Bridging the Gaps in Primary Care through Community Health Workers in Kilinochchi District

The rural health development project underscores the invaluable contributions of the  International Medical Health Organization through the Center of Digital Epidemiology,  Faculty of Medicine, University of Jaffna, which aims to address critical healthcare  disparities in Kilinochchi District through Community Health Workers (CHWs). 

With a severe shortage of primary care providers in the Northern Province, accessibility  to healthcare is hindered, exacerbated by the prevalence of chronic conditions such as  diabetes and heart disease. To bridge this gap, the project proposes to empower local  community members as CHWs to facilitate routine primary healthcare services  effectively. Implemented across Kilinochchi district, the project included training and  deploying CHWs to engage with the community, aiding with routine procedures, and  supporting administrative functions. 

By enhancing access to primary care and empowering local communities, 15 CHWs were  appointed and were engaged with a local public medical camp, school health promotion  and life skills development program, and mothers’ supportive group engagement and  involvement program.

Project Activities

a

Identifying and training the CHWs

Twelve women were selected through an interview conducted by the FOM, UOJ board among the  nominees from PHM, and three field coordinators were selected based on their experience on the  1st of February 2024. The capacity building program started every Saturday with mentoring in  FOM, UOJ and on-the-job training was assigned with MOH and PHM in Karachchi and Poonakary 5 days per week. 

Following are the activities underscored in training:

Activities undertaken with the Public Health Midwife:

  • Office Record Keeping: Recording office registers monitoring the height and weight of children and adolescents.
  • Maternal Care: Assessing the height and weight of pregnant mothers and providing nutritional supplements like Thriposha and Saththuma.
  • Well Women Clinic Services: Conducting height, weight, blood pressure (BP), and random blood sugar (RBS) assessments for women.
  • Field Visits: Undertaking field visits for pregnancy, post-partum, Adverse Event Following Immunization (AEF) visits, and family planning.

Activities at the Office of- Medical Officer of Health:

  • Weekly Clinics: Measuring the height and weight of children and adolescents during weekly clinic days.
  • Prenatal Care: Monitoring the height and weight of expectant mothers.
  • Vaccination Coordination: Organizing vaccinations and assisting with returns.
b

Engaging CHWs with Local Public

  • Engage with Mother’s Supportive Group (MSG) income generation activities.
  • Conducting health camps in the community
  • Conducting school health promotion & life skill development programs in the community.
c

Empower the CHWs to assist in providing healthcare

During on-the-job training, field coordinators and mentors started to monitor the CHWs regarding  their areas of interest in healthcare from April 2024. They will be trained as specialized health  assistants for health care services and providers according to their interests. 

d

Monitoring and evaluation

Field coordinators initiated observational visits and qualitative discussions with care providers  (PHM and MOH) from April 2024. Also, routine data from engagement activities with the local  public were recorded and stored. The activity summary is illustrated in the following table.