Testing an integrated care group model for community-based health promotion in Burundi: An operations research study

The Care Group model is an evidence-based behavior change methodology. Concern Worldwide is conducting operations research on an adapted, ‘Integrated' Care Group model designed to reduce the dependence of Care Group implementation on paid project staff, while increasing integration with the local MOH structure by task-shifting Care Group facilitation to appropriate MOH staff and Community Health Workers. 50 traditional Care Groups with 509 members and 48 integrated Care Groups with 483 members were established. The cluster-randomized study seeks to determine if the integrated Care Group model achieves the same improvements in key health and nutrition knowledge and practices and achieves the same level of functionality and sustainability as the traditional Care Group model. Knowledge and practices are assessed in baseline and endline population surveys using simple random sampling. Functionality is assessed by monitoring the number of Care Group meetings per month, volunteer attendance at meetings, number of home visits conducted, and reporting rates. Sustainability will be assessed by monitoring the five functionality indicators in the final six months of the study, once Concern has withdrawn all support in both areas. Results from the first 18 months of implementation indicate there is no significant difference (>15%) between Traditional and Integrated Care Groups in the five functionality indicators. End line surveys will be conducted in April 2013 and results will be analyzed by September 2013.The Integrated Care Group model is identified by the Ministry of Health as a promising model for implementing a realistic Community Health strategy in Burundi.