How communities in Kaduna are benefitting from the promotion of health practices by CHIPS agents
Through funding from GAVI, health promoters known as CHIPS agents have been trained across eight local government areas in Kaduna State to fill in the gaps in providing access to healthcare in rural communities.
“I really appreciate the way my people are changing their behaviors, particularly from home delivery to hospital delivery,” says Khadijah Musa, a 29-year-old mother of two.
Khadijah is one of the 449 Community Health Influencers, Promoters and Services (CHIPS) program Agents who have been trained across eight Local Government Areas in Kaduna State, Northern Nigeria to fill the gaps in community access to healthcare.
Critical to attaining Universal Health Coverage, the Agents are also expected to link households to the healthcare systems, complement national data systems, improve health outcomes, and strengthen the community component of Primary Health Care (PHC).
Khadijah of Tsauni Community, Jamfalan Ward, Ikara Local Government Area of Kaduna State said she joined the programme to assist her fellow women to access critical health services and imbibe essential practices that would ensure the optimal growth and development of children.
“My expectation is to change the attitude of my fellow women from unhealthy practices to essential healthy behaviors by encouraging them to access health services in health facilities”.
The CHIPS Program is designed to encourage and support local households to seek PHC services at clinics and outreach programs. The Program also helps clients to get necessary PHC services by bringing these services closer to households through home visits by CHIPS Agents, especially in rural underserved regions. The programme is carried out with assistance from GAVI through UNICEF.
A minimum of 10 CHIPS Agents, preferably females, are being trained in each political ward to work at the household level, providing counselling services, creating demand, and referring household members to PHC facilities to access the necessary services. They also manage simple cases of cough, diarrhea and fever in children under the age of five years as well as provide basic promotional, preventive and case management services.
Khadijah, who visits at least 13 households in her community daily, said her day usually begins with house chores before setting out for the house-to-house routine visit to educate and enlighten mothers and caregivers on essential health practices.
“Every morning when I wake up, I pray, make breakfast for my family, get my children for school, clean the house, do other chores, and take a bath. I start my routine visit after completing all my housework by 8:30 a.m. I always start with the Ward Head residence as my first stop.
“From there I will proceed from house to house, educating women and caregivers about healthy practices and how to access essential care in health facilities before returning home between 3:30 pm and 4:00 pm,” she said.
Hafsat Saleh, a mother of seven and a program beneficiary in the Tsauni Community, stated quickly after a session with Khadijah that the program had enhanced her understanding of proper care for young children under the age of five.
Hafsat, 30, stated specifically, "I learn the value of early commencement of breastfeeding, exclusive breastfeeding, including Antennal Care (ANC) and facility delivery."
Similarly, 30-year-old Aisha Saleh, a mother of six who is nine months pregnant with her seventh child, agreed and added that because of the actions of the CHIPS agents, she has learned the value of going to the hospital for ante natal care, ANC and other services.
“I've learnt a lot from the CHIPS agent, and after receiving antenatal care from the health facility, I've chosen to give birth to my seventh child there because I've witnessed the advantages” she said.
Saleh Ibrahim, the Ward Head of the Tsauni Community, stated that Khadijah's activities as a CHIPS agent has had a tremendous impact on the attitudes of parents and caregivers regarding the health care of their children.
She enlightens our women on the importance of antenatal care, routine immunization, hospital delivery and other essential health practices that ensure the safety of the mother and child under five years,” he said.
Sharing similar experience, another CHIPS Agent, a 25-year-old mother of two, Shamsiya Kabir, in charge of Aji community in the LGA, said she visits at least 11 households daily.
“I am so happy that I was able to influence a significant number of women in my community who now visit health facilities for antenatal care, uptake of routine immunization and other health services,” she said.
To support the work of the CHIPS Agents, Community Engagement Focal Persons (CEFPs), preferably males, were selected and trained. This is equally promoting male involvement and community engagement and participation in Reproductive, Maternal, Newborn, Child, Adolescent Health and Nutrition (RMNCAH+N) service utilization. One of them, Abubakar Bello, the Community Engagement Focal Person (CEFP) for the Jampala Ward in the LGA, stated that his main responsibility was to oversee all CHIPS in the Ward, collect their reports, make corrections as needed, and coordinate with the Local Government Health Management Information Officer before uploading to the DHIS platform.
“We equally facilitate and track community referrals, and also help with addressing non-adherence to Routine Immunization (RI), Antenatal Care, and other maternal and child health services,” he said.
In order to integrate a critical mass of qualified Volunteer Community Mobilizers (VCMs) who meet the CHIPS selection criteria into the CHIPS program—as CHIPS agents—UNICEF Nigeria, with a program priority of strengthening community systems strengthening, is currently supporting the CHIPS Programme Implementation both technically and financially at the national and state level of the 13 states, including Kaduna. Following a risk structure established with the National Primary Health Care Development Agency (NPHCDA), which included criteria like polio non-compliance and low routine immunization rates, the Volunteer Community Mobilizers (VCMs) are working in the worst-performing settlements throughout Northern Nigeria. Targeted for this integration and execution across the chosen 13 states are more than 15,000 community health workers.