The Communication Initiative
Development action with informed and engaged societies
The Communication Initiative
After nearly 28 years, The Communication Initiative (The CI) Global is entering a new chapter. Following a period of transition, the global website has been transferred to the University of the Witwatersrand (Wits) in South Africa, where it will be administered by the Social and Behaviour Change Communication Division. Wits' commitment to social change and justice makes it a trusted steward for The CI's legacy and future.
 
Co-founder Victoria Martin is pleased to see this work continue under Wits' leadership. Victoria knows that co-founder Warren Feek (1953–2024) would have felt deep pride in The CI Global's Africa-led direction.
 
We honour the team and partners who sustained The CI for decades. Meanwhile, La Iniciativa de Comunicación (CILA) continues independently at cila.comminitcila.com and is linked with The CI Global site.
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Home-Based Records Country Learning

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Carried out with a grant from the Bill & Melinda Gates Foundation, JSI's Coordination and Implementation of Child Health Record Redesigns Project is exploring opportunities to improve the availability and use of home-based records (HBRs). These records can: aid health workers in documenting and tracking which vaccines have been given to a child; empower a parent or caregiver to play a role in the health of their children and to have documented information on their child's vaccination history; and serve as public health monitoring tools on vaccination coverage through household and other surveys.

As part of the project, JSI has generated evidence and provided guidance to promote advocacy for and country-focused experiences on the policy/stakeholder pathway for redesigning HBRs and for low-cost interventions to strengthen card availability and use beyond the design. This series of 2-page briefs describes interventions and strategies carried out in 4 countries in which JSI has worked. They include:

  1. Home-based Records Country Learning: Card Redesign for Improving Immunization Tracking in Benin - This brief highlights the approach and process of redesigning, updating, and standardising HBR cards in Benin, given the planned introduction of 2 dose measles/rubella (MR) and rotavirus vaccines in 2018. In June 2017, JSI co-organised and facilitated a workshop, led by the Benin Ministry of Health (MOH) and the Expanded Programme on Immunization (EPI) and involving various stakeholders. An external expert in human-centred design and a local designer (who works with the MOH) played key roles in the workshop to assist with prototypes for the immunisation content. Facilitation at the workshop used a consensus-based approach; together, participants arrived at a design for the immunisation section that all agreed was fit for purpose.
  2. Home-based Records Country Learning: Community Engagement to Improve Child Health Card Use in Zimbabwe - Although important for immunisation data collection and monitoring, HBRs in Zimbabwe were often unavailable and undervalued. To address this, JSI and MOH staff in Manicaland province implemented a one-year intervention to improve the use, retention, and availability of child health cards among users, including health workers, village health workers, local leaders, and caregivers. Interventions (using existing, low cost activities) promoted the cards as an essential counseling and communications tool. Among health workers, JSI focused on use of the cards to communicate with caregivers on the vaccination schedule and return dates as well as to fill data gaps in immunisation registers. JSI found that community leaders are strong advocates for the cards and well-positioned to promote their use.
  3. Home-based Records Country Learning: Improving Urban Immunization with Child Health Cards in the DR Congo - The objective of the HBR project the Democratic Republic of Congo (DRC) was to identify and implement low-cost interventions to improve the availability, use, and retention of cards, with the findings to be shared for users across the health system. JSI based a situational analysis on Demographic and Health Survey (DHS) data, findings and recommendations from a previous missed opportunity for vaccination study (led by the World Health Organization, or WHO), a rapid survey in the 2 Kinshasa health zones, and revisions of the cards already underway in DRC. JSI interventions focused on improving health worker training and use of the HBRs (with new detachable coupons as part of a tickler file system) and improving caregivers' understanding of the cards and empowering them to take responsibility for following vaccination schedules.
  4. Home-based Records Country Learning: Increasing Child Health Card Retention in Nepal - JSI supported Nepal's MOH and collaborated with other partners to improve the use, availability, and retention of cards among key users over an 18-month period. Although the interventions focused on 3 districts, JSI worked closely with national leaders throughout the process to consider needs and opportunities across Nepal. The package of interventions was evidence-based, responding to the perceptions and practices of users ranging from health workers and female community health volunteers to caregivers.

Other outputs from the project are available at Related Summaries, below, as well as on the JSI website.

Publishers

Languages

English, with some also in French

Number of Pages

2 pages (per brief)

Source

JSI website, September 5 2018.