TITLE OF PROJECT: Awareness rising on psychosocial issues among health staff practicing in BPHS structures

ORGANIZATION: HOSA (Humanitarian Organization Supporting Afghans)

FUNDED BY: Caritas Germany and CRS

LOCATION: Kabul, Herat, Balkh and Bamyan provinces (Afghanistan)

PROJECT DURATION: Eleven months (01.02.2008 – 31.12.2008)

PROJECT OBJECTIVES:
1. The overall objective of the program is to support social development by reducing the profound psychological impact amongst Afghans of chronic conflict, insecurity and deprivation.
2. The specific objective of the program is to improve the mental health of Afghan population affected by trauma, domestic violence and other psychological problems and promote psychosocial services in the Afghan health system trough trainings, workshops and awareness activities

ACTIVITIES DONE DURING THE RPOJECT TIME:

1. Coordination of Activities with MoPH and Other Relevant Stakeholders at Central Level:
A MOU stating the obligations and responsibilities of both parties has been signed with MoPH regarding the awareness rising trainings for about 150 health staff in the planned three provinces.
The organizations active in field of health (especially BPHS implementers in the target provinces) have been contacted at the central level and briefed on project objectives and planned activities. Six main BPHS implementers (AADA and ADRA in Bamyan, BRAC and BDN in Balkh, CHA and MOVE in Herat) have been identified in three planned provinces to conduct awareness rising trainings on psychosocial issues for their health staff practicing in health facilities (MD, Nurses, Midwives) as well as their community based health workers (CHWs and CHSs). Separate MOUs have been signed with each one clearly explaining the obligations and responsibilities of each party, duration of the trainings, participants’ selection criteria and the number of the staff to be trained.

2. Developing a Training Manual for Awareness Rising Trainings:
For conducting a culturally sensitive training, a new training manual has been developed taking into consideration the Afghan context and the different cultural aspects of the Afghan society.
A list of the topics that should be taught during the awareness rising trainings has been developed by training department of HOSA. Based on the prepared list of the topics, the first draft of the training manual had been produced in local language (Persian) by HOSA training department, then translated into English and was sent to project consultant, Mrs. Inge Missmahl, for revision and approval. Correction and comments made by Mrs. Inge Missmahl have been incorporated into the drafted English version. A three-day workshop was conducted in HOSA’s office in Kabul with the participation of Mrs. Inge, HOSA’s master trainers, training coordinator and General Director revising each drafted topic of the manual and finalizing them altogether. The finalized English version of the training manual has been translated back into local language (Persian).                                                        Facilitators’ guide and detailed training’s timetable have been developed and translated as well. 

3. Setting up a Training Room in HOSA’s Kabul Office:
A training room has been set up in HOSA’s Kabul office in order to have a proper place for the intensive training courses of new counselors and conducting awareness rising trainings.

4. Coordination of Awareness Rising Trainings with Local MoPH and Other Stakeholders at Provincial Level: All the activities planned for the project had been coordinated with MOPH, BPHS implementers and other stakeholders at the central and provincial levels. Having received the official introduction letter from central MoPH, and signing MOUs with BPHS implementers at central level, we did start going to the provinces in order to coordinate the trainings at provincial level with local MoPHs and BPHS implementers.
All the provincial coordination visits have been done having the following objectives and planned activities in mind:
1) Local coordination with PHDs (Provincial Health Directors) in order to facilitate the implementation of awareness rising trainings at the target provinces and becoming sure of their needed support.
 2) Establishing link and informing the active organizations in target provinces especially BPHS implementers to familiarize them with the project and making sure of their support.
 3) Booking training venues and making sure of stakeholders’ support in terms of providing required training equipments such as white-board, flipchart holder, screen, multimedia, logistic assistance etc.
 4) Making sure of receiving the participants list according to the stated criteria in signed   MOUs, at least 10 days prior to conducting the trainings.

5. Conducting the Awareness Rising Trainings:
The program is based on close co-operation with different governmental structures, mainly the Ministry of Public Health, local authorities, community leaders, Mullahs and other non-governmental organizations active in the field of health and social development to ensure the sustainability of the project and the gradually increasing independence from external support. In general we did conduct awareness rising trainings on psychosocial issues for two categories of participants: First category was the health staff practicing in the health system of the country and 2nd category was the staff of the organization providing social services for the Afghan populations.

a. Conducting Awareness Rising Trainings for the Health Staff:
Specific three-day training courses had been conducted for MDs, Nurses, Midwives as well as community health workers and supervisors in three provinces of the country.
The trainings have been conducted in two rounds for two categories of primary health staff (community and health facility based health workers). In total, it was planed to train 150 person of different category of health staff (which means 50 health workers per province).
All the planned trainings are conducted in the target provinces. The nominations of trainees took place in result of central and local coordination with MoPH and relevant main BPHS implementers. Attention has been paid to take in consideration the gender issue and replication of knowledge to the rest of health staff. The details concerning the conducted trainings in three target provinces are given in the following table.

Trainings were conducted in accordance to the developed training manual and guideline. Participatory and brain storming methods are used in regard to increase the efficiency of training. In addition, the self-experience methodology, very closely linked with the topics taught in training was also used. The stories of real cases are anonymously presented in respect to provide enough elaboration and understanding of the topics.  (For detail please see training manual)

b. Conducting Awareness Rising Trainings for the Staff of Organizations Providing Social Services:
It is worth mentioning that it is an extra activity which was not part of the main project proposal. Several trainings have been conducted for the staff of organization providing social services, mainly for the staff of UNFPA youth centers and Kinderberg International. The training was implemented in three batches and each batch was facilitated for 20 participants (in total 60 staff members of UNFPA youth centers have been trained).
The following table shows the details of the training conducted for the staff of organizations providing social services:

7. Offering Counseling Services to the Population in-Need through Kabul Counseling Center:
On top of routine activities of offering professional counseling services through HOSA’s Kabul counseling center, the counselors conducted psycho-education and awareness rising sessions in the community and organized open and closed group counseling in the center. 
The following table shows the details of psycho-education and Awareness Rising Activities done during the year 2008 at the community level:

The following table shows the details of the groups’ activities done in the Kabul counseling center:

The table below shows the counseling center activity in terms of offering professional counseling services from January 1st 2008 till December 31st 2008.

Results:
1.A training manual to raise awareness on psychosocial issues is developed for the health staff practicing in BPHS structures.
2.A training room is established and equipped with training materials for conducting further trainings.
3.147 health staff and 84 staff of social services are trained on psychosocial issues.
4.96 clients received professional individual psychosocial counseling, 326 persons received group counseling and 877 persons received psycho-education/awareness on psychosocial issues.