Community Health Workers Manual

A manual for use by Community Health Workers in Southern Province, Zambia

Updated: August 2012

Author: Aaron Harris, Peace Corps Zambia Volunteer 2011 201! Publisher: Ministry o" Health o" Zambia

#able o" Contents

Number 1 2 ! ) , 0 3 + 7 10 11 12 1! 1) 1, 10 13 1+ 17 20 Section $ntro%uction &esponsibilities o" a CHW $n"ormation 'atherin( Pro*ect Cycle -on .ormal /%ucation 1eha2iour Chan(e Malaria H$V4A$56 -utrition Water an% 6anitation $nte(rate% &epro%ucti2e Health #uberculosis 8#19 Positi2e :i2in( Chil% Health an% -utrition :i"e 6kills Con%uctin( a Health #alk Health #alk #opics Con"i%entiality Alternati2e #echnolo(y Pro*ects #emplates Starting Page 1 2 ) + 12 1, 1+ 20 2+ )0 )) ), )0 )3 ,0 ,7 00 01 02 0+

Community Health Wor ers !anual Section:"ntroduction# $anguage: %nglish# &opic: "ntroduction Page: 1 Welcome' Thank you for using this manual. The purpose of this manual is to provi e the information vital to all Community Health Workers in Zambia, inclu ing the !ob of a CHW, "ays to teach an the community, key facts about the core health thrusts, an a fe" sample "ays to use local materials to improve health. This is the #nglish Section of the manual. There is also a Citonga section follo"ing the complete manual in #nglish. This is meant to ai those "ho are unable to fully utili$e this manual in #nglish. This manual is a result of collaboration "ith the %inistry of Health an Peace Corps Zambia. &t has been authore by Aaron Harris, Peace Corps Zambia volunteer in the Community Health &mprovement Pro!ect 'CH&P( )*++, statione from )*++ to )*+, in -imb"e, .alomo -istrict. &opics Co(ered &oles an% &esponsibilities o" a CHW Ministry o" Health 5ecentrali;ation an% the CHW -on .ormal /%ucation techni<ues $n"ormation 'atherin( Appropriate #echnolo(y Pro*ects 6olar Water Puri"ication 6olar 5ryin( Chlorine 'enerator #ippy #aps Malaria H$V an% A$56 -utrition Chil% Health an% -utrition Water an% 6anitation, inclu%in( =ater treatment metho%s #uberculosis Positi2e :i2in( .amily Plannin( an% 6a"e Motherhoo% 1eha2iour chan(e Con%uctin( a Health #alk Con"i%entiality 6amples :i"e 6kills: 'oal settin( 5ecision makin( Peer pressure Communication 6el" esteem Peer e%ucators #ypes o" &elationships

Community Health Wor ers !anual Section:)esponsibilities o* a CHW# $anguage: %nglish# &opic: )ole in !inistry o* Health +ecentrali,ation Page: 2 What is the !inistry o* Health +ecentrali,ation To permit the %inistry of Health to better a ress the nee s of a iverse population, it has share responsibility "ith several levels /ational level Provincial level -istrict level 0ural Health Center level 'multiple villages( Health Post1Zone level 'about +*** to +2** people( 3illage level Househol level &nformation goes from the bottom up4 from local to national policy & eally, "ill allocate resources to "here they are nee e most an "ill benefit the nation an the in ivi ual communities much more than a centrali$e system Cause by the nee to re uce health care costs at the national level ue to the economic o"nturn of the +56*s Also cause by the government "anting communities an in ivi uals to be more active in their health care &he Community Health Wor er in +ecentrali,ation Community health "orkers operate on the village an $one level They "ork "ith the 0ural health centre '0HC( an the /eighbourhoo Health Committee 'one per $one, /HC( to promote health They are responsible for meeting "ith people "ho are ill an either giving them basic me ication, a vice, or referring them to the 0HC. They help "ith 7n er 2 Clinics They are given a kit of basic me icines that they help the 0HC gives them to istribute locally accor ing to nee They help "ith the operation of the 0HC They are volunteers 8ut the 0HC an community members shoul help provi e lunches an "ater1cib"antu for them "hen they "ork at the clinic They shoul be respecte by the community, as they are traine in provi ing health a vice an basic treatment 9ften they have !obs that provi e income. As such, their time is limite epen ing on the !obs an the seasons & eally there shoul be several per health post 9ften they also serve on /eighbourhoo Health Committees

Community Health Wor ers !anual Section:)esponsibilities o* a CHW# $anguage: %nglish# &opic: )ole in !inistry o* Health +ecentrali,ation Page: -

!inistry o* Health +ecentrali,ation $adder Ministry o" Health

Pro2incial Health >""ice

5istrict Health Mana(ement #eam

&ural Health Centre

Health Centre Committee -ei(hbourhoo% Health Committee Villa(es an% Househol%s

Community Health Workers Work here:

$n"ormation an% resource re<uests (o up $n"ormation, policy an% resources (o %o=n

Community Health Wor ers !anual Section:"n*ormation .athering# $anguage: %nglish# &opic: "n*ormation .athering &ools Page: /

Ways to gather in*ormation

9bserve the community &ntervie" in ivi uals Con uct a village inspection An in: epth intervie" of all of the househol s in the village This information is then use by the 0HC, the -istrict, all the "ay up to the %inistry of Health to etermine health interventions an programs %ap out the village -ra" a map of the key features Househol s 0oa s an paths Health posts Water sources T8As Tra itional healers %eeting places Schools Churches %arkets Hea men CHWs Skille "orkers ;ist the assets of the village -etermine "hat resources are in the community Physical resources such as buil ings People resources such as skills 9rgani$ational resources, such as organi$ations alrea y in the community Asses nee s Analyse the information to etermine "hat the nee s are Prioriti$e nee s -etermine "hich nee s have the greatest impact on the community -etermine "hich nee s are interrelate Analyse the causes an effects of problems -o a problem tree The problem is the trunk The causes are the roots, "ith each cause of those branching out like a root system "oul The causes are the branches, "ith the effects of those branching out

Community Health Wor ers !anual Section:Samples# $anguage: %nglish# &opic: Sample Community !ap Page: 0

CHW

Hea%man

&HC #1A

6hops Church

1orehole

1orehole

6chool

1orehole

Community Health Wor ers !anual Section:Samples# $anguage: %nglish# &opic: Sample Problem &ree Page: 1

Sample Problem &ree: !alaria :o=er income People =orry

:ess "oo% .e=er =orkers

People not as healthy

People (et sick

People %ie

Malaria

Mos<uitoes -ets not @se%

6tan%in( Water

-o $#-s

-ot enou(h %istribute%

@se% as .ish nets

#oo /?pensi2e

:ack o" Ano=le%(e

Community Health Wor ers !anual Section:Samples# $anguage: %nglish# &opic: Sample Asset $ist Page: 2

Sample Asset $ist: $imbu3a 4illage

Asset
Clinic Carpenters Mechanic Charcoal makers school

Ano=le%(e
>n Health Carpentry Ho= Machines =ork Makin( charcoal #eachin( others
Health, the community #he community .armin(, =eather

6kills
#reatin( patients Carpentry .i?in( thin(s Makin( charcoal #eachin( stu%ents
#eachin( about health lea%ership .armin(

Attitu%es
Willin( to help community Work /thic $n<uisiti2eness

&esources
Me%icine, =ar%s Woo%, #ools #ools Charcoal

Willin(ness to teach
Willin(ness to help the community Wantin( to maintain or%er

1ooks, pens, notebooks, classrooms

Me%icine, health books 6tatus, respect Crops, see%s, lan%

Community Health Workers hea%man .armers

Community Health Wor ers !anual Section:&he Pro5ect Cycle# $anguage: %nglish# &opic: &he Pro5ect Cycle Page: 6

&he Pro5ect Cycle is the 3ay e**ecti(e pro5ects and inter(entions are conducted in the community# &he NHC is H".H$7 encouraged to use this method *or all pro5ects

Gather Information Villa(e $nspection

Monitor Progress What is =orkin(B

Determine Need -ee%s Assessment

Implement Projects 5o =hat you planne%

Think of Projects #hat a%%ress the $ssues %etermine%

Plan Projects Action Plannin(

Community Health Wor ers !anual Section:&he Pro5ect Cycle# $anguage: %nglish# &opic: &he Pro5ect Cycle Page: 8

19Step 1: 3illage inspections to gather information on the health status in the community. Also o an asset listing to etermine "hat resources are able to be use 29Step 2: Asses the information to etermine nee . -9Step -: Think of an esign possible pro!ects using the information provi e by an the analysis from previous steps /9Step /: Choose a pro!ect an plan ho" you "ill implement it through action planning 09Step 0: &mplement the pro!ect itself 19Step 1: %onitor an evaluate the progress of the pro!ect What "orke < Why< What i not "ork< Why< What hin ere the pro!ect< What helpe the pro!ect< What "as learne from the e=perience< Was it a e>uate< -i it make enough of a change to be "orth the effort< Was it effective -i it achieve the goals of the pro!ect Was it appropriate -i it fit "ith the situation or problem< Was it cost effective -i the benefits !ustify the costs Was it timely Was the timing appropriate &s it sustainable Will the community continue the change<

Community Health Wor ers !anual Section:&he Pro5ect Cycle# $anguage: %nglish# &opic: !onitoring and %(aluation Sample Page: 10

Problem Malaria Goal &e%uce Malaria inci%ents by ,0D by 201! Action /%ucation Indicator of !uccess Can a%e<uately e?plain =hat malaria is, ho= to pre2ent it an% ho= it is contracte% 8+0D on a post test or better
Task /%ucate #eachers /%ucate Clinic 6ta"" /%ucate Villa(ers /%ucate 6tu%ents Goal 2, teachers 0 sta"" 200 2illa(ers 200 stu%ents Due Date Culy 2012 Au(ust 2012 6eptember 2012 >ctober 2012 6tatus 6uccess Achieved 2) 0 1!0 )00 Comments success"ul success"ul -ot success"ul Very success"ul

'oal /%ucate 2, teachers in malaria an% malaria pre2ention /%ucate 0 sta"" members on malaria an% malaria pre2ention /%ucate 200 2illa(ers on malaria an% malaria pre2ention /%ucate 200 stu%ents on malaria an% malaria pre2ention

&eason "or success or "ailure #eachers are =ell e%ucate% an% coul% un%erstan% the han%outs (i2en to them 6ta"" members at the clinic are %e%icate% to pre2entin( malaria Villa(ers %i% not un%erstan% the lectures =ellE Perhaps try other teachin( metho%sB $t =as easy (atherin( stu%ents to(ether "or meetin(sE Multiple teachin( metho%s =ere use%

success

-ot success"ul Very success"ul

Make "our goals !MA#T !peci"ic Measurable Achie2able #ealistic Timely

Community Health Wor ers !anual Section:Pro5ect Cycle# $anguage: %nglish# &opic: Sample Action Plan Page: 11

Sample Action Plan Goal $ncrease peoples kno=le%(e o" H$V Action 6ensiti;e people on H$V Action
#each CHWs #each 1asic 6chool #eachers #each -HCs

#ar(et
#each + CHWs 21 teachers

&esponsible Person
PCV Hea%master o" the basic school -HC Chairman

#ime
1 month 1 =eek

Materials
.lip charts, time, markers .lip charts, markers, snacks .lip charts, markers, notebooks, pens, "oo% "or lunch .lip charts, time, markers .lip charts, time, markers .lip charts, time, markers .lip charts, time, markers .lip charts, time, markers .lip charts, time, markers

21 -HC members

) months

#each 2illa(ers in :imbu=a #each Villa(ers in 6in(an%u #each 2illa(ers in 6iantebe #each 2illa(ers in Moomba #each 2illa(ers in 6il=iin%i #each 2illa(ers in 6iyoo=i

!0 2illa(ers

Hea%man o" :imbu=a Hea%man o" 6in(an%u Hea%man o" 6iantebe Hea%man o" Moomba Hea%man o" 6il=iin%i Hea%man o" 6iyoo=i

0 months

!0 2illa(ers

1 month

!0 2illa(ers

1 month

!0 Villa(ers

1 month

!0 2illa(ers

1 month

!0 2illa(ers

1 month

Community Health Wor ers !anual Section:Non :ormal %ducation# $anguage: %nglish# &opic:$earning Styles Page: 12 Ho3 do people learn; People learn in ifferent "ays Some learn best by listening Some learn best by oing Some learn best by seeing Some learn best by e=periencing something Some learn best by reflecting on "hat they e=perience Some learn best by analysing "hat they e=perience Some learn best by e=perimenting As a result< to best teach others< you must in(ol(e a (ariety o* teaching methods 3hen you gi(e health tal s# &hat 3ay e(eryone has a chance to learn in the 3ay they learn best &he Cycle o* $earning:

/?perience

/?perimentation

&e"lection

Analysis

Community Health Wor ers !anual Section:Non :ormal %ducation# $anguage: %nglish# &opic:Non :ormal %ducation &ools Page: 1-

Some e=amples o* teaching methods

3isual learners 'learn by seeing( Pictures Charts ?raphs -emonstrations Skits 'performe by others( %etaphors Analogies Au itory learners 'learn by listening( ;ectures -iscussions 8rainstorming .inaesthetic learners 'learn by oing( Han s on activities Skits -ramati$ations -emonstrations Creating charts ?ames Pu$$les 8oar games -emonstration games Such as games that sho" ho" H&3 affects the bo y

To be most effective, use at least one metho from each group 'au itory, visual, an kinaesthetic( per session. @ou shoul have the message repeat in each metho . That "ay, everyone "ill learn the same material in the "ay that best suits them. @ou nee to change up "hat you are oing at regular intervals to keep the au ience attentive @ou nee to get the au ience to participate often. That "ay they are actively involve , making the learning e=perience more memorable Start "ith a "arm:up &ntro uce the key concepts an information #ngage the au ience -o an activity that reinforces the information After the activity, iscuss the activity an revie" "hat happene Wrap up the session "ith a revie" an a fun activity

Community Health Wor ers !anual Section:Non :ormal %ducation# $anguage: %nglish# &opic:Principles o* adult education Page: 1/

Principles o* Adult %ducation

A ults e=pect to be treate "ith respect an recognition A ults "ant practical solutions to real life problems A ults can reflect on an analyse their o"n e=periences A ults can be motivate by the prospect of fulfilling personal nee s As "ith everyone else, ifferent a ults learn in ifferent "ays A ults nee support from their peers A ults nee to communicate their feelings in culturally appropriate "ays A ults are capable of making their o"n ecisions A ults are capable of taking charge of their o"n evelopment 8ehaviour change can be a challenge for them They nee to be taught the same thing repeate ly for it to stick in memory They e=pect an "ant the presenter to be, or at least seem, authoritative on

the sub!ect at han

A ults shoul be involve in the presentation A ults have a lot of time commitments, so keep presentations an trainings

as short as possible

%ake the presentation fun an en!oyable

Community Health Wor ers !anual Section:>eha(iour Change# $anguage: %nglish# &opic: >eha(iour Change Page: 10 What is >eha(iour change; The process by "hich one goes from one behaviour or habit to another 7sually one goes from a habit that is not con ucive to a healthy life to one that is con ucive to a healthy life &t usually takes a long time. 8ehaviour change oesnAt happen over night Bor successful behaviour change to occur, the person must haveC #ncouragement from frien s 0ecognition of the benefit of the ne" behaviour %ust fin "ays to cope "ith the stresses of the change Ways to prevent a relapse 'returning to the ol habit( Persistence Want to change %ake the effort to change ?oo reasons to change &he Stages o* >eha(iour Change: +.Pre:a"arenessC not reali$ing that there is a nee for change ).A"arenessC recogni$ing the nee for change ,.Planning the changeC etermining "hat nee s to change an ho" to go about the change D.8eginning to changeC starting to actively change by follo"ing through on the plan ma e in stage ,. 2.%aintaining the changeC continuing to o the behaviour E.&nternali$ing the changeC the change has become part of every ay life &hings that can pre(ent success*ul beha(iour change: Bear Thinking that Fit oesnAt matterF Peer pressure Work Stress Bamily an frien s ;ack of self "orth -ifficulty of the change ;ack of resolve Brustration ;ack of a support net"ork Criticism from the community

Community Health Wor ers !anual Section:>eha(iour Change# $anguage: %nglish# &opic: +esigning *or >eha(iour Change Page: 11 &he >eha(iour Change :rame3or A "ay to esign interventions that "ill promote behaviour change Some ?ey &erms: >eha(iour: An action that someone oes regularly A habit 9ften one "ithout thinking >eha(iour Statement: A statement of "hat you "ant people to o at the en of your pro!ect &t is a specific behaviour you "ant to promote &t specifies a goal &t is measurable &t contains a ate "hen you "ant to complete your task &t e=plains the benefit of the ne" behaviour &t etails "ho you are targeting Priority .roup: Who you are targeting &t is a specific group of people, such as chil ren un er 2 years of age @ou shoul think about "hat this group "ants Sometimes, if you are targeting people "ho are unable to make their o"n ecisions 'such as infants younger than +) months(, your priority group "ill be the group most responsible for the group you are targeting "n*luence .roups: These are the groups that have a big influence on the priority groups behaviour an ecisions These can inclu e peers, parents, el ers, teachers, co:"orkers, etc @ou shoul think about "hat this group "ants for the priority group +eterminants: These are the key factors that greatly influence the success of the behaviour change These are general things Some e=amples Social norms Perception of pro!ect efficacy Access etc Actions: What you "ill o to encourage behaviour change The actions shoul a ress the eterminants The actions shoul be irecte to"ar s the influence groups an priority groups

Community Health Wor ers !anual Section:>eha(iour Change# $anguage: %nglish# &opic: Sample +>C Page: 12

Designing for $ehaviour Change !ample

$ehaviour !tatement #o promote health throu(h proper sanitation, ,0D o" chil%ren in :imbu=a 2illa(e =ill use the pit latrine e?clusi2ely 8not the bush9 by Culy 2012 Priorit" Group Chil%ren in :imbu=a 2illa(e #hey =ant to be healthy so they can play Influencing Groups Parents Peers >l%er chil%ren #eachers 'ran% parents .rien%s Determinants 6ocial norms Access Very "e= latrines in the entire 2illa(e Many arenFt e2en in (oo% repair Actions 'o aroun% to each school to e%ucate stu%ents 'o to 2isit parents to e%ucate on proper sanitation &epair ol% latrines 1uil% ne= latrines

Community Health Wor ers !anual Section:!alaria# $anguage: %nglish# &opic: !alaria Page: 16 What is !alaria; %alaria is a parasite that attacks the bloo &t repro uces in the bloo , causing bloo cells to burst This bursting of bloo cells causes the symptoms &t is transferre from person to person through the female Anopheles Symptoms Hi(h "e2er Chills 6=eats 1o%y aches "ati(ue 'eneral malaise -ausea Vomitin( Achin( in the "ront o" the hea% 5iarrhoea

Note that these s"mptoms ma" not appear all the time% &nl" fever is a sure indication of a potential malaria infection% Pre(enting !alaria: 6leep un%er a mos<uito net e2ery ni(ht 6pray your house seasonally Aeep the area surroun%in( your house clear Co2er your cimbu;i Pre2ent stan%in( =ater 6tan%in( =ater is the i%eal place "or mos<uitoFs to bree% At ni(ht =ear lon( slee2es 5onGt lea2e "oo% unco2ere% &reating !alaria: $" you think you ha2e malaria, (o to the clinic imme%iately 'et a malaria test %one Check the status o" the test $" the test is positi2e, take an antimalarial me%icine such as Coartem as %irecte% Complete the entire course o" the me%icine 'et treate% "or any other health issues

Community Health Wor ers !anual Section:!alaria# $anguage: %nglish# &opic: !alaria Page: 18

&he !alaria $i*e Cycle: A person "ith malaria is bitten by a female anopheles mos>uito The mos>uito then carries malaria &t can transmit malaria, but it is unaffecte by it The malaria parasite enters the liver "here it matures When it matures, it e=its the liver an enters the bloo The malaria parasite then inva es bloo cells &n the bloo cell, the parasite repro uces The bloo cell bursts, releasing the ne" parasites These then enter the liver to mature The process continues until the malaria is treate or causes eath A mos>uito then bites the infecte person, starting the cycle over again

7ou are most li ely to get bitten by an anopheles mos@uito at night *rom about 22 hours to 1 hours# !alaria is most pre(alent during the rainy season< since the rain produces an ideal en(ironment *or mos@uitoes to multiply Antimalarial medicine destroys the malaria parasite in the li(er An added measure o* protection is to ta e prophyla=is *or malaria# &his pre(ents the parasite *rom e=iting the li(er and entering the blood# Note that " did not put this method under the Apre(enting malariaB section< as this is not an ine=pensi(e nor an a(ailable method *or people in Cambia# %(en in America< prophyla=is is e=pensi(e#

Community Health Wor ers !anual Section:H"4# $anguage: %nglish# &opic: H"4 Page: 20 What is H"4; $t stan%s "or 'uman Immunodeficienc" (irus $t is a 2irus that only a""ects humans $t attacks the bo%yFs immune system #his makes it easier "or other %iseases, calle% opportunistic infections) to in2a%e the bo%y an% cause sickness >2er time, the immune system becomes so =eak that e2en a simple %isease such as a col% =ill se2erely a""ect the bo%y $t is the opportunistic in"ections that kill, -># H$V :luids that &ransmit H"4 8loo Semen 8reast milk 3aginal flui s

Ports o* %ntry Dho3 H"4 can enter the body9 %ucus membranes an soft tissues Tip of the penis 3agina Anus /ose %outh eyes Cuts an "oun s Tattooing Piercing Shaving Cuts from knives, etc. Sores This is "hy ST&s greatly increase the transmission of H&3. %any ST&s cause sores. Common 3ays o* getting H"4: Sharing nee les 'for tattooing, rugs, etc.( 8reastfee ing At birth from the mother #=change of bloo 'e.g. a octor treating a patient "ith H&3 "ho has a cut( 7nprotecte Se= Anal 9ral vaginal

Community Health Wor ers !anual Section:H"4# $anguage: %nglish# &opic: H"4 Page: 21

'I( Progression
1200

C5 ) Count H$V H$V Antibo%ies

1000

+00

000

)00

200

0 Win%o= Perio% 1e"ore in"ection 0 months Honeymoon Perio% 8latency9 2 2)H years A$56 /n%

Community Health Wor ers !anual Section:H"4# $anguage: %nglish# &opic: H"4 Page: 22 &he Stages o* H"4 Win o" Perio ;asts up to , months after e=posure The bo y has not ha time to make antibo ies yet 8ecause of this, the stan ar H&3 test "ill sho" a false negative 'it "ill say that you are negative "hen you actually have H&3( H&3 is multiplying rapi ly in your bo y @our C-D cells are >uickly ying At this stage, you are e=tremely infectious Honeymoon Perio 'Asymptomatic Perio ( @ou begin to pro uce antibo ies H&3 is controlle by the immune system @ou are not very infectious This can last from E months to over +* years The stronger your immune system, the longer it "ill last &f you engage in healthy behaviour, such as sanitation an a proper iet, you can e=ten this perio @ou o not have any ma!or symptoms An H&3 test "ill be positive 9ver time, though, H&3 egra es the immune system A&-S 9nce your C-D Count rops belo" ,2*, you have A&-S @ou e=perience opportunistic infections @our immune system is compromise To e=ten your life an help you live better, you "ill nee to take Antiretroviral me ication 'A03s( They help suppress H&3 to allo" your immune system to recover They can have serious symptoms, but over time they prevent the si e effects of H&3 9nce you start, you take them for the rest of your life @ou nee to take your me ication at the same time every ay as per the octors instructions. &f you onAt, it "ill not "ork an "ill make H&3 resistant to the me icine &t is critical that you engage in habits that strengthen the immune system 9ver time, if you are on A03s, you may re uce H&3 to the point "here you onAt have any symptoms an your C-D count returns to normal This is the stage "here you are most likely to succumb to an opportunistic infection @ou are very infectious at this stage

Community Health Wor ers !anual Section:H"4# $anguage: %nglish# &opic: H"4 Page: 2&he immune System

The immune system protects the bo y by targeting the bacteria, viruses an parasites that cause sickness There are several specific cells that operate in the immune systemC

C-D cellsC these are the coor inators of the other cells. They i entify the isease, call T6 cells that pro uce antibo ies. These are also your White bloo cells T6 cellsC these are the factories that pro uce antibo ies. These have to be calle by C-D cells an tol "hat antibo ies to pro uce. Cytoto=ic cellsC these are the first to respon to the isease. They kill everything in an aroun the point of infection. As a result, they estroy parts of the bo y as "ell as the isease. They help prevent the sprea of the isease "hile antibo ies are pro uce Antibo iesC these are cells that are ma e specifically to counteract a particular isease. They only attack that isease an they stay in the bo y for a long time.

3accines trick the bo y into creating antibo ies, helping to prevent that isease /e" born chil ren o not have any antibo ies. As a result they are particularly vulnerable. This is "hy a mother must breastfee soon after birth so that she can give her chil some of her antibo ies. This initial efence allo"s the chil Fs immune system to gro" stronger.

When your C-D count rops belo" )** cells per millilitre of bloo , you have evelope A&-S &f the immune system is not able to fin things to efen the bo y against for a "hile, it may start to attack the bo y or to treat more common things like groun nuts like a isease.

This only occurs if the in ivi ual sterili$es everything possible. This is not a problem in Zambia, but in evelope nations such as America, this is becoming a concern

Community Health Wor ers !anual Section:H"4# $anguage: %nglish# &opic: H"4 Page: 2/ H"4 in the >ody: &.H&3 enters the bo y &&.H&3 enters C-D cells &&&.C-D cells are force to make ne" H&3 &3.After a time, the ne" H&3 burst out, killing the C-D cell 3.Then the H&3 enter ne" C-D cells 3&.9ver time, H&3 sprea s faster than the C-D cells can pro uce antibo ies. This is because the fe"er C-D cells, the fe"er antibo ies an thus more H&3 is pro uce . A)4s When you evelop A&-S, you nee Antiretroviral me ication to help your bo y suppress H&3 an to strengthen the immune system. A03s suppress the pro uction of H&3 in a variety of "ays They %7ST be taken at the SA%# T&%# #3#0@-A@ for the rest of your life &f you onAt take them regularly, H&3 may become resistant. There are , tiers of A03 Therapy. Tier + is the most mil , an tier , is the harshest on your bo y They have potent si e effects, "hich is "hy octors "ill not prescribe them to one "ho has a C-D count above D** or for one "ho has no symptoms. /ote that A03s -9 /9T C70# H&3G Pre(enting H"4 The A8Cs Abstain from se= 8e faithful to your partner 7se a Con om correctly every time you have se= &f you "ant chil ren, then you onAt nee a con om Also: -onAt share nee les .no" your H&3 status .no" your partners H&3 status -onAt engage in risky behaviour %en an 8oysC get circumcise This can re uce the risk of infection by up to 2*H H&3 positive %others "ho are breastfee ingC breastfee e=clusively for the first E months then give only other foo s. %i=ing breastfee ing an other foo s can create tiny tears in the oesophagus 'throat( an thus greatly increases the risk of mother to chil transmission H&3 positive %others elivering a babyC eliver your chil in a clinic an have it elivere 9/;@ by traine staff They are most e>uippe to prevent complications that can transfer H&3 into the chil uring birth

Community Health Wor ers !anual Section:H"4# $anguage: %nglish# &opic: H"4 Page: 20 Why are 3omen and girls more at ris ; Social reasons Women an girls have less access to information an e ucation Women an girls have less po"er in their relationships To say no to se= To insist on the use of a con om Poverty, many feel that they nee to e=change se= for money or things such as foo Cultural reasons -ry se= practices This creates friction "hich causes tears in the vaginal "all, thus increasing the risk Se=ual cleansing This can sprea H&3 if the one oing the IcleansingJ is H&3 positive @oung girls marry too young an thus have their first se=ual encounter too early The BA;S# i ea that one can be cure of H&3 by having se= "ith a virgin. This has cause many "omen to be rape by an H&3 positive male 8iological reasons The vagina has much, much more mucus membrane, greatly increasing the opportunity for the virus to enter the bo y Bemales receive more flui s uring se= &t is har er to see sores from ST&s in the vagina, thus making it more ifficult to recogni$e "hen the "oman is more vulnerable to infection 4oluntary Counselling and &esting D4C&9 3CT is voluntary 8efore you are teste for H&3, you are given information on H&3 an the test itself @ou are given a vice as to coping "ith a positive result Then you take the test. &t is often one in as little as +2 minutes &f you are negative, you are one &f it is positive, another test is taken to check the result &f that is positive, you have H&3 &f that is negative, a thir Ftie breakerF test is one &f that is positive, you have H&3, if not you are H&3 negative After the test, if you are positive, they "ill counsel you on "hat to o from here They "ill also provi e assistance in coping "ith the result They "ill instruct you on ho" to live positively

Community Health Wor ers !anual Section:H"4# $anguage: %nglish# &opic: S&"s Page: 21 What are S&"s Se=ually Transmitte &nfections Transmitte through se=ual intercourse an other forms of se=ual acts Can be cause by bacteria, fungus, viruses an the like Can greatly increase your risk of getting H&3 &f the ST& causes sores, the risk of getting H&3 greatly increases Some are mil an mostly frustrating, others can be ea ly Some can be cure , others can only be treate Common S&"s Cancroi s '8ola 8ola( Symptoms evelop D:K ays after infection Causes small boils "ith a lot of puss 8oils are very painful /o cure ?onorrhoea Symptoms evelop ):K ays after infection in males an ,* ays in females Symptoms in men @ello"ish ischarge from penis Pain "hen urinating S"elling of the scrotum Symptoms in "omenC @ello"ish ischarge from the vagina Pain "hen urinating Pain uring intercourse Pain in the ab omen Can lea to Pelvic &nflammatory -isease, "hich causes sterility Can be treate an cure Syphilis An ulcer "ill appear at the site of infection. This "ill heal "ithin a fe" "eeks. &t is clean an "ithout puss After 5:++ "eeks a rash on the bo y an gro"ths on amp areas of the bo y 'such as the groin or armpits( After years if untreate "ill affect the brain, heart an ki neys. Can lea to insanity an eath Causes ma!or birth efects in chil ren of infecte mothers Can be treate an cure

Community Health Wor ers !anual Section:H"4# $anguage: %nglish# &opic: S&"s Page: 22 Common S&"s Continued

Herpes 3ery contagious Symptoms appear ):)* ays after infection Symptoms occur in outbreaks of up to ) "eeks each The first outbreak is the most severe Skin on the infecte area "ill become re an sensitive Then blisters an bumps "ill appear 8listers may burst open &nfection is usually painful, an may burn, itch or tingle 9ther symptoms that may or may not appear S"ollen lymph glan s Hea ache %uscle ache Bever -ischarge from the vagina or penis 8urning uring urination 8urning feeling in the genitals ;o"er back pain 7p to E*H of people "ith herpes have no symptoms an are thus una"are that they are unaffecte , but they can still infect others /o cure

Community Health Wor ers !anual Section:Nutrition# $anguage: %nglish# &opic: Nutrition Page: 26 What ma es a meal nutritious; &t inclu es Protein to buil an rebuil the bo y &t inclu es carbohy rates, for short term an long term energy &t inclu es fats, for long term energy an to provi e a "ay to use certain nutrients &t inclu es nutrients, such as vitamin A an iron, to promote proper gro"th an to help the bo y fight isease &t inclu es fibre, to ai in igestion &t inclu es "ater, "hich is vital to all bo ily functions 9ur bo ies are K2H "ater &t cleans the bo y of to=ins &t helps the bo y to function

%=amples o* *ood 3ith 4ital nutrients

Protein
.ish meat 1eans soya

.at
(roun% nuts soya sala%i milk mabisi e((s li2er see%s "ish 1eans

Carbohy%rates -utrients
nsima soya milk mabisi (rains mai;e "lo=er s=eets biscuits "ruits su(ar "ruits 2e(etables soya (roun% nuts e((s li2er milk mabisi "ish meat .orti"ie% "oo%s

.ibre
"ruits 2e(etables soya mai;e Whole (rains &oller meal

Water
#reate% =ater "ruits 2e(etables milk *uices tea

(roun% nuts milk mabisi e((s

#emember:
'>: the "oo%s that (i2e you ener(y '&>W: the "oo%s that help you (ro= an% rebuil% your bo%y ':>W: the "oo%s that help keep your bo%y =orkin( =ell an% pre2ent %isease

Community Health Wor ers !anual Section:Nutrition# $anguage: %nglish# &opic: 4itamin A Page: 28 4itamin A

All chil ren nee 3itamin A for proper gro"th an goo health Helps fight isease Can be foun inC

8reast milk 9range an yello" fruits S"eet potatoes ?reen vegetables #ggs ;iver Bish %ilk

9ver cooking estroys 3itamin A 9ur bo ies onAt pro uce 3itamin A4 "e nee to get it through our foo %others nee to receive a vitamin A supplement "ithin + month of giving

birth

Chil ren E months to E years shoul get vitamin A supplements t"ice a year Chil ren nee e=tra vitamin A if they haveC

-iarrhoea %easles #ye iseases or infections %alnutrition

Community Health Wor ers !anual Section:Nutrition# $anguage: %nglish# &opic: 4itamin > Page: -0 4itamin >

#veryone nee s 3itamin 8 for proper gro"th an goo health Helps fight isease /ee e for goo skin, hair an muscle /ee e for metabolism 'turning foo into energy( Helps "ith brain evelopment an maintenance

Too little for too long can result in brain problems

Helps prevent Pancreatic Cancer Can be foun inC

;iver %eats, especiallyC

Turkey Tuna

Whole grains 8eans 8ananas ;entils

9ver cooking estroys 3itamin 8

Community Health Wor ers !anual Section:Nutrition# $anguage: %nglish# &opic: 4itamin C Page: -1 4itamin C #veryone nee s 3itamin C for proper gro"th an goo health Helps fight isease &t is an antio=i ant 'helps prevent the bo y from breaking o"n( /ee e for many vital bo ily functions &t is crucial to many chemical reactions in the bo y /ee e for metabolism 'turning foo into energy( Helps "ith brain evelopment an maintenance Too little for too long can result in brain problems Helps prevent lung iseases Prevents scurvy Can be foun inC ;iver %eats, especiallyC Turkey Tuna %any vegetables %any fruits &t is foun in high >uantities inC ?uavas Chilli peppers 'piri piri( 9ranges ;emons %angos ;imes 9ver cooking estroys 3itamin C

Community Health Wor ers !anual Section:Nutrition# $anguage: %nglish# &opic: 4itamin + Page: -2 4itamin + #veryone nee s 3itamin - for proper gro"th an goo health Helps maintain bones &t is vital in young chil ren because it is vital for goo bone gro"th The bo y is able to pro uce 3itamin &t is pro uce in the skin When you are out in the sun, the bo y uses the suns energy an light to make 3itamin &f you are outsi e for several hours a ay, your bo y makes enough &n places "here the sun is very strong, inclu ing Africa, &n ia, parts of Asia an South America, the bo y pro uces more than enough. People "ith arker skin nee more sunlight to pro uce the same amount of 3itamin -. This is because arker skin protects the bo y from 73 ra iation from the sun. 9ver time, people living in areas of stronger sun evelope arker skin, since their bo ies coul pro uce enough 3itamin - an because they nee e more protection from the 73 ra iation. People living in areas of "eaker sun 'such as /orthern #urope an 0ussia( over time evelope lighter skin, since they nee e less protection from 73 ra iation, but also nee e more sunlight to pro uce enough 3itamin @oung chil ren an ol er "omen nee more 3itamin 3itamin - is nee e for goo heart health A lack of it can lea to breathing problems such as asthma A lack can lea to %ultiple Sclerosis &t helps the immune system &t is nee e for goo hair health &t is nee e to promote goo brain health Can be foun inC ;iver Bish Some types of plants 9ver cooking estroys 3itamin -

Community Health Wor ers !anual Section:Nutrition# $anguage: %nglish# &opic: 4itamin % Page: -4itamin %

#veryone nee s 3itamin # for proper gro"th an goo health Helps fight isease /ee e for goo skin, hair an muscle /ee e for the bo y to repair itself /ee e in many vital chemical processes in the bo y Helps "ith brain evelopment an maintenance

Too little for too long can result in brain problems

Can be foun inC

;iver Bish Papaya %ango Tomatoes /uts Sunflo"er oil Palm oil Avoca os Pumpkin

9ver cooking estroys 3itamin #

Community Health Wor ers !anual Section:Nutrition# $anguage: %nglish# &opic: "odine Page: -/ "odine

#veryone nee s &o ine for proper gro"th an goo health &t is vital in proper gro"th of chil ren /ee e for goo brain evelopment /ee e to prevent fatigue Too little of it causes evelopmental retar ation Too little of it can result in epression Too little of it can lea to cancer Too little of it can lea to obesity ' angerously high bo y "eight an fat(

9besity can cause heart isease, lung isease an other iseases 9besity increases mortality 9besity re uces "hat the bo y can o 'ie it cant farm, lift much, move much, "alk long istances, etc(

Too much of it is also angerous

Too much of it can amage the thyroi , "hich is vital for metabolism an gro"th an evelopment.

This is "hy it is not goo to use io ine tablets to treat "ater for longer than ) "eeks every E months

Bor most people in Zambia, this is not a problem

Can be foun in io i$e salt 'all salt manufacture in Zambia for the general

public, ie not coarse salt(

Community Health Wor ers !anual Section:Nutrition# $anguage: %nglish# &opic: "ron Page: -0 "ron

#veryone nee s &ron for proper gro"th an goo health &t is vital in proper gro"th of chil ren /ee e for healthy bloo Too little of it results in anaemia 'lo" bloo ( &t is vital in many chemical reactions in the bo y Too much of it is also angerous

&ron is a heavy metal 8ecause of this, it stays in the bo y for long perio s of time Too much of it can amage organs in the bo y Ho"ever, it is very ifficult for a typical Zambian to consume too much iron. &ron eficiency is a much greater concern in Zambia.

Can be foun in

-ark green vegetables %eat Bish 3ery goo sources inclu e

Spinach 0ape ;iver 8eef

Community Health Wor ers !anual Section:Nutrition# $anguage: %nglish# &opic: Calcium Page: -1 Calcium

#veryone nee s Calcium for proper gro"th an goo health &t is vital in proper gro"th of chil ren /ee e for bone formation an repair /ee e to buil parts of the bo y, such as cartilage an ten ons /ee e for healthy finger an toe nails Too little of it can result in bone eformations Too little of it can lea to brittle bones Chil ren an ol er "omen nee more calcium

Chil renFs bones are gro"ing very >uickly 9l er "omen nee more to maintain the bones they have

&f they o not, they "ill have brittle bones an "ill shrink over time

Can be foun in

-ark green vegetables 0ape Spinach -airy pro ucts

%ilk %abisi Cheese @oghurt

Community Health Wor ers !anual Section:Nutrition# $anguage: %nglish# &opic: Phosphorus Page: -2 Phosphorus

#veryone nee s Phosphorus for proper gro"th an goo health &t is vital in proper gro"th of chil ren /ee e for goo gro"th of all bo y parts

8ones Teeth Skin %uscle #verythingG

/ee e to prevent fatigue Too little of it causes evelopmental retar ation &t is vital in metabolism 'turning foo into energy( Can be foun in many things

%eats Bish /uts Bruits an vegetables %ilk Whole grains

?enerally, if you are getting enough protein an calcium in your aily iet, &t is very ifficult to consume too much

you are getting enough phosphorus

&t is nee e in most processes in the bo y #=cess is gotten ri of through the urine

Community Health Wor ers !anual Section:Nutrition# $anguage: %nglish# &opic: Soya Page: -6 Soya

Soya is a very protein rich an healthy foo &t has a very goo ratio of protein to fat to carbohy rates &t is high in all vital nutrients, inclu ing fibre an vitamins &t is cheap an easy to gro", especially in Zambia &t can be turne into a large variety of foo s As a bean, gro"ing it helps improve the soil Preparing soyaC

Separate the soya from irt, etc 87T -9 /9T WASH @#T 8oil "ater an put the soya into it 'D cups "ater to + cup soya( 8oil for ,* minutes 0emove beans from the "ater -ump the "ater Wash the soya in col "ater /o" you can mash the soya, poun to po" er, an @ou can a it to mealie meal "hen making nshima o many other things

Community Health Wor ers !anual Section:Nutrition# $anguage: %nglish# &opic: :ood Security Page: -8 What is *ood security Having enough foo to last the entire year an be healthy 'not malnourishe ( Provi ing a regular supply of nutritious foo for your family Having foo even "hen there is a rought or frost or other things that cause crop loss

Ho3 it 3or s -uring times of plenty, preserve an store e=tra foo for the hungry season Bin ing "ays to use seasonal resources to get nutritious foo ?ro"ing a gar en 0otating crops to promote fertile soil Creating irrigation systems to "ater crops uring ry seasons ?ro"ing crops that are best suite to the "eather an environment Planning ahea to the rest of the year /ot eating or rinking all of the foo at harvest time /ot rinking your income after you sell your crops

Ways to preser(e *ood Canning foo -rying foo 9n the roof &n a solar ryer 9ver a fire Putting foo s like meats in a brine 'salt "ater solution( to preserve it Store foo in a cool ry place that cant be broken into by ro ents or other animals

Community Health Wor ers !anual Section:Water and Sanitation# $anguage: %nglish# &opic: +iarrhoea Page: /0 +iarrhoea When a person passes a 2ery =atery stool $" there is bloo%, this may be %ysentery an% the person must (o to the clinic imme%iately :ea%s to %ehy%ration an% a loss o" salts an% other 2ital nutrients Can cause massi2e =ei(ht loss $" untreate%, can cause %eath Causes 6ome %iseases Contaminate% =ater Contaminate% "oo% @n%ercooke% "oo% 6poilt "oo% /?treme stress A %rastic chan(e in %iet

Pre(ention Wash your han%s be"ore eatin( Wash your han%s a"ter usin( the cimbu;i Wash your han%s be"ore an% a"ter cookin( or preparin( "oo% #reat =ater that you %rink Cook "oo% thorou(hly 'et ri% o" spoilt "oo% .in% =ays to re%uce stress i" nee%e% #reat the %iseases causin( %iarrhoea Pre2ent %iseases that cause %iarrhoea 5rink plenty o" =ater that has been treate%

&reatment Consume 9ral 0ehy ration Salts '90S(, available at the clinic &f it persists for more than a ay, go to the clinic imme iately 0est -rink plenty of "ater #at normally !a e your o3n E)S 1E1oil or treat =ater 2EWhen the =ater is coole%, mi? to(ether =ell:: 1E 1 litter o" the treate% an% coole% =ater =ith 2E I spoon o" salt =ith !E 0 spoons o" su(ar !EHa2e the person =ith %iarrhoea %rink as much as they can slo=ly 1E #his makes it easier to absorb )E5ispose o" any le"t o2er >&6 at the en% o" the %ay

Community Health Wor ers !anual Section:Water and Sanitation# $anguage: %nglish# &opic: >asic Sanitation Page: /1 Why proper sanitation is important: &t prevents iseases Cholera -ysentery -iarrhoea Boo poisoning #ye infections #.coli 3arious bacterial an fungal iseases Some parasites 8ilhar$ia &t prevents the sprea of isease to others What is needed *or proper sanitation in the (illage: Cimbu$i in goo repair at least 2* meters from the house Han "ashing station ne=t to the cimbu$i 8athing shelter -ish rack Protecte "ater sources 'sources that are protecte from contamination( Trash pit 'at least ) meters eep, 2* meters from the closest "ater source( What you need to do *or proper sanitation in the (illage 7se the cimbu$i only to pass a stool or to pass "ater Cover the cimbu$i Put ashes in the cimbu$i perio ically This helps sterili$e the cimbu$i an greatly re uces the smell Wash your han s before an after cooking "ith soap -ry your ishes on a ish rack Treat your "ater before you rink it Wash your han s before an after you eat "ith soap Wash your han s before an after using the cimbu$i "ith soap Cook your foo thoroughly &he Eral :aecal cycle

*ingers *aeces *luids flies *ields *ood Ne+ 'ost ,"ou-

#elationship $et+een .ater Problems and Disease

What Water 1orne :ack o" =ater Water base% Water relate% &elation to Water Carrie% by =ater -ot ha2in( enou(h =ater "or proper hy(iene Part o" the li"e cycle o" a parasite is in =ater $nsects that carry %isease bree% in =ater !ources of Contamination /?amples

Community Health Wor er !anual Section:Water and Sanitation# $anguage: %nglish# &opic: +iseases related to Water Page: /2

5iarrhoea, %ysentery, cholera, (iar%ia /ye in"ection, rashes, scabies 1ilhar;ia, schistosomiasis Malaria, yello= "e2er

.aeces, "ertili;ers or a(ricultural chemicals enterin( the =ater source @sin( %irty containers to store =ater 1athin(, urinatin(, %e"ecatin( in =ater sources @sin( %irty or communal cups to %rink =ater 6torin( =ater "or a lon( time Protection of +ater sources preventing contamination b" minimi/ing human and animal contact +ith sources of drinking +ater .ells 1, meters "rom latrines 5eep enou(h to not %ry up &aise% concrete slab an% plat"orm 1ucket an% co2er Clear surroun%in(s #ivers and streams Collect =ater "rom upstream, =ash an% bathe %o=nstream, an% animals %rink at "arthest part o" the ri2er -e2er urinate or %e"ecate in or near the ri2er 0atrines 1, meters "rom =ater sources, , 0 meters %eep, =ell 2entilate% :ine =ell =ith brick an% cement .loor is a raise% concrete slab &oo" an% =alls ma%e o" %urable materials Has a co2er "or the hole Ash put in perio%ically #ubbish Pits 20 meters "rom the house 00 meters "rom =ater sources 1 or more meters %eep

Community Health Wor ers !anual Section:Water and Sanitation# $anguage: %nglish &opic: Water &reatment Page: /&he importance o* Water &reatment &t kills isease causing bacteria an parasites &t makes the "ater taste better The "ater is clearer Cooking "ith treate "ater is less amaging to your pots an pans Boo cooke "ith treate "ater tastes better &t prevents iarrhoea an many other iseases Water treatment methods 8oiling "ater /o chemicals nee to be a e Sterili$es the "ater if boile for , minutes or more 0e>uires time to cool 0e>uires fuel for the fire Water shoul be filtere through a citenge if there is a lot of irt in the "ater first Putting chlorine in the "ater A little goes a long "ay /o nee to cool the "ater /ee to keep the chlorine in a cool, ark place /ee to shake "ell /ee to "ait ,* minutes before use &f you use too much the "ater "ill not taste goo Water shoul be filtere through a citenge first if there is a lot of irt in the "ater Purifying the "ater "ith the sun Works best in the ry seasons Bill clear plastic bottles "ith "ater Put the bottles in the sun for +) hours 'full sun( or ) ays 'partly clou y( Time consuming Water nee s to cool before use Putting in io ine tablets Can only be use for ) "eeks every E months to avoi thyroi amage %akes the "ater murky Has a metallic after taste Har to fin io ine tablets 0e>uire ,* minutes before use

Community Health Wor ers !anual Section::amily Planning# $anguage: %nglish# &opic: :amily Planning Page: // What is :amily Planning; Planning "hen you have chil ren 'if any( Planning ho" many chil ren to have 'if any( Planning "hen to start having chil ren 'if any( Why is this important; &t helps the mother heal bet"een births &t empo"ers the mother to eci e "hen she has chil ren &t helps the chil live a healthier life &t allo"s the father to "orry less about provi ing for his family Child spacing Spacing the time bet"een consecutive births A family shoul "ait at least , years after the birth of their latest chil before conceiving another This allo"s the mothers bo y to completely heal &t makes it easier for the family to provi e for the chil uring the crucial first ) years &t gives the mother an father time an energy to a e>uately raise the chil Women should not concei(e a child >%:E)% age 16 nor A:&%) age -0 8efore age +6, a "omanFs bo y is not fully evelope . As a result, the stress of pregnancy an birth can o serious amage to her bo y, an conse>uently harm to the chil as "ell After age ,2, a "omanFs bo y becomes more vulnerable to the stress of chil birth. &f a "oman starts having chil ren at age +6 an spaces her chil ren , years apart, by age ,2 she can have as many as K chil ren :amily PlanningFcontracepti(e methods 0hythm1natural metho C timing "hen to have se= base on a "omanFs menstruation cycle so as to prevent conception AbstinenceC not engaging in se=ual intercourse. +**H effective Con om useC using a con om correctly "hen you onAt "ant to conceive a chil . 55H effective 9ral contraceptiveC a pill taken every ay that alters a "omanFs hormonal balance, preventing menstruation an thus eliminating the possibility of conceiving a chil &n!ectionC a me icine in!ecte un er the skin that acts like the oral contraceptive, but each in!ection lasts about E months ;actation metho C "hen a "oman is breastfee ing a chil , she is much less able to conceive 3oluntary sterili$ationC an operation that ren ers the in ivi ual sterile. %en have a 3asectomy an "omen have a Tubular ;igation

Community Health Wor ers !anual Section:tuberculosis D&>9# $anguage: %nglish# &opic: &> Page: /0 What is &uberculosis; A bacterial airborne isease that affects the lungs &t is highly contagious People "ith H&3 are more susceptible to contracting it Symptoms /ight s"eats Significant "eight loss Cough lasting over ) "eeks Sometimes bloo may be coughe up ;oss of appetite Batigue Weakness Bever Chest pains

&reatment Pills that must be taken for K:5 months Treatment must be complete to "ork Bollo" the irections given to you by the octor prescribing the treatment &f one person in a househol is iagnose "ith tuberculosis, everyone must be treate for tuberculosis To prevent infecting others, the person un ergoing treatment shoul be >uarantine from others uring the course of the treatment

Pre(ention %ake sure your home is "ell ventilate & entify patients as early as possible Treat patients as early as possible Luarantine those "ith tuberculosis from others to prevent infecting others Treat patients completely an properly Train tuberculosis supporters Train tuberculosis patient caretakers

Community Health Wor ers !anual Section:Positi(e $i(ing# $anguage: %nglish# &opic: Positi(e $i(ing Page: /1 What is Positi(e $i(ing; -eveloping an maintaining habits that promote a healthy life Positive living helps people living "ith H&31A&-S to live longer an live better by increasing the bo yFs immune system as much as possible naturally Positive living incorporates "ays to prevent H&3 "t includes: A Positi(e Attitude' ?oo nutrition ?etting enough energy ?etting enough protein ?etting enough vitamins an minerals People "ith H&3 nee more energy an nutrients to stay healthy 0egular e=ercise #=ercise that is challenging but not stressful on the bo y Try for ,* to E* minutes D:E times a "eek &nclu es "alking, biking, s"imming, etc. Proper sanitation Support net"ork of family an frien s A group of people "ho are there to support an encourage you A group that makes sure you a here to positive behaviours, such as taking your A03s on time People "ho can a vocate for you to re uce stigma Habits that prevent an re uce the risk of H&31A&-S &f the person must take Antiretroviral Therapy 'A03s( they must take their me ication on time every ay consistently &f you have H&3, going to get your C-D count 'the number of C-D cells per millilitre of bloo , usually from 6** to +***( measure perio ically This number "ill etermine "hen 'if( you nee to go on A03s an "hat stage of the isease you are in ?oing to the clinic on a regular basis for a check up ?oing to the clinic to treat any isease that you feel you have Treating all iseases Preventing iseases from progressing to a stage that can be ifficult to treat Accepting your status Bin ing "ays to cope "ith stress, an=iety an epression ?oing for 3oluntary Counselling an Testing to etermine your status Having your partner's( go for testing as "ell &nforming your partners of your status .no"ing your partners status &f you are une=pecte ly e=pose to H&3 'through rape, etc.(, going to get Post #=posure Prophyla=is "ithin K) hours to prevent H&3

Community Health Wor ers !anual Section:Child Health and Nutrition# $anguage: %nglish# &opic: Child Health and Nutrition Page: /2 Causes o* !alnutrition in Children -isease /ot enough 3itamin A /ot enough &ron /ot enough &o ine /ot enough protein /ot enough energy

Ways to pre(ent malnutrition Brom birth to E months, breastfee only. Bee the chil "henever he1she is hungry ' uring the first E months, this "ill be about +* times a ay( After E months, breastfee an give other soft foo s 2 or more times a ay up to ) years After ) years, fee only regular foo , still 2 times a ay &f the mother is H&3 positive, onAt mi= breastfee ing an other foo s as this increases the chance of infecting the chil The breast milk that the mother pro uces right after birth, calle Colostrum, is vital in boosting the chil Fs immune system imme iately. -9/T ?#T 0&- 9B &TG &t is rich in antibo ies that prevent isease an also rich in the nutrients that the chil nee s right after birth ?et all immuni$ations an supplements specifie in your chil Fs Chil Health Car "hen specifie Weigh your chil regularly at the 7n er 2 clinics to make sure they are not un er"eight !alnutrition +iseases %arasmusCcause by a lack of all nutrients 'not enough energy, protein, vitamins etc.( Fol personF face 3ery lo" birth "eight 3ery un er"eight #=treme "aisting &rritable Bretfulness Hunger Pot belly ."ashiorkorC /ot enough protein S"ollen legs, arms an belly Fmoon faceF Thin hair %isery Apathy Peeling skin ;o" "eight

Community Health Wor ers !anual Section:Child Health and Nutrition# $anguage: %nglish# &opic: Child Health and Nutrition Page: /6 !alnutrition Continued 3itamin A -eficiencyC not enough vitamin A Causes night blin ness Stunte gro"th Weak immune system AnaemiaC not enough iron Flo" bloo F Weak Tire Pale gums White fingernails Sometimes light hea e ness Ether ma5or childhood diseases -iarrhoea -ehy ration is a ma!or concern Weight loss &f it persists for over )D hours, go to the clinic &f breastfee ing, encourage the chil to breastfee more often -uring the first E months, the chil shoul not be given "ater to prevent ehy ration. 8reast milk is all they nee Bee them as usual, but also encourage them to eat more Cause byC Tainte "ater 7n ercooke foo /ot breastfee ing e=clusively the first E months Boo contamination ;ack of a e>uate sanitation Acute respiratory infections Bast breathing -ifficulty breathing Chest goes in "hen the chil breathes 7nable to rink Cause byC Poor ventilation #=posure to ust #=posure to col %alnutrition /ot being breastfe enough TA.# @970 CH&;- T9 TH# C;&/&C &%%#-&AT#;@

Community Health Wor ers !anual Section:Child Health and Nutrition# $anguage: %nglish# &opic: Promoting Child Health Page: /8

.a"s to Promote Good Child 'ealth

$reastfeeding 8reast milk is the best foo for a baby /othing else is nee e to fee chil ren up to E months of age The first milk, calle colostrum, is 3&TA; for the health of a ne" born infant. A vantages Bree an al"ays available Clean an safe Contains antibo ies "hich helps protect against isease 8rings mother an chil closer together Successful breastfee ing 8egin imme iately after birth Wean babies slo"ly from breastfee ing /ee to keep their breasts an han s clean "ith soap Bee fre>uently especially "hen the chil is hungry Continue until the secon year or later 1nder 2 Clinics ,1CI All chil%ren shoul% (o to @n%er , Clinics e2ery month "or immuni;ation an% "or (ro=th monitorin( $mmuni;ations: All chil%ren nee% 2accinations a(ainst: Polio, Measles, 5iphtheria, tetanus, #uberculosis 8#19, Whoopin( Cou(h $t is sa"e to immuni;e a sick chil% $mmuni;ations shoul% be complete% =ithin the "irst year Chil%ren =ho has not recei2e% all 2accinations are more likely to become sick, malnourishe%, %isable%, an% may e2en %ie .or the "irst , years o" birth, chil%ren nee% to be =ei(he% e2ery month #his allo=s the clinic sta"" to *u%(e i" your chil% is (ro=in( =ell or not Whether a chil% is un%er=ei(ht or not is the most important in%icator o" the health o" the chil% $" a chil% %oes not (ain =ei(ht "or 2 months, the parents nee% to be instructe% ho= to e""ecti2ely "ee% the chil% $" a chil% has =orms, you nee% to (i2e the proper me%icine to the chil%

Community Health Wor ers !anual Section:$i*e S ills# $anguage: %nglish# &opic:Peer %ducators Page: 00 Peer %ducators are role models *or good and bene*icial beha(iour selected by teachers *or their leadership potential# &hey help to train and in*luence positi(ely their peers in schools and in the community# Why use peer educators; A person is more likely to a opt a behaviour if they see their peers oing it A person is more likely to listen to "hat a peer has to say They can help solve problems in groups &t buil s self esteem in the peer e ucators &t teaches them valuable skill &t eases the bur en on the teachers to instruct stu ents Gualities o* good peer educators &nfluential ?oo listeners -epen able -iverse Concerne about others Have self confi ence Well like Sometimes those "ho have learne from making risky ecisions themselves Potential problems: #=tra time commitment -ifficulty maintaining motivation Potential for !ealousy amongst peers Can themselves become engage in risky behaviour /ot necessarily the most informe They leave the program &ips *or selecting peer educators &nvolve community lea ers Survey the community Ask stu ents "ho they go to "ith problems Ask for peers to nominate or choose peer e ucators %i= up the group Select from a variety of interests an backgroun s Select both boys an girls Select from ifferent gra e levels

Community Health Wor ers !anual Section:$i*e S ills# $anguage: %nglish# &opic:Peer Pressure Page: 01 What is peer pressure When a group of your peers encourage you to o or to not o something Can be one in many "ays #ncouragement Threats 9stracising those "ho onAt comply Popularity Can peer pressure be good; 7%S &t is beneficial "hen it encourages one to a opt beneficial habits ?oing to school 0especting others Helping others Working har etc. &f it is one in a respectful "ay &f it oes not threaten or harm others Can peer pressure be bad; 7%S When it encourages one to a opt risky or harmful habits -oing rugs Having unprotecte se= Skipping school -rinking 8ully others When it threatens or is harmful to others When it is one in a isrespectful "ay Ways people pressure others Put you o"n Argue Threaten 0easoning Changing the topic Saying that there is no problem #ncouragement Popularity

Community Health Wor ers !anual Section:$i*e S ills# $anguage: %nglish# &opic:Peer Pressure Page: 02

When do you listen to peer pressure; @ou must make your o"n ecisions ;isten to the people "ho are trust"orthy an respecte Ask someone you trust an "hose opinion you value for a vice -o things that are goo -o things that are goo for you -onFt o things !ust because someone sai to +ealing 3ith peer pressure Avoi those pressuring you Talk to someone for a vice ?et help from others Ask the person 'people( to stop 8e assertive 8e upfront "ith your concerns 8e respectful, but irect #=press your feelings #=press "hy you feel that "ay Ways to stop being pressured 0efuse -elay 8argain Stay on the topic if someone tries to change it Ask for "hat the other person feels about your response 8e respectful

Community Health Wor ers !anual Section:$i*e S ills# $anguage: %nglish# &opic:Communication Page: 0-

Ways people communicate 3erbally 8o y language -emonstrations Ask >uestions Ans"er >uestions ;istening to others ?ive an receive fee back Passi(e Communication ?iving in Apologi$e often Putting others first at the e=pense of yourself Avoi ing problems /ot e=pressing your feelings Taking it out on the "rong person Talking behin someoneFs back Sulking in silence Trying to forget the problem /ot "anting to hurt others Aggressi(e communication Borceful /agging Shouting &nterrupting #=plo ing in anger Persistent 0evengeful &ssue "arnings Putting yourself ahea of others 0eaching your goals at the e=pense of others 9verpo"ering others 8eing belligerent Threatening others

Community Health Wor ers !anual Section:$i*e S ills# $anguage: %nglish# &opic:Communication Page: 0/ A better 3ay o* communication is being Asserti(e #=pressing yourself in a respectful "ay &nforming other of your nee s an "ants in a respectful "ay Stan ing up for yourself /ot putting others o"n Confi ent but not pushy Staying balance #=pressing positive an negative feelings Proper self "orth ;istening an talking Staying calm 8eing rational /ot being confrontational, but also not allo"ing others to take a vantage of you Ho3 to be asserti(e:

/?plain your "eelin(s #he person tries to %istract you Make your re<uest 'et back on topic Make your re<uest Ask them about their opinions an% "eelin(s #hey accept #hank them &e"use #hey re"use

5elay

1ar(ain

Community Health Wor ers !anual Section:$i*e S ills# $anguage: %nglish# &opic:+ecision !a ing Page: 00

What are good decisions -ecisions that "ill benefit you -ecisions that help you to achieve your goals -ecisions that you "ill feel goo about later -ecisions that help solve problems -ecisions that others "ill respect -ecisions that make your frien s an family prou -ecisions that are moral -ecisions that are !ust -ecisions that a here to the la"s an customs of "here you live -ecisions that "ill remain goo in the long term !a ing good decisions Take a break from the situation -efine the problem Think about the problem Seek a vice from others ;isten an think about the a vice given Consi er personal an family values Consi er all the possible solutions Think about the potential outcomes for each potential solution Consi er ho" the ecision "ill impact others Choose the best alternative

Act on the ecision Take the conse>uences of the ecision you ma e Accept responsibility for your actions an ecisions ;earn from the conse>uences of the ecision

!a e the decision

Community Health Wor ers !anual Section:$i*e S ills# $anguage: %nglish# &opic:.oal Setting Page: 01

!a ing good goals %ake your goals specific %ake your goals oable %ake your goals timely %ake your goals measurable -etermine "hat you "ant to achieve in the future Think about ho" to accomplish that Plan ho" you "ill accomplish your goal Act on the plan -etermine ho" successful you "ere -etermine "hat "orke 0evise your goals an actions To make big goals, break them into smaller goalsC

P r o g r e s s

%N+

0egend
6maller (oals:

S&A)&
&ime

Community Health Wor ers !anual Section:$i*e S ills# $anguage: %nglish# &opic:Sel* %steem Page: 02

What is sel* esteem; When you kno" "hat you can an cant o When you feel like you can accomplish your goals A sense of purpose A sense of belonging A sense of self "orth &he importance o* sel* esteem &t is vital to ones mental health &t is vital to ones emotional "ell being &t is a key motivator to try things &t is a key motivator to persist through ifficulty &f you believe that you can o something, you are more likely to accomplish it >uilding sel* esteem 8eing recogni$e for your successes Accomplishing things Self kno"le ge ?etting encouragement from others Accepting failure, but not letting it control you Cycles o* esteem building

>uilding up /steem

>rea ing +o3n :o= esteem

&eco(nition

Positi2e 5isappointment attitu%e

-e(ati2e attitu%e

/ncoura(ement 6uccess

5iscoura(ement .ailure

Community Health Wor ers !anual Section:$i*e S ills# $anguage: %nglish# &opic:)elationships Page: 06 &ypes o* )elationships Baithful %onogamyC 9ne partner for your entire life This is the safest relationship in terms of ST&s an H&3 Serial %onogamyC 9ne partner at a time, but multiple relationships across ones lifetime. This can sprea H&3, but not as prolifically as in %ultiple Concurrent Partnerships or as se= "orkers relationships %ultiple Concurrent Partners '%CP(C %ultiple partners at the same time, "hether or not one is marrie . Can >uickly sprea H&3 PolygamyC Having multiple "ives Polyan ryC Having multiple husban s ?roup se=C Se=ual encounters "ith many people of a mi= of male an female PolyamoryC ;oving multiple people at one time Se= WorkersC Those "ho serve as prostitutes, escorts or as actors1actresses in pornography Percieve as the most risky, but because it is percieve as risky, con om use is common Homose=ual relationshipsC 8oth partners are of the same se= Heterose=ual 0elationshipsC Partners of both se=es 'one male an one female( Nonse=ual )elationships: Parent:Chil C The relationship bet"een ones parents an onself %utual love, parents nurture chil ren, chil ren pespect an honor parents SiblingC The relationship bet"een brothers an sisters Can be antagonistic, but often very close Brien shipC The relationship bet"een frien s %utual respect an love amoung e>uals ?ran parent:?ran chil C The relationship bet"een ones gran parents an oneself Collegues1Co"orkersC The relationship bet"een those "ho "ork "ith you %utual respect bet"een e>uals 8oss:Subor inateC The relationship bet"een ones boss an oneself Heirarchical relationship Chief:Sub!ectC The relationship bet"een a chief an a sub!ect Heirarchical relationship

Community Health Wor ers !anual Section:Conducting a health tal # $anguage: %nglish# &opic:Conducting a Health &al Page: 08 Conducting a health tal @ou nee to plan a health talk by ans"ering the follo"ing >uestions Who "ill you be speaking to. -ifferent au iences nee ifferent types of health talks. Bor instance, you "oul not give the same health talk to a ?ra e 5 class as you "oul to a group of mothers "ith chil ren un er 2 years of age Where "ill you con uct it When "ill you con uct it Ho" "ill you con uct it. Will it !ust be a lecture or "ill you involve some other teaching metho s. Also ho" "ill you present the information. %ake sure you kno" "hat information you "ill present Why are you con ucting the talk< What are you hoping to achieve by teaching it. @ou nee to have a specific goal or set of ob!ectives Bor "hat reason are you con ucting the health talk< What is the problem you seek to solve in the community by con ucting the health talk What "ill you be teaching< @ou nee to have a specific topic in min When con ucting a health talking, you nee to keep the talk to the length of time of your au iences attention span. This is often aroun + hour to 5* minutes. 8egin "ith a "arm up an an intro uction of the topic an the ob!ectives Set groun rules. Bor instance, if one "ants to talk they nee to raise their han s an be calle upon first. &f you are giving a talk that lasts ) or more hours, you nee to have a break every E* to 5* minutes. & eally this "oul be +*:)* minutes an "oul inclu e some rink like tea an a small snack like biscuits. At the en , "rap up "ith a revie" of "hat "as taught &f able, provi e han outs, note pa s an pens to make it easier for participants to take an keep notes &f you are making flip charts, make them ahea of time so that you are not al"ays "riting. %ake it clear that you e=pect people to arrive on time. This "ay you onAt have to "aist your time an your au iences time "aiting for others Bor gen er specific topics, it is often a goo i ea to separate the au ience into men an "omen Perio ically >ui$ your au ience to make sure they remember an kno" the information you have been teaching them.

What is it Preventing it ;iving "ith it %alaria What is it Preventing it /utrition Boo groups /utrients ?oo meals Chil Health /utrition Antenatal Proper gro"th 3accinations What are they Bor chil ren Bor everyone Bamily planning What is it %etho s 8enefits Water an sanitation &mportance of sanitation Water treatment Water borne iseases Ho" to live in a sanitary "ay ;atrines -ish racks Trash pits Han "ashing Tuberculosis What it is Ho" to prevent it Treating it Positive living ;ife skills ?oals Healthy behaviour Peer pressure communication

H&3

Community Health Wor ers !anual Section:Conducting a health tal # $anguage: %nglish &opic:Health &al &opics Health &al &opics Page: 10

Community Health Wor ers !anual Section:Con*identiality# $anguage: %nglish# &opic: Con*identiality Page: 11

What is con*identiality
/ot letting others kno" about something When asking about a personal health issue, you may not let anyone else kno" This makes your patients more "illing to tell you personal >uestions regar ing health 9ften you "ill nee these private etails to effectively treat them All health care professionals are re>uire to a here to this -ocumentation of a persons health history is only to be use for iagnosing a problem, obtaining emographic ata, it is /#3#0 to leave the clinic "ithout the patients e=plicit consent When con ucting e=ams, the results of those e=ams are never to be isclose to anyone other than that patients health care provi ers -isclosure of test results must be approve by the patient

What is the purpose o* con*identiality Confi entiality prevents people "ho o not nee to kno" personal information from obtaining personal information &t helps to reassure patients that any >uestions you nee to ask are for me ical use only &t helps encourage people to go to the clinic &t encourages people to go for H&3 an ST& testing, since they un erstan that the result "ill not be kno"n by frien s an family &n some countries, confi entiality is a legal man ate &f you break it, you "ill suffer criminal charges an possibly even a !ail sentence. &t buil s trust bet"een a health care provi er an a patient

Community Health Wor ers !anual Section:Appropriate &echnology# $anguage: %nglish# &opic: "ntroduction Page: 12

.hat is Appropriate Technolog"3

Appropriate technolo(y re"ers to easy to buil% an% use technolo(ies to make #hese technolo(ies are ma%e "rom rea%ily a2ailable materials in the 2illa(e #hey are o"ten lo= cost or e2en "ree #hey make li"e much better #here are se2eral pro*ects =hich can be use% in the 2illa(e that =ill impro2e Chlorine (enerator 6olar %ryin( 6olar =ater puri"ication #ippy tap 6oap creation

li"e in the 2illa(e better

health:

$" you use a little bit o" ima(ination an% in(enuity, you can %esi(n your o=n

appropriate technolo(ies

Community Health Wor ers !anual Section:Appropriate &echnology# $anguage: %nglish# &opic: &ippyH&aps Page: 11ranch Cap

&ope ,: 6ala%i Container Hole 6tick

6tep on the stick that is connecte% to the rope #he container =ill tip #his causes =ater to come out o" the hole As the =ater %rips %o=n, you can =ash your han%s #his allo=s you to =ash your han%s =ithout touchin( anythin( #his makes it much cleaner, an% thus pre2ents %isease MAA/ 6@&/ J>@ @6/ 6>AP A6 W/::K

Community Health Wor ers !anual Section:Appropriate &echnology# $anguage: %nglish# &opic: &ippyH&aps Page: 1/

!a ing the &ippy &ap Mark the location "or the hole on the container, aroun% 12 cm belo= the cap Hol% the nail =ith pliers, an% heat it =ith a li(hter4open "lame With the hot nail, make the hole in the container, an% a secon% hole in the cap Put the rope, =hich is attache% to the stick, throu(h the hole in the capE Make a knot in the rope =hich cannot pass throu(h the hole 6cre= the cap back on the containerE #he stick is no= connecte% to the container =ith the ropeE @sin( a scre=%ri2er, make a hole throu(h the soap by slo=ly rotatin( an% pushin( the scre=%ri2er throu(h the soap Put the secon% piece o" rope throu(h the hole in the soap, an% tie a piece o" =oo% to itE .ill the container =ith =ater, up to the le2el o" the holeE @sin( a sho2el4hoe4spear, put the poles in the (roun% to a %epth o" ,0cmE #he %istance shoul% be about 30 cmE Put the stick throu(h the han%le o" the container, an% put the stick bet=een the polesE A%*ust the len(th o" the rope such that the en% o" the stick is about 1,cm abo2e the (roun% #ie the rope =ith the soap to the stickE 1et=een the t=o poles, belo= the container, %i( a hole o" )0 ? )0 cm, an% 10 cm %eepE .ill the hole =ith (ra2elE #he =ater soaks a=ay in the hole, an% pre2ents a mu% hole "rom "ormin(E #he (ra2el also keeps mos<uitoes "rom bree%in(E Push the stick %o=n =ith your "ootE #his tips the container, =hich makes =ater run out o" the holeE Wet your han%s an% release the stickE Apply soap to your han%sE Push the stick %o=n a(ain an% clean your han%sE

Community Health Wor ers !anual Section:Appropriate &echnology# $anguage: %nglish# &opic: Solar Water Puri*ication Page: 10

1sing the sun "ou can treat "our +ater

@V &a%iation sterili;es the =ater #he =ater must be le"t out "or 12 hours in the sun on a clear %ay >n a clou%y %ay, it must be le"t out "or 2 or more %ays consecuti2ely #o set it up

#ake empty clear bottles an% =ash them #ake the label o"" the bottle .ill the bottles =ith =ater Put the bottles in %irect sunli(ht A"ter 12 hours 8sunny %ay9, it is %one >n clou%y %ays, you nee% to lea2e it in the sun "or 2 or more %ays consecuti2ely :et the =ater cool #rans"er the =ater to a clean an% secure container "or stora(e

Community Health Wor ers !anual Section:Alternati(e &echnology# $anguage: %nglish# &opic: Solar +rying Page: 11

What is Solar +rying; A "ay to preserve foo by rying it in the sun This is goo for fruits, vegetables, an even meats This is a "ay to store foo from times of plenty, such as mango season, for use later "hen the foo is scarce

Ho3 it 3or s Slice the foo into thin slices Put the slices ne=t to each other 87T /9T T97CH&/? #ACH9TH#0 on a flat surface that is elevate an in the sun ;eave the foo out in the sun till the foo is completely ry 9n clou y ays, you may have to take the foo back insi e for the night an return it in the morning Preferably, the surface is ark #levate the surface an make sure it is clean to prevent foo contamination &f possible, buil a solar ryer A shelter that protects the foo from contamination "hile allo"ing the sun to ry the foo ?enerally a solar ryer containsC A "oo en base that elevates it 8lack plastic on the back an si es of it -oors an clear plastic on the front Clear plastic on the top A fine netting or "ire mesh on the bottom They are easy to make They are the most sanitary "ay to ry foo s They can easily be customi$e to suit your nee &t can have multiple levels &t can be of any length, epth an height They are not e=pensive if local materials are use

Community Health Wor ers !anual Section:Alternati(e &echnology# $anguage: %nglish# &opic: Chlorine .enerator Page: 12 Procedure Put a teaspoon o" salt in 2,0ml =ater in a *ar, stir until salt %issol2esE $ntro%uce the t=o battery electro%e ro%s into the solution, the electro%e ro%s are the core o" the so"t cell Lti(er bran%M batteries =i%ely a2ailable across ZambiaE Clean them =ell be"ore useE Connect the ro%s to , 2olt current 82ia the cables an% batteries or cell phone char(er plu((e% into the =all9 Wait "or ten to "i"teen minutes Pour the resultin( solution into 20 : o" =ater, stir an% =ait "or !0 minutes be"ore %rinkin(E #he %esire% concentration o" chlorine a"ter a container o" =ater has been treate% is bet=een 0E2 an% ! parts per millionE #he recommen%e% amount o" chlorine solution "or =ater treatment is base% on a =i%e ran(e o" =ater <ualities, *ust as %oses are %etermine% "or commercial ChlorinE #hese <uantities are not set in stone ho=e2er, an% i" a particular =ater source seems especially contaminate%, consi%er ac<uirin( chlorine testin( strips an%4or per"ormin( a%%itional testsE

Community Health Wor ers !anual Section:&emplates# $anguage: %nglish# &opic:&emplates Page: 16

Using the &emplates #he "ollo=in( pa(es inclu%e templates "or se2eral 2ital "orms 6imply photo copy the pa(e8s9 as nee%e% 5o not be limite% by these templates $" nee%e%, make a ne= "orm or use another "orm

Community Health Wor ers !anual Section:&emplates# $anguage: %nglish# &opic: 4illage "nspection &emplate Page: 18

Community Health Wor ers !anual Section:&emplates# $anguage: %nglish# &opic: !onitoring and %(aluation &emplate Page: 20

Problem Goal Action Indicator of !uccess

Task Goal Due Date Achieved Comments

'oal

6tatus

&eason "or success or "ailure

Community Health Wor ers !anual Section:&emplates# $anguage: %nglish# &opic: Sample Action Plan Page: 21

Action Plan &emplate Goal Action Due Date Action #ar(et &esponsible Person #ime Materials

Community Health Wor ers !anual Section:&emplates# $anguage: %nglish# &opic: Asset $ist &emplate Page: 22

Asset $ist &emplate Asset Ano=le%(e 6kills Attitu%es &esources

Community Health Wor ers !anual Section:&emplates# $anguage: %nglish# &opic: +>C &emplate Page: 2-

Designing for $ehaviour Change Template

$ehaviour !tatement

Priorit" Group

Influencing Groups

Determinants

Actions