Improving Public Sector Case-reporting for Childhood Diarrhea through Capacitating Female Community Level Volunteers (CLVs) in the Indian State of Bihar.

ABSTRACT

Objectives: CLVs play an important role in prevention and treatment of diarrhoea. However, only a small proportion of the cases treated by these semi-literate CLVs are reported and fed into the Health Management Information Systems (HMIS). Micronutrient Initiative capacitated and equipped semiliterate female CLVs to report on childhood diarrhoea cases as part of the ‘Reducing deaths from diarrhoea’ in the Indian state of Bihar. Methods: Simple pictorial reporting tools that could be used by semiliterate CLVs were developed, pilot tested and provided to 42,258 CLVs. Hands-on training was undertaken for the CLVs and their capacities were continuously enhanced through an appropriate supportive supervision mechanism. Results: In 15 demonstration districts between 2011 to 2013, a total of 1,037,910 diarrhoea cases have been reported treated in the public sector of which 55% of the cases were treated by CLVs. Majority of the above cases were not being reported previously. The successful demonstration has encouraged the state government to scale-up the involvement of CLVs in reporting on childhood diarrhoea through use of pictorial tools. However, 64% of CLVs do not report regularly due to non-availability of tools and poor accountability. The programme is considering strengthening of supportive supervision and provision of incentives to improve compliance to reporting. Conclusions: Reporting from CLVs is feasible by providing simple reporting tools and imparting them training to use the tools along with continuous follow-up and handholding. Improved reporting of childhood diarrhoea cases treated by CLVs is useful in informing program decisions and initiating corrective action.