Community Health extends the principles of Public Health down to the households through proactive promotion of good health, and disease prevention and control. Communities are therefore vital resources and form part of the network of relations and support on which people rely when seeking health services. Community health complements primary health care by incorporating the element of strengthened referrals between community health and other levels of care.
As we continue to scale up the Community Health Assistants’ training programme, Ministry of Health, with support of its key stakeholders has reviewed and updated the Community Health Assistant curriculum so that it is responsive to the needs of our communities. It is my
sincere hope that this revised curriculum will provide the much needed guidance in the training of Community Health Assistants for many years to come and significantly contribute to a healthy and productive Zambian citizenry.
COURSE MODULES
AIM
To introduce the learner to the health care system in Zambia
OBJECTIVES
At the end of the module the learner should be able to:
1. Describe the organisation, concepts, principles and functions of the health care system
in Zambia
2. Explain the rationale, roles and responsibilities of a Community Health Assistant (CHA)
3. Describe the code of conduct of a Community Health Worker
CORE COMPETENCES
1. Describe the organisational structure within Zambia’s Ministry of Health
2. Describe the role of a Community Health Assistant in the health care system
3. Identify systems for collaboration and networking
4. Outline the code of conduct for Community Health Assistants
AIM
To strengthen the learner’s interpersonal communication and community engagement skills,
to promote the adoption of positive health behaviours among patients and community
members
OBJECTIVES
At the end of the unit, learners will be able to:-
1. Communicate effectively on various health issues
2. Describe appropriate local communication strategies
3. Describe communication barriers and how to overcome them
4. Identify priority health issues on which to mount local communication activities
5. Distribute print IEC materials
6. Identify partners in communication
CORE COMPETENCIES
Applies education through listening communication skills to properly communicate
effectively with clients and community members about individual needs, concerns and
assets.
Demonstrate behavioural changes communication skills to promote and sustain
behavioural changes.
Use standard knowledge of the effects of positive and negative behaviours, in order to
assist clients in adopting behaviours that are mutually acceptable and understood by
families and community contacts.
Ability to network, form partnerships, and work with others in planning efforts in
community health.
AIM
To introduce the learner to concepts of psychology and sociology; and their application to the
community health care system
OBJECTIVES
At the end of the module the learner should be able to:
1. Explain the relevance of psychology to community health work.
2. Identify common symptoms of mental health problems and refer to the next level.
3. Describe common health beliefs, practices and their influence on health seeking
behaviour.
4. Describe the structure and functions of the family and community.
5. Identify support systems in the communities.
CORE COMPETENCIES
1. Identify and collaborate with community based groups that provide rehabilitative
service for clients with mental health disorders
2. Initiates and participates in activities that promote mental health in the community
3. Identify social factors, their impact on health and provides appropriate care to clients
4. Identify at-risk groups and refers them to next levels of care
5. Collaborate with the individuals, families and the community in advocating for
improved health services
6. Provide counselling to clients in need and refer them to appropriate services; Mental
Health Services, Epilepsy Association of Zambia, DEC, Police, Alcoholic Anonymous.
AIM
To introduce learners to principles of disease prevention, control and Primary Health Care
as well as equip students with programme data management system.
OBJECTIVES
At the end of this module, the learner will be able to:
1. Describe the causes of diseases, prevention and control measures.
2. Define community diagnosis and its procedures.
3. Describe principles and elements of Primary Health Care and components of Millenium
Development Goal Indicators (MDGIs)/ Sustainable Development Goals (SDGs).
4. Introduction to community level data collection, compiling, interpretation and reporting.
AIM
To provide learners with knowledge and skills in environmental health
OBJECTIVES
1. Describe the environmental factors that influence health and their linkages.
2. Outline the principles of infection prevention.
3. Describe water and the water related health problems and how to deal with them
4. Identify types and factors to be considered before selecting suitable excreta disposal
system, with community collaboration for proper excreta disposal.
5. Describe solid waste management, types, its importance in public health, major sources
and demonstrate common disposal methods.
6. Describe the principles of food spoilage and factors affecting growth of microorganisms in
food.
7. Explain types of rural and peri-urban housing and their association of housing to human
health.
8. Describe common vectors of disease, methods of vector born disease transmission and
control methods in the community.
CORE COMPETENCES:
1. Identify the main environmental factors of disease causation and linkages to human
health.
2. Practice infection prevention procedures as stipulated in the infection prevention
guidelines.
3. Provide Information, Education and Communication (IEC) to clients on:
• Importance of hand washing.
• Importance of clean and safe water supply.
• Control of insects and rodents
4. Inspect various water supply systems for potential contaminants using a protocol.
5. Monitor health care waste disposal using a standard assessment tools.
6. Recommend appropriate methods for waste storage, collection and disposal systems in
communities
7. Provide appropriate information and strategies for the protection of the environment
8. Conduct health education talks on food hygiene.
9. Advise clients on principles of good housing and proper sanitation.
10. Identify communicable diseases and initiate measures for prevention and control using
various protocols
11. Mobilise the community, other team members and stakeholders in meeting clients’
health needs in the communities.
AIM
To introduce learners to the basic structure and functions of the human body.
To enable participants to acquire knowledge on the basic structure or anatomy of the
human body and how different parts function
OBJECTIVES
At the end of the module, the students will be able to:-
10.6 Outline the basic anatomy of the human body
10.7 Describe how different parts of the human body function.
10.8 Describe the physiology of the human body.
CORE COMPETENCIES
1. Learner applies knowledge of anatomy and physiology of human body in the provision of
care to clients.
AIM
To enable learners to safely and correctly perform simple point of care diagnostic
procedures, interpret results and make timely referral of patients/ clients to the next level
of health care.
OBJECTIVES
At the end of the module, the participants should be able to:
1. Observe safety when performing all diagnostic procedures.
2. State the steps and importance of carrying out rapid diagnostic tests (e.g. for malaria,
estimation, Urinalysis, pregnancy test) in a safe environment.
2. Advises clients based on the test results.
3. Collects specimens for various laboratory investigations:
• Sputum for TB
• Dry Blood Spot (DBS) for HIV testing
• Stool for diarrhoeal diseases
• Urine
• Any other specimens as necessary
4. Packages and refers quality specimens to the next level.
5. Participates in laboratory quality control programmes for rapid diagnostic tests (e.g. Malaria, HIV, Glucose, Hemoglobin estimation, Urinalysis, Pregnancy test).
6. Stores and manages laboratory commodities according to Standard Operating Procedures (SOPs) and guidelines.
7. Documents, keeps and reports on diagnostic and logistics information.
AIM
To equip students with basic knowledge and skills in the provision of health care in the
health post and community.
OBJECTIVES
At the end of this module, the learner should be able to:
1. Describe the common medical and surgical conditions affecting adults and children.
2. Provide initial management of specific medical and surgical disease conditions.
3. Be able to transfer and refer patients appropriately for continuity of care at higher health
facility.
4. Provide information to community members on the prevention of common preventable
medical and surgical disease conditions.
5. Utilise first aid knowledge and skills in the management of emergency situations at
community level.
6. Perform basic procedures required in the provision of basic health care of clients at health
post and within community.
CORE COMPETENCIES
1. Utilise knowledge on signs and symptoms of common medical and surgical disease
conditions and agents responsible for causing them, to manage clients.
2. Be able to identify, transfer and refer clients appropriately for continuity of care.
3. Demonstrate basic medical history taking and physical examinations on patients.
4. Utilise first aid knowledge and skills appropriately to prevent communicable illnesses
and advice clients /patients.
5. Collaborate with other team members and stake holders in management of clients to
ensure continuity of care.
6. Applies principles of infection prevention during provision of care to clients
AIM
To equip learners with basic knowledge and skills of maternal and new-born health
programmes, focusing on life saving interventions, in order to support provision of health
care and contribute to decrease morbidity and mortality of mothers, new-born and
promote adolescent health.
OBJECTIVES
At the end of the module, learners will be able to:
1. Describe the basic concepts of reproductive health.
2. Describe the ‘7 Pillars of safe motherhood’.
3. Provide Modern Family Planning (FP) services including counselling and prescription of modern contraception products including oral contraceptives, condoms and injectable contraception (Depo-Provera).
4. Describe the role of Community Health Assistants in maternal, new-born and adolescent programmes.
5. Identify danger signs in pregnant mothers, including during pregnancy, emergency delivery and post-partum period and newborn treatment in the community, or provide referral for complications.
6. Demonstrate lifesaving skills, including providing Misoprostol for attending uncomplicated delivery: providing care for the newborn as safely and cleanly as possible, in an emergency and unexpected situations, where there is no any skilled birth attendant as well as providing initial dose of Misoprostol for post-partal hemorrhage (PPH) before immediate referral.
7. Counsel and refer clients for safe motherhood and care of the newborn
8. Describe and demonstrate essential newborn care for a newly delivered baby
9. Define and recognise signs of Gender Based Violence (GBV), and Educate the community on the topic, lead community discussions/sensitisations to prevent GBV practices,
10. Promote voluntary male circumcision and describe its importance for male reproductive health and reducing the rate of transmitting HIV.
CORE COMPETENCIES
1. Provide IEC to women, men, fam i li es, community and hard to reach groups i.e. adolescents on promotion of FP, FANC, PNC, ENC and other Reproductive Health services.
2. Utilise counselling skills for informed decision making on modern FP contraceptive methods, birth plans, advantages of ANC, facility delivery and PNC as well as Voluntary Medical Male Circumcision
3. Recognise danger signs in pregnancy, labour, postnatal stages for mothers and their newborn and make timely referral for further management
4. Demonstrate skills to provide emergency lifesaving skills and services (such as providing Misoprostol for postpartal hemorrhage, emergency delivery attendance and essential newborn care) and make timely referral for further management.
5. Provide adequate information on good nutrition for the mother during antenatal and postnatal; and promote exclusive breastfeeding for at least the first 6 months.
6. Utilise the PMTCT approach/ guidelines in providing HIV counselling and testing services, support and care to pregnant women, HIV positive mothers, couples and HIV exposed infants.
AIM
To equip learners with basic knowledge and skills for providing health care service to
infants and young children, mother’s and adolescents in child health programmes.
OBJECTIVES
At the end of the module, learners will be able to:
1. Describe the Community Health Assistant role in child health programmes.
2. Discuss the national strategy for infant and young child feeding (IYCF).
3. Explain the role and scope of the code of marketing of breast milk substitutes in IYCF.
4. Explain the importance of growth monitoring and promotion in children.
5. Explain the CMAM approach to management of acute severe malnutrition.
6. Describe 16 key family and community practices for the well child.
7. Discuss the role of micronutrient deficiency control programmes in Zambia.
8. Use the sick child recording form to guide the tasks in caring for sick children and to record decisions and action.
9. Identify danger signs in the child for treatment in the community or refer to the next level of care.
10. Explain the immunisation guidelines and schedule.
CORE COMPETENCIES
1. Counsel pregnant and breastfeeding women, including adolescent girls, on the right food to eat
2. Support mothers to maintain exclusive breastfeeding
3. Ability to explain how breastfeeding works
4. Ability to teach a mother how to position and attach a baby at the breast
5. Ability to explain IYCF decision in HIV context
6. Ability to help mothers give appropriate complementary feeds
7. Ability to teach caregivers infant feeding practices in context of HIV
8. Ability to explain code of marketing of breast milk substitutes
9. Take weights, record and interpret growth curves, take MUAC measures, assess and classify Oedema
10. Identify IDA, VAD and IDD problems
11. Identify children with SAM
12. Communicate immunisation schedule and participate in programmes
13. Ability to identify a sick child needing care
14. Skills for listening and learning, as well as building confidence and giving support
15. Educate caretakers on the 16 key family and community practices for the well child
AIM
To equip learners with basic knowledge and understanding about medicines and
commodities management
OBJECTIVE
At the end of the module, the participants should be able to:
1. Identify the products found in the Community Health Assistant drug kit.
2. State the uses, side effects and contraindications of the drugs used in common conditions.
3. Describe the procedure for ordering and reporting of drugs and commodities.
4. Describe how drugs and medical supplies should be stored.
5. Explain the procedure for handling and disposal of expired drugs.
CORE COMPETENCES
1. Identifies medicines and their uses (within CHA scope) in treating common medical conditions
2. Demonstrates knowledge on the dosages, side effects and contraindications of the drugs used in common conditions within CHA scope.
2. Describes the procedure for ordering and reporting drugs and commodities
3. Explains how drugs and medical supplies should be stored
4. Monitors adherence and compliance to medication
Course Duration: 3 Months hours.