Sample CDD Module on Community Case

CDI Module 11: Sample CDD Module on
Community Case Management
©Jhpiego Corporation
The Johns Hopkins University
A Training Program on CommunityDirected Intervention (CDI) to Improve
Access to Essential Health Services
Module 11 Objectives
By the end of this simulated, community-directed
distributor (CDD) training module, learners will:
 List the basic local resources needed to carry
out CDD training
 Describe the basic malaria content that is
appropriate for community-level volunteers
 Outline training methods that are appropriate for
community volunteers
 Explain how community volunteer training can
be evaluated
Simulated Module for CDDs
 This module is a bit
different from the others
 We will simulate the
steps in presenting a
training session on
malaria case
management for CDDs
 We ask each of you to
pretend you are a CDD
from your home village
Resources Needed for Local CDD Training
on Malaria Case Management
 A community-directed intervention (CDI) focal
person from the health center to serve as a
 Samples of malaria medicines
 Flip chart and marker and/or chalk and chalkboard
 Treatment recording forms
 Job aids
 Information, education and communication (IEC)
materials (e.g., counseling card)
 Quiet, well-ventilated room near the community
 Time: Two hours
Overview of Session on Community Case
Management for CDDs
During this CDD training session, we will cover the
 Module Objectives
 Recognizing Malaria
 Treating Malaria
 Counseling for Adherence
 Recording Services
 Monitoring, Follow-up and Referral
 Evaluation of Module
Objectives for Training Session
on Malaria Case Management for CDDs
By the end of the session, the CDDs will:
 List clinical signs and symptoms for recognizing
 Demonstrate how to treat malaria with
appropriate medicines and doses
 Role play counseling on how to encourage
clients to take their medicines correctly
 Record the services provided in the register
 Explain how, when and why to monitor, follow up
and refer clients
Recognizing Malaria
Ask CDDs: “In your village …”
 How do we know if someone has malaria?
 (Write answers on chart/board)
 What are the most common, important signs?
 How do we know if someone has fever?
 (Demonstration and return demonstration)
 What other diseases come with fever?
 (Write answers on chart/board)
 How do we tell which of these diseases is really
How Do We Check for Fever?
Rapid Diagnostic Tests (RDTs)
Volunteers in Rwanda and Mozambique use RDTs
What about in your country?
Treating Malaria
Ask CDDs:
 What medicines are used for treating malaria in
this community?
 (Write answers on chart/board)
 Which are most effective? Why?
 What medicines for malaria are recommended
by the Ministry of Health?
 (Show samples of artemisinin-based combination
therapies [ACTs] in age-specific packets)
 (Ask CDDs to discuss what they see and what they
know about these; address concerns)
Coartem Comes in Different Age Doses
Pass around samples
Ask learners what they observe
Review Doses by Age
 Ask learners what
they see on the card
 Make sure they:
 Note the picture at the
top to determine
dosage by age group
 Identify the six
clusterings of tablets
and explain what
these mean
Treating Dosage for Malaria
Cover the following topics with CDDs:
 Review dosages by age
 Talk about the importance of taking all of the drug dosage, as
 Discuss what to do about people who have fever but do not
have malaria
 Ask a volunteer to tell a story about what happens when a
 Gives correct treatment
 Gives incorrect treatment
 Ask one of the learners to tell a story about what happens
 A client takes a drug correctly
 A client does not take a drug correctly
Treatment Scenarios
What would you do?
Yemi is two years old, has
fever and is coughing
Ibrahim is five years old, has
fever, chills and loss of
Uwem is three years old,
has fever, running nose and
sore throat
Uche is four years old, has
body ache and fever
Work in groups/pairs and report back
Counseling for Treatment
Steps in Counseling
1. Show the patient/caregiver the appropriate ACT
Ask the client what she or he sees
Point out the days and doses
Explain the importance of taking all of the medicine
over the three days
Ask clients if they will have any problem taking the
drugs correctly, and explain what to do
Ask the client to repeat all instructions/steps
Sample Job Aid
Provide simple job aids that are
actually used in your own country
Counseling: Lead the Following Activities
The facilitator should:
 Conduct a role play
about recognizing,
treating and
give feedback; repeat
role play
 Ask learners to make
up a song that will help
clients remember how
to take their drugs
correctly and fully
Record the Treatment Provided
The facilitator should:
 Show samples of the recording form
 Discuss the different sections
 Practice recording different scenarios (e.g., different
CDDs should:
 Give each other feedback on quality of recording
Recording Treatment
Monitoring and Following Up
after Treatment
The facilitator should:
 Remind learners that people need to take ACT
twice a day for three days
 Explain what happens if a person does not take all
of the medicine or takes it incorrectly
 Lead a group discussion on how to do monitoring
and follow-up to ensure that people take their
medicines fully and correctly
The facilitator should:
 Outline when a patient
needs to be referred to
the health center
 Hold a discussion on
how to ensure that people
will transport the referred
patient to the health
 Conduct another role
play using ideas
generated on how to
ensure that referral
Evaluation Q & A for (Simulated) CDDs
How do we know a person really has malaria?
What are the correct drugs for malaria?
What is the dosage for these drugs?
What happens if people do not take the drugs
fully and correctly?
 What are the steps to counsel a client to take the
malaria medicine?
 How do we record the treatment provided?
 What should we do to follow up clients to ensure
that they completed the correct treatment?
Now return to your role as regular workshop learners
and discuss the following:
 Were we able to make information easy to
understand for typical village CDDs?
 What methods are effective in training CDDs and
how do these differ from formal classroom
 How can we ensure participatory learning for CDDs?
 What are the most effective ways to evaluate what
CDDs learned in training?

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