Background: In 1998, Save the Children/US invited indigenous citizens and health providers from ten rural Bolivian villages to assess maternal and child health (MCH) and to plan for health services together using a locally designed, community-based health information system (CB-HIS). Volunteer health promoters gathered raw MCH data from their neighbors. They then worked with local health personnel to combine community and facility-based health data and to present this information at monthly community meetings. Aim: This research describes the experiences of villagers and health personnel who participated in this CB-HIS project for one year, and compares the use of MCH practices and services in intervention and comparison communities. Methods: SC staff kept project-related records for all ten intervention communities and supervised an ethnographic study involving fifty key informants and nine focus groups in three of the intervention communities. Local interviewers conducted a cross-sectional survey in seven intervention and seven comparison communities, randomly sampling 218 households and 344 children. Results: Intervention communities promoted local health, demanded more responsive and accountable health services, and built positive working relationships with participating health personnel. More intervention than comparison households reported: complete child immunization (OR=4.78,11.2%vs2.6%,p<.05); vitamin A supplementation (OR=1.96,58.6%vs41.9%,p<.05); health card possession (OR=2.12,44.9%vs27.7%,p<.05); early breast-feeding (OR=2.62,25.7%vs11.7%,p<.05); and oil supplementation (OR=1.95,67.5%vs51.6%,p<.05). Conclusions: The CB-HIS enabled communities to assess their health, plan, and act as partners in the local health system. Intervention communities were more likely to use child-related practices and services. Communities in other settings should be offered the opportunity to use this highly participatory CB-HIS approach.
Learning Objectives: After attending this session, the participant will be able to: 1. Describe a community-based health information system (CB-HIS) that enables illiterate or semi-literate communities to assess maternal and child health and plan for local health services with health professionals . 2. Identify methods to monitor and evaluate the impact of a CB-HIS. 3. List the benefits and challenges of a CB-HIS used by indigenous communities in rural Bolivia.
Keywords: International MCH, Community-Oriented Primary Care
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Save the Children Federation/Westport,
Johns Hopkins University PCS4 project
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.