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   Home / Working Groups / IMCI / Element One

Linking Communities and Facilities

Framework Element One

Element One: Improving partnerships between health facilities and the communities they serve.

In many countries, children die without ever coming into contact with the health system. Communities need to be linked to health facilities so that they can access life-saving health services. Improvements made in the health system through the first two components of IMCI (training of facility-based workers and strengthening of the health system) don't benefit children if they are not accessible. While distance is often a barrier to accessing health services, it is not the only barrier; language and cultural barriers between communities and health facilities can keep community members from accessing services even when they are physically available. Addressing both of these issues involves improving partnerships between health facilities and communities.

Several interventions can improve these two-way partnerships:

  • Facility staff can reach out to the community and attract more clients through improved counseling by health workers, increased outreach by health workers, and greater accountability for quality of services. Strategies include:
    • Improving provider skills in communicating with community members.
    • Instituting outreach days where clinics take their services to different communities.
    • Developing feedback mechanisms to assess service quality and demand and involve communities in discussions on improving facility services and promoting use by the community.
  • The community can advocate that caretakers increase usage of facilities where services have been improved, provide community-based data to health facilities to plan appropriate promotional and outreach events, and help manage facilities with government staff. Strategies include:
    • Developing mechanisms for formal community involvement in facility-level management decision-making.
    • Setting up systems for collecting health data at the community level and ensuring that the data has an impact on the kind of services provided.

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