Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #104496

Maria E. Compte, MD, MPH & TM, Vice President for Programs, Intermed International, 420 Lexington Avenue, Room 2331, New York, NY 10170, 212-687-3620, compte@dooleyintermed.org

The Coco River region of Nicaragua is populated predominantly by indigenous,semi-nomadic, subsistence-farming populations that are widely dispersed over a vast and remote geographical area. This represents a significant challenge for the provision of sustainable health care services to these disenfranchised minorities. This and other factors have resulted in this region's suffering from some of the worst health indicators in Central America. We present a comprehensive community-oriented program with a strong Maternal/Child Health component that has been in place in rural Waspam County, Nicaragua, for the past five years. This ongoing project, ultimately aimed at reducing morbidity and mortality rates, is a partnership between Intermed International, Santa Ines Clinic, the Nicaraguan Ministry of Health, community members, and lay health care providers. The program addresses a complex problem from a multi-perspective approach that incorporates both traditional and non-traditional interventions. Methods: Review and analysis of service statistics; analysis of results from community focus groups; participants' feedback; objective pre/post testing of lay workers-in- training; direct observation of field performance (lay health workers); minutes of Community Health Councils and other indicators of community organization and mobilization for health. Recommendations: This multi-pronged, multi-partner, multi-centered approach to a complex, rural and remote, public health situation has proved quite successful in fulfilling a number of its goals. Sustained efforts and commitment on the part of the present and future partners are necessary in order to maintain and advance the health and quality of life of women and children in Waspam County's Coco River region of Nicaragua.

Learning Objectives:

• Recognize the value of, as well as the challenges presented by, multi-pronged and multi-centered aproaches in the provision of primary care services to remote, geographically dispersed, semi-nomadic traditional populations.
• Assess the applicability and sustainability of the comprehensive rural health care initiative presented here into other complex rural health scenarios in resource-poor settings.
• Identify potential collaborations and partnerships conducive to facilitate the participatory provision of services to hard-to-reach rural populations.

Keywords: Rural Health Care, Community-Oriented Primary Care

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Recorded presentation