CHE Perinatal Support

(CHEPS) Lessons

The Community Health Education Perinatal Support (CHEPS) program was designed to address the problem of high maternal/infant morbidity and mortality rates in developing countries.

• Yearly 60,000 women die from pregnancy related causes.

• 54 million have complications from pregnancy.

• 99% of this mortality occurs in developing countries.

• In developing countries, the average is 1 in 48 women die from pregnancy

related causes. In Africa it is as high as 1:16 dies.

• This is compared to Europe where 1:4,000 deaths occur from pregnancy

related causes.

The Community Health Education Perinatal Support (CHEPS) material was developed to be used by CHE Trainers to train experienced CHEs at existing project sites. The establishment of CHEPS will greatly increase the CHEs abilities to minister to the whole village in a very practical and needy area.

A CHEPS is a CHE who has been trained in prenatal care and support. She (or he) will be able to meet regularly with pregnant women in their homes for the purpose of physical, emotional and spiritual preparation in prenatal care, childbirth and infant care. The goal is to affect women and their families to make behavioral changes that will benefit the pregnancy both physically and spiritually. The subjects addressed are related to the prevention of pregnancy and infant complications. CHEPS are the answer to the need.

Desirable Elements to Begin CHEPS:

Following principles for development of the CHE program, the following need to be in place before implementing CHEPS:

1. Trainers experience in training CHEs.

2. A community with an existing CHE project and recognition that they have a need to help pregnant women and their infants.

3. A committee that catches the vision to implement CHEPS in their area.

4. Experienced, responsible CHEs with interest in following women through their pregnancy.

5. Workable relationship with existing curative care clinic and/or midwives in the area.

Training for CHEPS:

1. Trainers should survey villages to determine best sites for CHEPS. Area should have a large proportion of child bearing age women.

2. Trainers meet with committees of favorable projects to share results of survey and get their buy into project.

3. Trainers chose CHEs for training of CHEPS with some of the following

characteristics:

a) Experienced, active CHE

b) Committed to their family and community

c) Able to learn basic anatomy of pregnancy and basic CHEPS lessons

d) Compassionate, non-judgmental

e) Good listener and observer

4. The Trainers should meet weekly for 1-2 hours with the chosen CHEPS for training in CHEPS lessons until basic topics are covered.

5. CHEPS training should be in the LePSAS or participatory format.

6. Trainers should hold regular CHEPS training sessions after the initial basic topics are covered to introduce the remaining topics.

7. The CHEPS should learn to use the prenatal home-visit log included in lessons and submit timely reports to the committee and trainer. These reports are to be completed monthly.

8. Trainers and CHEPS should initiate a relationship with the providers at the existing curative care clinic and/or midwives in the area. Every effort should be make to include them and be of assistance to them in their care of women.

Basics of the CHEPS Home-Visit:

1. The heart of an effective CHEPS program is the home-visit.

2. CHEPS should be assigned from 5-10 homes to visit recurrently. The

workload assigned depends on the available time of the CHEPS volunteer and if their case load is comprise of only prenatal or a mix. The committee is consultation with the trainers assigns the work load and homes.

3. Each assigned home should be visited at least every two weeks or more often if visits start late in pregnancy.

4. Each home-visit should consist of the presentation of a physical and spiritual topic.

5. Each CHEPS should keep an up-to-date prenatal home-visit log (in manual) recording the spiritual and physical lessons presented along with other important information (i.e. spiritual status, special physical problems, etc.).

6. Each CHEPS should have his own personal lessons and access to an adequate supply of lessons for new members.

7. Trainers should make regular home-visits with each CHEPS and give

constructive criticism after the visit (not in the home). A Trainer should make a home-visit with each CHEPS at least once every three months (more frequently when the CHEPS first begins to visit).

8. The CHEPS should have a model home, which should include appropriate sanitation, hygiene, clean water, etc. The CHEPS should model healthy living for the community. Trainers should regularly visit each CHEPS home and encourage improvement when necessary.

9. In order to cover more topics in a short period of time the CHEPS may decide to conduct a prenatal group class once a week for a month addressing Complications, Childbirth, Pain Control, and Newborn Care. But this does not take the place of the home-visit.