Selection Training and Deployment of Community Health Navigators

Selection, Training and Deployment of Community Health Navigators (a project to improve the health and welfare of communities) F. Zacarías, C. Schaub, M. Barrios (August 28, 2014, Washington, D. C. )

COMMUNITY HEALTH NAVIGATORS (Questions to be answered in this seminar) What are CHNs? What will CHNs do? How will CHNs be selected? How will CHNs be trained? Where will CHNs be deployed? How will CHNs be supported?

JUSTIFICATION: what is missing in (some, many, a few) communities? § Leadership § Management § Solutions!!!

WHAT IS NEEDED? (community empowerment) Give a man a fish and you feed him for a day. Teach a man to fish and you feed him for life. Show people how to solve problems and they will feed themselves (even if there’s no fish)

WHAT IS A COMMUNITY HEALTH NAVIGATOR? The CHN is a problem-solver, a catalyst and agent of change who provides orientation and advice to (individuals, families and) communities, and helps them asses their needs, understand their rights, and access, navigate and benefit from the best possible and available health services and social development opportunities in order to improve their health and welfare.

Community Health Worker Social Mobilization Worker Social Worker Development Worker Microfinancing Advisor Health and Patient Navigator COMMUNITY HEALTH NAVIGATOR Agricultural Extension Agent Community Educator

Type of worker Description Community Health Frontline public health worker Worker Development Worker Community organizer focused on economic development Social Mobilization Social and political development agent Worker Agricultural Extension Agent Specialist in environmental/ agricultural/ veterinary issues Micro-financing Advisor Source of financial services for entrepreneurs and small businesses Community Educator Promoter of learning and social development of the community Functions Special Characteristics Provides health care and increases Member of the community health knowledge and selfsufficiency of the community supported by the health system but not necessarily a part of its organization Builds capacity, advocates, and Commitment to social justice; identifies assets, needs, flexibility, resourcefulness, opportunities, rights and resilience and sensitivity and responsibilities of the community respect for diversity Strengthens multi-sectoral Ability to motivate and inspire participation in local decisionpeople to act and participate in making, improves access to social the political process and production services and increases efficiency in the use of locally available financial resources Provides leadership in determining, Knowledge of best agricultural and implementing, and evaluating environmental practices educational programs designed to solve social, economic, and environmental problems in agriculture and natural resources Provides advice and means for Good knowledge of business, permanent access to necessary finance and/or economics financial services Creates a learning environment and Knowledge of cultural differences educates the community on ways and a clear understanding of to achieve better living conditions behavior change and communitybased education

Type of worker Description Community Health Frontline public health worker Worker Functions Special Characteristics Provides health care and increases Member of the community health knowledge and selfsupported by the health system sufficiency of the community but not necessarily a part of its organization Professional who helps Seeks to improve the well-being of Ability to analyze complex people increase their individuals, groups, and situations and patience and capacities for problemcommunities through research, flexibility to adequately address solving, coping, and obtaining policy, community organizing, those situations resources to improve their direct practice, crisis intervention, lives and teaching Good understanding of the Health and Patient Specialized and focused on Promotes health literacy and removing barriers in Identifies and alleviates financial infrastructure, financing and Navigator accessing and using health and logistical barriers to care of functions of all services within the services chronic, severe, and complex health system problems, such as cancer, diabetes and others Social Worker Community Health A problem-solver, connector, Provides orientation and advice to Wide and clear understanding of advocate, “ knowledgeable i communities and helps them community health and Navigator authority”, facilitator and agent of change structure, navigate and benefit from the best available health services and social development opportunities in order to improve their health and welfare development from a health and social determinants perspective and a multi-sectoral vision and approach.

What will CHNs do? § § § Guide Advise Inform Facilitate Teach Catalyze

What should CHNs learn? § Guidance and leadership § Advising (problem-solving) § Information gathering and dissemination § Advocacy, negotiation, and resource mobilization § Management methods § Specific subjects, as needed

How will CHNs be selected? § AGE: legal age § EDUCATION: minimum ten years § LANGUAGE(S): full fluency required § EXPERIENCE: relevant (minimum 2 years) § SENSIBILITY: cultural, gender, political, religious § ATTITUDE and commitment § ABILITY to master new knowledge, skills and technology § INTELLIGENCE: intra- and interpersonal

Where will CHNs be deployed? § Where they are needed; § Where they are wanted; § Where they are matched based on their abilities and the specific needs of the community; § Where they can be afforded.

What support do CHNs need? Compensation Incentives Networking Education Logistics Back-up Monitoring Recognition

“FOREVER” SKILLS (what you won’t forget) § Riding a bicycle § Drawing lines, curves and dots (writing) § Swimming Все люди рождаются

“FOREVER” COMPETENCIES (that CHNs should have)* § Engage (how to connect, lead, advocate) § Plan (ability to imagine, strategic thinking) § Negotiate (bargaining and persuasion power) § Manage (organizing the right people – including self - to do the right thing at the right time, to obtain the right results) * (to be successful)

TIMELINE (approximate) INITIAL PHASE (research) (2015 -2019) EXECUTION (development) EXTENSION (2020 - ) (2016 - )

WHAT’S IN A NAME? Community Health… § Promoter §Navigator § Advisor §Connector § Advocate § Guide § §Trainer §Specialist §Facilitator §Assistant §Planner §Other

QUESTIONS? ANSWERS TO QUESTIONS?