COMMUNITY HEALTH EXTENSION WORKER (CHEW)

SENIOR CHEW

The Community Health Extension Worker (CHEW) is a member of the health team for Primary Health Care (PHC). The Community Health Extension Worker will spend 50% of his time in the clinic. He or she has the responsibility of supervising the Junior Community Health Extension Workers (JCHEW), the Community Health Extension Worker in training, the Volunteer Village Health Workers and the Traditional Birth Attendants. He or she is to be supervised by the Community Health Officer (CHO).

JOB TITLE

Community Health Extension Worker (CHEW) or Diploma in Community Health.

LOCATION OF THE JOB

LGA PHC Department or community

PERSONAL QUALIFICATION

• Physically and mentally fit.
• Able to communicate and work well with people in the community.
• Able to guide, supervise and give good leadership to his subordinates.
• Willing to live and work in the community.
• Mature, approachable, friendly and honest.
• Able to work independently when necessary and make payment.

ENTRY QUALIFICATION

For advancement of confirmed, academically qualified Junior Community Health Extension Worker who has been on the grade for a minimum of 2 years. Four credit level passes at WAEC, NECO or GCE O’level at not more than two sittings. These must include

• Biology or Health Science.
• One subject chosen from Chemistry, Food & Nutrition, Physics and Geography.
• Two subjects chosen from Economics, Accounts, Commerce, Agricultural Science and Social Sciences.
• Credit in English language and Mathematics is compulsory.

DURATION OF COURSE

3 calendar years.

CERTIFICATE AWARDED

Diploma in Community Health.

COMMUNITY BASED FUNCTIONS

• Explain to the community the Primary Health Care approach of the Nigerian Health System and his role as a member of the health team to link the community with health care system.
• Carry out community mobilization for health action.
• Guide and support the Volunteer Village Health Workers (VVHWs), Traditional Birth Attendants (TBTs) and Junior Health Extension Workers (JCHEW) to initiate preliminary contact with the leaders.
• Familiarize self with target population and health services within the community.
• Follow up and provide support for the initial contact made by the Volunteer Village Health Workers, Traditional Birth Attendants or Junior Community Health Extension Workers with the community leaders.
• Initiate the information and facilitate the effective functioning of the Development Committee.
• Attend Community Development Committee meetings in rotation at least two times a year.
• Participate in, and supervise Primary Health Care house numbering and placement of home based records.
• Update house numbering and placement of home based records during home visits and through reports and records from Junior Community Health Extension Workers, Volunteer Village Health Workers and Traditional Birth Attendants.
• Initiate and work with the community and other health workers to carry out community diagnosis and continuous health needs assessment of the community (Health needs include areas related to provision of good roads, good water supply, education, agriculture, nutritional problems, HIV&AIDS, poverty eradication, etc).
• Initiate and work with the community and other health workers to carry out general community survey, social and cultural characteristics of the community.
• Work with other health workers and the community to identify major health problems of the community, including HIV&AIDS, Teenage Pregnancies, Juvenile delinquency, problems of the elderly, gender inequality, etc.
• Teach the Junior Health Extension Workers simple methods of data collection and analysis. Participate in the analysis of data collected.
• Initiate and or work with the supervising officer and community members to Prioritize health problems.
• Plan solutions to identified health needs.
• Identify available resources to solve the health problems.
• Set coverage objectives (targets).
• Identify workable interventions.
• Prepare and or assist the supervising officers in preparing budget for implementation of plans.
• Prepare a schedule of activities for the delivery of services to tackle the priority health problems.
• Work with Supervising Officer, Junior Community Health Extension Workers, Volunteer Village Health Workers or Traditional Birth Attendants and community members to carry out plans.
• Develop a monthly work plan with the approval of the supervising officers.
• Coordinate the work of the Junior Community Health Extension Workers and the Volunteer Village Health Workers or Traditional Birth Attendants.
• Manage Junior Community Health Extension Workers and Volunteer Village Health Workers or Traditional Birth Attendants referrals and ‘At Risk’ cases within the community using Standing Orders.
• Support Junior Community Health Extension Workers and Volunteer Village Health Workers or Traditional Birth Attendants’ efforts on health education and initiate periodic health campaigns within the community.
• Supervise the activities of the Junior Community Health Extension Workers and Volunteer Village Health Workers or Traditional Birth Attendants and give feedbacks.
• Assess the accomplishments of set coverage objectives (targets) by Junior Community Health Extension Workers and Volunteer Village or Traditional Birth Attendants.
• Collect and collate records collected by Junior Community Health Extension Workers and Volunteer Village Health Workers or Traditional Birth Attendants and forward these to the Supervising Officer.
• Supervise the operation of the Essential Drug System and the Drug Revolving Fund.
• Keep accurate records of activities and health problems as required within the area of coverage.
• Analyze and summarize data collected and present them in simple graphic forms.
• Compile monthly returns and reports, and send to the Supervising Officer and the Community Development Committee.
• Collect updates from Volunteer Village Health Worker or Traditional Birth Attendant on records of information on births, deaths and new entrants into the community.
• Decide, in consultation with Community Health Officer where available, when there is need for more packaged drugs.
• Maintain a roster for regular servicing of equipment, if Community Health Officer is not available.
• Constantly monitor staff and vehicle movements, if Community Health Officer is not available.
• Maintain a roster decided upon with Volunteer Village Health Workers (VVHWs) or Traditional Birth Attendants (TBAs) for meetings, and inform the community.
• Carry out all the other duties assigned him or her by the Supervising Officer.

CLINIC BASED FUNCTIONS

Provide Integrated Primary Health Care services.

1.1. Organize and run Integrated Primary Health Care Services where the Community Health Officer is not available. These services are listed in the Nigerian National Health Plan and include

• Health Education concerning prevention and control of prevailing problems.
• Promoting water supply and basic sanitation.
• Maternal and child health, including reproductive health, e.g. provision of antenatal care and delivery of normal pregnancy, postnatal care and specified reproductive health services.
• Providing immunization services.
• Managing logistics and cold chain system.
• Carrying out of equipment sterilization according to established protocol.
• Treatment of common conditions and injuries.
• Performing simple laboratory tests and examination e.g. hemoglobin estimation, stool and urine testing etc.
• Keeping and checking that clinic equipment are in safe and good working order.
• Promoting mental and dental health.

1.2. Collect and collate monitoring and evaluation data for the National Health Information System (NHIS) from the Community Facility and forward to the Ward level.

1.3. Carry out with Community Health Officer (where available) the day-to-day administration of health services in the target population.

TRAINING FUNCTIONS

1.0. Identify learning needs of Junior Community Health Extension Workers (JCHEWs) and Volunteer Village Health Workers (VVHWs) or Traditional Birth Attendants (TBAs). And members in the Community Development Committee.

2.0. Provide on the job training as necessary.

3.0. Collaborate in the planning, implementation and evaluation of training programmes for JCHEWs and VVHWs or TBAs.

4.0. Teach the Junior Community Health Extension Workers simple methods of data collection, collation and analysis.

NOTE: A CHEW has now been rated as a skilled Attendant at Birth just like Doctors, Nurses and Midwives by the Federal Government of Nigeria.

JUNIOR CHEW

The Junior Community Health Extension Worker is a member of the Ward Health Team who works directly with VVHWs/TBAs. He/she is employed by the formal Health system and is expected to spend 80% of his/her working time in the community and 20% in the clinic. He/she is supervised by the Community Health Extension Worker (CHEW).

Entry Qualification

• A candidate should possess five (5) passes in English, Mathematics, Biology or Health Science and any other two (2) subjects in WAEC/GCE or NECO at not more than two sittings, and must be domicile in the local government area.
• Existing workers (e.g ward orderlies, ward maids and health attendants) in the health facility with relevant qualification as stated above, if found suitable for training by training institutions and with nomination and support of his/her governmental establishments are eligible.

Personal Qualification: willingness to reside in the rural community as a pre-requisite to understand the norms of a community and thereby be in a better position to identify feasible local health problems.

Duration of the course: 2 calendar years.

Certificate awarded: certificate in community health.