Beyond the volcanoes: Planning for community action to improve health in rural Nicaragua

Background: Health inequities related to gender, ethnicity, socioeconomic status, and geography exist in rural Nicaragua. The purpose of this ongoing project is to improve health equity in rural Nicaragua through social transformation using community-based participatory action research. Bronfenbrenner's ecological model of human development, school health, and primary health care theories provided the framework for this research.

Methods: Community-based participatory action research involves six phases: partnership, assessment, planning, implementation, evaluation, and dissemination. In the planning phase, the goal was to use the data obtained during the assessment phase to develop an action plan to reach the community's health-related goals. Community health leaders and researchers engaged community members in a forum which included three small focus groups.

Results: Sixteen community members participated in the forum and resulting focus groups. The consensus among each focus group was to develop a culturally appropriate action plan to improve health promotion and disease prevention that included the use of sociodramas and poetry to deliver health education in the implementation phase of the project. Three examples of sociodramas and two poems were recorded and analyzed during the planning phase. Several health promotion/disease prevention themes resulted, including: improving air quality, water quality, and sanitation.

Conclusions: Results from the focus groups were used by the community to develop an action plan to address their primary health concerns through participatory educational techniques including sociodramas and poetry. Partnership in planning health promotion and disease prevention provides a mechanism to engage community members in working toward a common goal—health for all.