Aderonke

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This is my summary of the activities as well as lessons learnt from the home-visiting program which took place from February- September, 2019. At the beginning of the program, 13 women were assigned to me for supervision but 12 completed the program due to the unavailability of one to begin the program as a result of sickness. I supervised 12 women, 11 in Lagos and 1 in Ibadan. 

ACTIVITIES

February– I was involved in training and selection of home-visitors for the program. I also distributed supplies across the program sites.

March– I began online/digital supervision through whatsapp platform which I created and regular phone calls. I also carried out field supervision to some of the sites which helped to better understand the demographics of the women I was working with. I began data collation and entry into the database system.

April- I continued with online and field supervision to program sites as well as data entry on provided data systems. I advocated for the case of Yusuf Taiwo, a pregnant teenage girl who was using a TBA.  I alongside her home-visitor registered her in the community health centre for quality antenatal services. I went on field supervision to Ibadan, Oyo state, Nigeria where Mrs Adesina Fasilat conducts her home-visits.

May– I was involved in the mid-program training and mid-program evaluation for the home-visitors. I conducted a whatsapp webinar for my home-visitors on better approaches to home-visiting and forms completion. I conducted field supervision with Mrs Anike Lawal on some of the program sites.  I also called some of the enrollees who delivered during the program.  I was involved in the recovery of Yusuf Taiwo from the hospital after her delivery through Caesarean section.

July– I was involved in home-visiting filming in selected program sites in Lagos state. I also continued in supportive supervision of my home-visitors and data collation. I was involved in the planning of the Breastfeeding week program and liaising with hospitals for activation programs.

August– I was actively involved in the breastfeeding week by speaking in two hospital activation programs and working with the team in the implementation of the highlighted programs. I continued field supervision and filming of one enrollee in her community. There were also field visits to some of the program sites I supervise by the representatives of Health Partner Plans (Dr. Kearline and Dr. Tierra) and Anike Lawal.

August– I was actively involved in the breastfeeding week by speaking in two hospital activation programs and working with the team in the implementation of the highlighted programs. I continued field supervision and filming of one enrollee in her community. There were also field visits to some of the program sites I supervise by the representatives of Health Partner Plans (Dr. Kearline and Dr. Tierra) and Anike Lawal.

September– I carried out final collation of data as well as data cleaning and programs evaluation among enrollees through a survey conducted among selected enrollees in program sites across Lagos.

CHALLENGES

  1. A major challenge is transportation- The unavailability of a structured transportation vehicle made the work very challenging especially in some parts of the city with bad roads.
  2. Data Collation/Entry- Some of the home-visitors upon explanations did not comply with the proper way to fill their forms which made data entry difficult and incomplete. Some do not snap well and hence have to resend. These reasons caused most of the double-entries or non-entry in any case.

LESSONS LEARNT FROM HOME-VISITING PROGRAM 

  1. Home-visiting kits should include rainboots /raincoats, hand sanitizers and face caps.
  2. The smartphone purchased was not really useful in achieving the purpose intended as most home-visitors complained of low phone memory, poor quality of pictures and phone hanging. A tablet would be better for the next program.
  3. The challenge of re-supplying in a short time to different home-visitors needs to be reviewed so that cost can be saved. I suggest that at the beginning of the program after enrollees are registered, an estimation of supplies should be delivered to each home-visitor which would last till the mid-program meeting.
  4. Patience is a great virtue needed to work with married women who have their various challenges but are still trying to make an impact still.
  5. There is a need to be firm with home-visitors especially concerning allowances based on visits per month. Some of the women erring did not make improvements because they did not see any measures taken against them as stated at the beginning of the program.
  6. Home visitors who refuse to participate in events during the project should be excused. This is because they will miss out on vital information and end up being a source of challenge in the program.
  7. Personally, I learnt never to mix work with relationships so that you would not lose one or both.  I also learnt to be a patient listener and manage my emotions when relating with people in order to get the job done.

RECOMMENDATIONS

  1. Home visitors should be paid according to number of visits per month
  2. Data should be entered by the home-visitors from the field and a structured online monitoring system should be built to ensure data correctness.  This will lessen the workload on field officers who need to input piled up forms after field visits. It will also improve correctness and timeliness of data.
  3. Standard funding should be budgeted for hospital needs of enrollees to avoid a feeling of helplessness from home-visitors and hence discouragement. 
  4. Education information materials should be on e-copy to avoid wastage and wear-out of paper materials. A tablet would be suitable for this.
  5. Home-visitors should be mandated to attend all educational programs during a project so that they would not be a source of problem later.
  6. Program Logistics- I suggest that a structured method of transportation should be made available to avoid injury and facilitate quick response to needs of home-visitors.
  7. Program Planning- I suggest that the programs team (especially field workers) should be involved in planning the program at the beginning so that they would be able to make inputs on best field practices.
  8. The organization can partner with other companies to provide sponsorship through donations of their products. This will reduce the burden on the organization to buy gifts for people.
  9. Field allowance should be paid to field workers (example is risk allowance, welfare, e.t.c).
  10. There should be included in the program training for significant others to facilitate behavioural change and good health practices among the target population.

CONCLUSION

The home-visiting program has been a great experience and a successful one. The impact in the communities is quite awesome while the change in knowledge, practice and awareness of health topics/services is laudable. Indeed, the program worked and should be continued.