Abstract
Community empowerment: The key to sustainable health and development in Jamkhed, India
Lavanya Madhusudan, MPH, MSW1, Connie Gates, MPH2, Surekha Sonawane, BEd3, Pushpabai Sutar, VHW4 and Ravi Arole, MBA3
(1)Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, (2)Jamkhed International, Carrboro, NC, (3)CRHP Jamkhed, Jamkhed, Maharashtra, India, (4)CRHP Jamkhed, Jamkhed, India
APHA 2016 Annual Meeting & Expo (Oct. 29 - Nov. 2, 2016)
The Comprehensive Rural Health Project (CRHP), Jamkhed, India, was started in 1970 by Drs. Raj and Mabelle Arole. CRHP pioneered a comprehensive, community-based primary health care (CBPHC) approach. Working with the communities, the Aroles learned the importance of the principles of equity, integration and empowerment, especially for sustainability. CRHP builds capacity of villagers to solve their own problems through empowering individuals and communities, with special focus on the poor and marginalized, women and children. From January to May 2015, a project was undertaken to understand and document the processes and outcomes of empowerment as occurring through, and resulting from, CRHP's CBPHC approach, and develop indicators and tools for measuring empowerment in this context. Through a logical sequence of questions and considerations, participatory evaluation was selected as the locally appropriate framework for measuring community empowerment. Through a participatory evaluation process, indicators to measure empowerment were developed, along with quantitative and qualitative tools for longitudinal measurement of empowerment. The processes and outcomes of empowerment in project villages were also identified from data collected during the participatory process. The processes of empowerment originate from the essential values of CRHP, which are passed from CRHP staff to VHWs, who in turn embody and spread these values throughout their communities, resulting in collective and individual empowerment. The villages become caring and sharing communities. The outcomes of empowerment are evidenced by dramatic changes over time in health and social outcomes, including improved quality of life and peace. Sustainability is accomplished through empowerment, specifically through the knowledge, skills, attitudes, and values acquired by individuals. The benefits of community empowerment were found to go far beyond the improvement of quantitatively-measured health outcomes. This project reveals the importance of values-based programming and highlights the need for greater focus and investment in community empowerment, including the identification of best practices.
Administer health education strategies, interventions and programs Assessment of individual and community needs for health education Conduct evaluation related to programs, research, and other areas of practice Implementation of health education strategies, interventions and programs Planning of health education strategies, interventions, and programs Provision of health care to the public
Abstract
Religious leaders knowledge on immunization communication and social mobilization, Semi Pastoralist, Ethiopia:Qualitative Study
Muluken Alemu
CCRDA/CORE Group, Addis Ababa, Ethiopia
APHA 2016 Annual Meeting & Expo (Oct. 29 - Nov. 2, 2016)
Background: CORE Group Ethiopia aimed at building the technical capacity of religious leaders; developing key messages and producing immunization communication materials to implement a health communication intervention through the church system.
Objective: assessing religious leaders' knowledge on Immunization Communication and Social mobilization mainstreaming program to EECMY Church after provision of Training of Trainer on it.
Method: Qualitative study was conducted through in-depth interview from purposively selected Mekane Yesus Church Priests, Evangelists, Pastors and Project staffs from Synod, Presbyterians and congregation in different localities.
Result: The degree of respondents' knowledge seems to vary. Despite the undisputed difficulty to conclude towards saying the immunization communication and social mobilization training as the main source of their knowledge about immunization, it is certain that it has significantly helped in raising their knowledge about immunization as well as in opening ways in which they mobilize and share their knowledge with the faithful people they are serving in their respective areas.
The 78 year old Evangelist said; "Yes, I have received training on vaccination. We have been told that there are nine types of diseases that we can prevent through vaccines. We have received training that vaccination is necessary to keep our children healthy and strong. We tell them to go to the hospital and vaccinate their children. Even my grandson has been vaccinated this week since I told his mother to go to the hospital and vaccinate him. And I will keep telling people in my village to do the same".
Recommendation: The religious leaders have been share strongly what they trained so the project better to expand the trainings for religious leaders in order to refresh, update and equip their knowledge towards immunization and in turn to address correct information to faithful people they are serving.
Conduct evaluation related to programs, research, and other areas of practice Systems thinking models (conceptual and theoretical models), applications related to public health
Abstract
Identifying and Addressing Barriers to Primary Health Care for Cardiovascular Disease and Diabetes in India, South Africa and the United States
Dasha Migunov1, Chanza Baytop, MPH, DrPH1, Pat Shifflett, RN, MS2, Rose Gabert3, Jessica Daly, MPH4, Mary Beth Woodin1, Pamela Naidoo, PhD5, Zaino Petersen6, Anam Nyembezi6, Priscilla Reddy, Prof6, Conjeevaram Haricharan1 and Komal Khanna1
(1)Abt Associates, Bethesda, MD, (2)Abt Associates, Atlanta, GA, (3)Institute for Health Metrics and Evaluation, Seattle, WA, (4)Medtronic Foundation, Washington, DC, (5)Human Sciences Research Council, Cape Town 8001, South Africa, (6)Human Sciences Research Council, Pretoria, South Africa
APHA 2016 Annual Meeting & Expo (Oct. 29 - Nov. 2, 2016)
Despite a wealth of evidence regarding effective clinical approaches to diagnosing and treating non-communicable diseases (NCDs), morbidity and mortality rates for these illnesses are rising globally, particularly among underserved populations. A key reason for this paradox is that patients face both demand- and supply-side barriers to accessing chronic care. The HealthRise program identifies and addresses these barriers to cardiovascular disease (CVD) and diabetes primary health care for underserved populations through community-based demonstration projects in India, South Africa and the US.
To identify the key barriers to CVD and diabetes care, HealthRise conducted local needs assessments that collected insights from patients, providers, clinical experts, civil society, government and the private sector. These efforts uncovered similar demand- and supply-side barriers in the three countries. Individuals in low-income/low-resource areas often do not seek screening and diagnoses or achieve treatment targets due to limited awareness of the disease risks and symptoms and distrust of the health system and its providers. Meanwhile, primary health care facilities are under-resourced and overburdened, supplies are limited and costly, and providers often lack the skills, time and resources to counsel and monitor their chronic patients.
In response to these barriers, HealthRise is working with community-based organizations and local stakeholders in the three countries to implement interventions that empower patients and strengthen primary health care providers in order to increase the diagnosis and control of CVD and diabetes. Cross-country learnings from the program will guide NCD programming for underserved populations in the focus geographies and beyond.
Chronic disease management and prevention
Abstract
Community Based Health Volunteers: An Important Stakeholder in Eradicating Polio from India
Adesh Chaturvedi, Dr.1, Jitendra Awale, MSW2, Shachi Adesh, Dr.3, Roma Solomon, Dr.4 and Manojkumar Choudhary, MA , Master of Population Studies (MPS)5
(1)Kaziranga University, Vaagdhara; Samriddhi Trust, Jaipur, Jorhat 785006, Assam, India, (2)CORE Group Polio Project, Gurgaon, India, (3)Don Bosco College, Panjim, Goa, India, (4)Core Group Polio Project, Gurgaon-122002, Haryana, India, India, (5)CORE Group Polio Project India, Gurgaon 122002, India
APHA 2016 Annual Meeting & Expo (Oct. 29 - Nov. 2, 2016)
South East Asia Regional Certification Commission for Polio Eradication (SEA-RCCPE) declared the Southeast Asia region polio free on 27 March 2014. With the certification, four of the six WHO regions became polio-free, leaving only WHO's African region and East Mediterranean region to be certified. This is the most significant milestone in the Global Polio Eradication Initiatives (GPEI), which could happen in India because of determination and dedication of the Government of India, state governments and partners with active participation of the community. CORE Group Polio Project (CGPP), as a partner in social mobilisation for Polio Eradication Program, contributed significantly in carrying out such a Herculean task successfully.
An independent assessment study was done to assess the Polio eradication program implemented by the CGPP in India in 12 districts of Uttar Pradesh, India, which has the most resistant communities with regard to administration of Polio vaccine. In this study, the role of community based health volunteers was recognised and found to be extremely crucial in mobilising the resistant community and thereby eradicating Polio from India. ‘Well equipped and motivated community based health volunteers are the key success factor of large scale public health program' was one of the key learning of the assessment study on Polio eradication. This paper also deals with the capacity building of community based health volunteers and their role in eradicating polio from their area.
Conduct evaluation related to programs, research, and other areas of practice Implementation of health education strategies, interventions and programs Public health or related education Public health or related research
Abstract
Helping community health workers support people with cancer and promote prevention
Sarah Shannon, Executive director Hesperian Healthguides
Hesperian, Berkeley, CA
APHA 2016 Annual Meeting & Expo (Oct. 29 - Nov. 2, 2016)
Background: More than 60% of world cancer cases occur in Africa, Asia and Central and South America annually. While these regions disproportionately experience cancer deaths, they are ill-equipped to bear this burden despite low-cost prevention and treatment opportunities available.
Objective: A new resource in development, New Where There is No Doctor, outlines current and potential roles of community health workers (CHW) to educate about cancer and support cancer patients. Global CHW partners provided feedback and experiences to shape the validity and quality of draft materials.
Methods: Five focus groups (averaging 12 individuals per group) were conducted in India, Cameroon, Belize, and Palestine to gather feedback on cancer prevention and treatment materials. Facilitators followed uniform instructions and a structured questionnaire. The detailed notes and event summaries were reviewed and coded to elucidate common themes.
Results: CHWs reported insufficient knowledge and widespread stigma faced by cancer patients as well as lack of access to diagnostic testing or treatments in both rural and urban settings. Participants previously experienced inadequate training which limited their current role. However, they identified potential roles including: aiding community members with diet and smoking, promoting cancer screenings, addressing pollution sources (e.g. wood smoke, burning garbage), helping patients locate treatment resources, and destigmatizing cancer as not caused by personal misconduct.
Conclusion: Even with limited cancer treatment resources, CHWs can mobilize informational and other tools to: have an impact on early detection of cancer, advocate for early treatment, address environmental cancer causes locally, and reduce stigma faced by cancer patients.
Chronic disease management and prevention