility SOPs/policies/procedures Higher frequency of such programs/ more to increase impact Language- URDU Copyright 2013- Intellectual Property of Nur Center for Research and Policy

Questions? Thank you

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ONE DAY NATIONAL LEVEL WORKSHOP ON CHBC GUIDELINES FOR NGOS AND CBOS