CORE Group, in collaboration with multiple partner and member organizations, has produced a range of state-of-the-art tools, curriculums and technical resources.
The World Health Organization (WHO) estimates that approximately 500,000 children each year are diagnosed with tuberculosis (TB) and 64,000 HIV-negative children die annually due to TB. The true burden of childhood TB is unknown; children are often undiagnosed and therefore do not receive appropriate care. Childhood TB is often seen with other common childhood illnesses such as HIV/AIDS, pneumonia and malnutrition, and should be considered in sick children, particularly in areas of high TB burden. Family-centered and community based care models and strategies can be used for TB prevention, identification of children with presumptive TB, and for diagnosis and management of children with TB.
A community approach to TB prevention, case finding, and supportive care is needed to ensure that all infants and children with TB receive high quality care, and to ultimately eliminate TB deaths in children. This need was recently outlined in a roadmap for childhood TB, published by the World Health organization with broad support by UNICEF, The Union, USAID and others. Frameworks such as the Integrated Community Case Management (iCCM) and Integrated Management of Childhood Illness (IMCI) can be modified and used to asses TB risk in children, provide contact tracing, refer to higher level facilities for appropriate diagnosis, and provide treatment support.
This document outlines community-based strategies for integrating childhood TB activities with other maternal and child health care services through existing diagnosis and management algorithms. Such activities include prevention, identification of children with presumptive TB, and referral to higher level facilities. The extent to which community- or facility-based tools and strategies such as integrated Community Case Management (iCCM) of common childhood illnesses or Integrated Management of Childhood Illness (IMCI) can support TB identification and care depend on the setting, availability of services, training of health care workers (HCW), and agreements among all stakeholders involved.
This document is written for decision-makers, program managers, and officials at the global policy and national Ministry of Health (MOH) levels who can (in collaboration with NTPs) make changes to country specific child health frameworks, and also to those in the field who can implement interventions directly. The aim of this guide is to emphasize the importance of childhood TB, stimulate discussion and move toward early integration of childhood TB into other maternal and child care activities.
A Practical Guide to Conducting a Barrier Analysis is a training curriculum that builds skills to plan and carry out a Barrier Analysis survey. The very practical, hands-on learning exercises help learners to answer the most common and frequently perplexing questions that arise during implementation. The use of the survey as a behavior change tool is made clear by first introducing the Designing for Behavior Change framework and the determinants of behavior change. The manual uses a step-by-step approach starting with the definition of the behavior to be studied and development of the Barrier Analysis questionnaire. As part of the training course, a Barrier Analysis survey is conducted. The guide covers topics including sampling, interviewing techniques, coding, tabulation and data use. After completing the course using The Practical Guide to Conducting a Barrier Analysis, trainees will be able to effectively plan and implement a Barrier Analysis survey and use the results to inform their behavior change strategy.
A Tool for Improving Behavior Change Communication in Child Survival and Community Development Program
The Barrier Analysis tool is a rapid assessment tool used in community health and other community development project to better identify barriers to behavior change that (if adopted) would have a significant positive impact on the health, nutrition, or well-being of targeted groups (e.g., preschool children) in a project area. The tool also helps staff members to identify positive aspects of behaviors which can be used in health promotion efforts. The tool is in some ways similar to Doer/NonDoer Analysis (part of the BEHAVE framework), but focuses on a much broader list of possible determinants and barriers. The manual focuses on eight determinants: perceived susceptibility, perceived severity, perceived action efficacy, perception of social norms, perceived self efficacy, cues for action, perception of divine will, positive and negative attributes associated with the action.
The methodology can easily be modified to identify a wide range of barriers to behavior change in health, agriculture, nutrition, or other domains, and is applicable to any geographic location in the world.
Barrier Analysis was initially developed in the early 1990s using behavioral change principles that were applied to a community-level child health project in the Dominican Republic. The tool was further developed by FH staff members and has been used to train over 100 FH field staff from Mozambique, Kenya, Bolivia and Ethiopia in identifying barriers to behavior change. Since the late 1990s, the tool has been used in Haiti, Kenya, Mozambique, Ethiopia, and Bolivia to discover key barriers to behavior change regarding breastfeeding, other nutritional practices, latrine use, agricultural practices, HIV/AIDS behaviors, and other intervention areas.
Additional Information on Barrier Analysis
This manual was developed as a training resource for designing, training, implementing and monitoring Care Group (CG) programs. It seeks to help CG approach implementers to clearly understand the structure of the CG approach, how to establish CGs, how to monitor the work of CGs and assess their impact, and how to maintain the quality of the approach through supportive supervision and quality control.
*NEW* Care Groups: A Reference Guide for Pracitioners is meant to serve as a companion to the training manual. It was developed in response to practitioner requests and assumes the reader already has a general understanding of the Care Group methodology.
While many Ministry of Health (MoH) community health strategies around the world include community health committees, the reality on the ground shows that these groups are often weak and poorly supported. Literature and field experience suggest that before the strength of individual groups can be considered, there are fundamental programmatic, structural and policy elements that must be in place in order for the community health committee programs to function effectively. It was felt that ministries and partners could benefit from a tool that listed and described these recommended programming components, to use for assessment and programming improvements.
This tool has been developed to help Ministries of Health and supporting organizations to assess community and health facility committee program functionality against 14 elements deemed essential for program success; to review the scope of roles and responsibilities intended for the groups; to identify existing program strengths, and to address those elements assessed as weak. Note that the tool is not intended to assess individual community or health facility groups but rather to assess the functionality of the program as a whole, in line with the understanding that the prerequisites must be in place first, before the strength of the groups themselves can be considered.
Tuberculosis is both curable and preventable. The cost of diagnosis and the medicine to treat TB is free for patients in most countries. Yet despite this, women, men, children, and babies are still becoming ill and dying from TB every day. Amazing progress has been made by governments, health systems, the World Health Organization, the Stop TB Partnership, private sector practitioners and companies, advocates, and other organizations. But one group still needs a stronger presence on the team: civil society. This includes community members, nongovernmental organizations (NGOs) and civil society organizations (CSOs) of all kinds, at all levels—from local to global—including community health, education and development efforts, religious groups, patient advocates, maternal and child health programs, traditional groups including healers, kinship groups and neighborhood associations, national and international NGOs, and many more.
But how can they help—especially if they are not health experts? In many ways. People living with TB often live in places that government services have a hard time reaching. TB spreads in households and communities, ranging from rural villages to urban apartment blocks to schools to workplaces and crowded places like workers’ hostels and prisons. Within ALL communities, community-oriented efforts can both help prevent the spread of TB AND support diagnosis and treatment. This happens through educating the public and health workers, finding people with TB symptoms and getting them to diagnostic and other services, reducing stigma, offering daily support for those taking the medicines, advocating for improved services—and in many other ways.
This document is designed to serve as a handbook, or primer, for NGOs and CSOs that are considering joining the fight against TB. It provides information on TB and how it is prevented, diagnosed, and treated, how TB programs work on the ground, how communities and CSOs can get involved, and special populations that need extra attention. Step-by-step guidance on getting started in addressing TB, pitfalls to avoid, and a list of useful resources are included.
More than ever, international development organizations see the consortium model as a viable framework for addressing the challenges associated with the implementation of complex programs at a significant scale. Yet, those of us with consortium experience understand that establishing a highly-functional consortium with multiple partner organizations is often easier said than done. The CAFÉ Standards from Catholic Relief Services and other conceptual frameworks have helped project designers and planners to address key considerations in the planning of a consortium, but what happens once a consortium is formed and implementation begins?
The Consortium Management and Leadership Training Facilitator’s Guide offers a reflective process to strengthen the consortium management and leadership skills of the senior leadership team of a consortium, technical team leaders within partner organizations, and the senior management of local partner organizations for Food for Peace-funded development food assistance programs.
Although this guide approaches consortium management with foremost consideration for the implications for Food for Peace-funded development food assistance programs, this consortium management and leadership training can serve as a useful framework for strengthening consortia of any type.
This field-tested, six-day training package will enable private voluntary organizations (PVOs) and partners to replicate the BEHAVE workshops conducted with CORE Group members in multiple countries and regions around the globe. The manual consolidates handouts and facilitator materials with easy-to-use training guidelines.
The “Designing for Behavior Change” workshop responds to community health managers’ and planners’ need for a practical behavioral framework that aids them in planning their projects strategically for maximum effectiveness. It is built upon the BEHAVE Framework, developed by the Academy for Education Development (AED). The workshop trains participants to apply AED’s BEHAVE Framework to improve maternal and child health programming.
This document was adapted in 2013 for agriculture, natural resource management, health and nutrition. View the updated version here.
This field-tested, six-day curriculum responds to community development program managers’ and planners’ need for a practical behavioral framework that strategically aids them in planning for maximum effectiveness. The DBC Framework was developed from the earlier BEHAVE Framework (developed by AED) by members of CORE Group’s Social and Behavior Change (SBC) Working Group and the Food Security and Nutrition Network SBC Task Force.
The curriculum enables private voluntary organizations (PVOs) and partners to replicate the DBC workshops conducted with food security practitioners and CORE Group members in multiple countries and regions around the globe. The resource is designed to help train participants to apply the DBC Framework to improve development programming. It combines handouts and facilitator materials with easy-to-use training guidelines. This tool also helps practitioners to respond to FFP’s new RFA guidance on identification of behavioral determinants and creation of a behavior change strategy in their programs.
View the document in additional languages here.
This document is an in-depth review of issues and questions that should be considered when addressing key issues relevant for large-scale CHW programs.
Rather than being an instructional manual, the Reference Guide is meant to provide a framework for those in leadership positions in-country as they consider how to develop, expand and strengthen their CHW program. It was developed in parallel with the URC/Project ASSIST CHW Decision-Making Support Tool, which is also in the process of being released.
The Reference Guide has many practical examples from CHW programs around the world. The contents are in four sections and contain a total of 16 chapters covering such topics as a history of CHW programs, planning, governance and financing, national coordination and partnerships, roles and tasks, recruitment, training, supervision, motivation and incentives, relations with the community and health systems, scaling up, and measurement and data use. There is an appendix containing (1) case studies from Afghanistan, Bangladesh, Brazil, Ethiopia, India, Indonesia, Iran, Nepal, Pakistan, Rwanda, Zambia and Zimbabwe; (2) a summary of perspectives on large-scale CHW programs from key informants; and (3) important resources.
This set of lesson plans to control Ebola Viral Disease is for use in Care Group projects. The plans are designed for use through Care Groups in countries that currently are using that model or that will be in the near future. These lesson plans should add to, not replace, informational materials available in Ebola-affected countries. The lessons and photos are not perfect, and the recommended guidance changed through development, over the course of the epidemic. We highly encourage practitioners to ensure all information and behaviors promoted are aligned with what official agencies (e.g., MOH, CDC) are promoting in their countries, and to make changes to this generic module based on their situation and guidance. Lesson Plans 1-4 are intended for use in countries which have not yet experienced but are at risk for an Ebola outbreak. Lesson Plans 5-9 are designed for use in countries which are currently or have been in the midst of an Ebola epidemic.
Through a TOPS Program Small Grant, CORE Group has developed a module to improve preparedness for and response of communities in countries at risk of a cholera epidemic. The module consists of four lesson plans with accompanying flipcharts, intended to be delivered through community health workers. The lessons target mothers and caregivers of children under age five, a group that is at particular risk of death if infected. The module shares information about symptoms and risks; what families can do to prevent infection; how, when, and where to seek care; and what actions to take in the aftermath of an outbreak.
From August 2015 to September 2016, CORE Group Ethiopia Secretariat and implementing partners implemented a project that aimed to enhance AFP surveillances in three woredas through Community Based Surveillance system. This good practices write up contains, among other issues, the problems that existed, the responses made, the results gained following the interventions as well as lessons learnt.
This technical resource guide, along with the complemenary technical brief, is designed to build the capacity of development practitioners working in nutrition and food security to plan, implement, and evaluate gender-sensitive SBC programming in order to improve nutritional outcomes for pregnant and lactating women (PLW) and children under two. It does this by providing an overview, rationale, critical actions, best practices, resources, and tools for integrating gender-sensitive SBC into project activities.
The technical resource guide seeks to achieve three main goals:
- Increase the reader’s knowledge about the importance of gender-sensitive SBC programming in nutrition and food security programs/projects;
- Strengthen the planning, implementation, monitoring and evaluation (M&E), and documentation of gender-sensitive projects and gender mainstreaming of organizations to reduce gender gaps in nutrition outcomes; and
- Share resources and tools to support gender-sensitive SBC programming
Developed in 1997, the Essential Nutrition Actions (ENA) framework has been implemented in Africa, Asia and Latin America. It is a tool for advocacy, planning, training and delivery of an integrated package of interventions to reach the high coverage (>90%) needed to achieve public health impact. As such, partners are now promoting the framework to support the realization of Scaling Up Nutrition (SUN) objectives on the ground.
The updated ENA-EHA training builds on the ENA 2010 Training Trilogy, keeping the overall format of the materials.
Understanding the Essential Nutrition Actions and Essential Hygiene Actions Framework [FRENCH] describes the selection of tools and guidance that have been developed to support implementation of the ENA and EHA framework, including key message booklets, training programs, and assessment tools.
The Essential Nutrition Actions and Essential Hygiene Actions Training Guide: Health Workers and Nutrition Managers (Word Version) [FRENCH (Word Version)] introduces health professionals to the most up-to-date hygiene and nutrition information, and how to deliver nutrition through health visits.
The Essential Nutrition Actions and Essential Hygiene Actions Reference Manual: Health Workers and Nutrition Managers (Word Version) [FRENCH (Word Version)] accompanies the aforementioned training manual and contains reference information such as UNICEF’s conceptual framework, contact points at which to deliver essential nutrition actions and essential hygiene actions, technical guidance on adolescent and women’s nutrition, family planning, infant and young child feeding, and much more.
The Essential Nutrition Actions and Essential Hygiene Actions Training Guide: Community Workers (Word Version) [FRENCH (Word Version)] strengthens the capacity of community workers to deliver and promote the essential nutrition and hygiene actions.
The Essential Nutrition Actions and Essential Hygiene Actions Reference Materials on Key Practices: Community Workers (Word Version) [FRENCH (Word Version)] accompanies the Community Worker training as a job aid, covering key concepts for each of the nutrition and hygiene practices as well as some ideas on how Homestead Food production (HFP) can be developed to improve household dietary quality and diversity.
ENA Case Studies
This training of survey trainers (TOST) curriculum is designed to prepare KPC TOST participants to replicate training activities to teach KPC field staff to carry out a KPC survey.
CORE Group’s KPC Curriculum consists of a set of trainer’s guides and participant handouts and resources to teach trainers and field workers to carry out a KPC survey. Based on extensive field testing in several countries, the complete set includes three separate instructional manuals.
- KPC Training of Survey Trainers: Trainer’s Guide and Participant’s Manual and Workbook with training development exercises, dialogue education warm-ups, and background information on organizing a five-day KPC workshop.
- KPC Survey Training: Trainer’s Guide which provides detailed instructions on administering a survey, selecting a sample selection, developing a survey instrument, training supervisors and interviewers, maintaining quality, analyzing results and using the results for program planning.
- KPC Survey Training: Participant’s Manuals and Workbooks includes a full set of handouts (including those for use as slides or overheads) for core team members, supervisor and interviewer use and for post-survey team analysis.
During the Child Survival Health Grants Program, Child Survival grantees were required to use the Rapid CATCH tool, which establishes a set of standard indicators to collect baseline and end of project data. This data is used to demonstrate the important contributions of the child survival portfolio to increase coverage and improve practices. In 2006, indicators for Rapid CATCH become more complex. This, along with the emergence of integrated programs that address the needs of multiple target populations created sampling challenges for grantees. The CORE Group M&E Working Group created this guidance document to clearly outline the recommended protocol for parallel sampling using Lot Quality Assurance Sampling (LQAS ) to collect Rapid CATCH information. The LQAS guide is for managers, field supervisors and others who plan, monitor and evaluate community health programs. The guide will aid them to train others in a simple and rapid method for collecting data. There is also a Guidance FAQ available.
The LQAS Excel Spreadsheets are designed to provide all of the calculations needed to determine if each Supervision Area (SA) has met the Decision Rule (DR) for every indicator entered, as well as calculating the average coverage for the entire project area (all Supervision Areas combined). Simply list each indicator collected in the data entry tabs, and then enter the responses for each indicator. The spreadsheet then automatically calculates the Decision Rules, whether each SA has met the Decision Rule, and the average coverage for each indicator, and the results are displayed in the LQAS summary tabs. The spreadsheets are available in English and French.
These lessons seek to build the skills of community-level workers, such as community development agents, community health workers, and agriculture extension agents, so that they can be more effective behavior change promoters in their communities. The lessons are not sector specific, but are tried and true generic skills, such as communication and storytelling, that can help a development worker in any sector become more effective as an agent of behavior change.
This document provides health workers with information on how to counsel pregnant and lactating women on how to meet increased nutrient requirements through dietary and behavioral changes and other health practices. This document also helps programs develop appropriate protocols and counseling materials on maternal nutrition.
This guide that explains how mHealth serves newborn health through referral and tracking of mothers and infants, decision support for CHWs, CHW supervision, scheduling and tracking postpartum and postnatal visits, and teaching and counseling for mothers and families. Case studies are provided from Afghanistan, India, Malawi and Indonesia. Links to resources for planning, implementation and evaluation are included along with lessons learned across the case studies.
Learn more about CORE Group’s mHealth work here.
The main objective of this study was to examine pregnancy and child delivery practices and identify mechanisms for improving polio birth dose coverage in CGPP implementation districts/woredas.
The Nutrition Program Design Assistant is a tool to help organizations design the nutrition component of their community-based maternal and child health, food security, or other development program. The tool focuses on prevention and also provides guidance on recuperative approaches that are needed when there is a high prevalence of acute malnutrition. The tool has two components: (1) a reference guide for understanding the nutrition situation and identifying and selecting program approaches, and (2) a workbook to record information, decisions, and decision-making rationale. The workbook is available as a pdf or Word file, and includes a separate Excel file with adaptable templates to use as needed for data collection and developing a Logical Framework.
The 2015 updated version reflects several changes in the nutrition programming landscape, including:
- New initiatives such as the 1,000 days and Scaling Up Nutrition movements
- New research/best practices, including revisions to World Health Organization micronutrient guidelines, the 2013 Lancet series on maternal and child nutrition, and guidelines on treatment of moderate acute malnutrition
- New programming guidance from donors
The creation of the tool was a highly collaborative effort coordinated by FANTA, Save the Children (including the Technical and Operational Performance Support Program), and the CORE Group’s Nutrition Working Group.
There are many tools and resources available for designing, implementing, and evaluating nutrition programs. However, CORE Group Nutrition Working Group members did not have one place to go to when determining which nutrition-specific tools and approaches to use for programming and research.
Consequently, members expressed an interest in developing a reference guide of nutrition-specific tools and approaches, information on how and when to use them, and special considerations for their use. This reference guide meets this need. It is targeted to program designers and technical staff among CORE Group members, as well as others working in the area of nutrition globally. Its purpose is to guide nutrition actors in selecting the most appropriate design, research, implementation, and evaluation tools, based on their program objectives, context, and available resources.
International Federation of Red Cross and Red Crescent Societies (IFRC); CORE Group; AI.COMM; InterAction; World Health Organization; Pandemic Influenza Contingency (PIC) Office for the Coordination of Humanitarian Affairs (OCHA).
The Humanitarian Pandemic Preparedness (H2P) Initiative and its many partners have developed ready-to-use training curricula for district- and community-level leaders, and community volunteers and workers in order to minimize morbidity and mortality in the event of an influenza pandemic. The time to put these tools into action is now.
The curriculum has separate tracks for district/community leaders and for first responders (community volunteers and workers) at the community level.
This curriculum equips trainers to lead a short skill-building workshop to provide meeting facilitators with some new “tools” and techniques for facilitation. We encourage trainers to modify this workshop as necessary to fit your audience and your needs.
This workshop is based on a session conducted for CORE Group in April 2015 to improve the ability of working group chairs to facilitate actively engaged working groups. The workshop was then modified for TOPS to focus on knowledge management practitioners and other development practitioners who implement food security and nutrition activities and who run or participate in a community of practice, working group, task force or project team. The curriculum has been adapted based on workshops held in July and August 2015 in Washington, DC.
Download additional documents and handouts here.
Positive Deviance/Hearth is a successful home-based and neighborhood-based nutrition program for children who are at risk for malnutrition in developing countries. It has enabled hundreds of communities to reduce their levels of childhood malnutrition and to prevent malnutrition years after the program’s completion.
The “positive deviance” approach is used to find uncommon, beneficial practices by mothers or caretakers of well-nourished children from impoverished families. The approach calls for spreading these practices and behaviors to others in the community with malnourished children.
A “hearth” is the setting where the nutrition education and rehabilitation part of the program is carried out. Suggesting a family around a fireplace or kitchen, “hearths” are carried out in home settings where caretakers and volunteers prepare “positive deviant” foods. They practice beneficial child care behaviors and feed malnourished children with extra energy-rich/calorie-dense supplemental meals.
- Answers to frequently asked questions on PD/Hearth
- What are the essential elements of an effective PD/Hearth program?
- Where will PD/Hearth work?
- How does PD/Hearth complement Ministry of Health Essential Nutrition Services?
- How does PD/Hearth fit with other nutrition and child survival interventions?
The Technical and Operational Performance Support (TOPS) Program and CARE USA are pleased to offer this set of field-friendly activities entitled Realize: Social and Behavior Change for Gender Equity and Diversity (SBC for GED). The aim of these lessons is to build awareness, facilitate critical reflective dialogue, and explore potential action to improve gender equity and diversity among development staff and community members and to identify GED linkages within social and behavior change interventions to increase their effectiveness.
The activities are designed to be experiential, to encourage new thought and communication patterns that motivate people to change gender norms (and other types of societal norms) that impede the success of development programming – in health, agriculture, and other sectors.
This flipbook, released in Nov. 2011, contains key messages that pregnant women and their families need in order to plan care of an infant at home right after birth. It focuses on essential actions families can take both to prevent newborn death and illness and to promote healthy newborn development.
This material encourages use, whenever possible, of skilled birth attendants and clinical services and, where that is not realistic, provides some information on what families can do for pregnant women and care of the baby at birth. Even where mothers deliver with a skilled birth attendant in a health facility, they are often sent home within 6–12 hours of delivery. This material can also be used with women going home soon after delivery in a health facility. It highlights danger signs in the infant that require immediate attention and referral.
This tool was developed by CORE Group, in collaboration with Save the Children, the American College of Nurse-Midwives, and MCHIP.
This material is meant for outreach to pregnant women and their families with poor access to health services. These communities may also have low-literacy levels and/or poor access to health information. It is important to test the material with outreach workers and community members to be sure the messages are understood and acceptable. For guidance on adapting or testing this material, please email email@example.com.
The Care Group Difference guide, developed by World Relief, explores the evidence base for the Care Group model, offers criteria to assist project managers in determining the feasibility of using this approach within their own programs, and provides a step-by-step guide for starting and sustaining care groups. A care group is a group of 10 to 15 volunteer, community-based health educators who regularly meet together with project staff for training, supervision and support. Care group volunteers provide peer support, develop a strong commitment to health activities, and find creative solutions to challenges by working together as a group. World Relief pioneered the Care Group model as part of its Vurhonga child survival projects in Mozambique (1995-2003).
Other organizations, including Food for the Hungry International and Curamericas have since applied the care group model in a Title II Food Security project in Mozambique and a CSP in Guatemala, respectively (see Appendix B for project information).
World Relief is also exploring ways to use the care model in other health and development contexts. For example, World Relief is using care groups to train peer educators in HIV/AIDS prevention and care. While the interventions differ, the core elements of the care group model — multiplication ofvolunteer effort, peer support and community mobilization — remain the same
This manual is a guide for non-governmental organizations carrying out child health programs to assess under-five mortality rates and evaluate programs using the CARE Group Model. By following this manual’s methodology to establish a Mortality Assessment for Health Programs (MAP) System, organizations can collect valid and precise information about vital events and detect statistically significant changes in under-five mortality rates over the life of a child health program. Our hope is that NGOs will find this manual practical and feasible to assess correlations between program activities and mortality trends in a variety of settings.
Links from Manual:
- Vital Events Database (ZIP)
- Pregnancy and Birth Register (PDF)
- Under Five Death Register (PDF)
- U5MR Trend Chart Creator (ZIP)
- Promoter Vital Event Monitoring Report Card – Chart Creator (XLS)