Monday, April 4, 2011

Community Based Primary Healthcare


AMOS Health and Hope partners with the communities we serve to improve health using the strategy of  of community based primary health care (CBPHC).  CBPHC is a holistic approach to health - it begins before a person ever gets sick.  When we wash our hands, eat good food, contain our waste and prevent it from contaminating our water, many preventable illnesses can be dramatically reduced.  If we add to this good hygiene education and medical training, we can identify and avert problems before they become crises and our capacity grows even greater.  Eventually, by cultivating an environment that fosters good health, we can prevent unnecessary disease and death.  


How does community-based primary healthcare work ? 
Primary healthcare is about treating and preventing illnesses, while also promoting good health (nutrition, sanitation, hygiene, etc.).  “Community based” simply means healthcarefor the community, and by the community.  AMOS walks alongside rural communities, helping them to identify local leaders who will take up the cause of good health.  These local leaders then form a health committee, which works in conjunction with a health promoter.  The health promoter is an individual who receives basic medical training in order to provide treatment, medicine, and preventive care.  Together, the committee and the promoter help to care for every individual in their community.  

How do local leaders care for their community?  
It all begins with a census and the belief that: “Every one counts and every one must be counted.”  The health committee and health promoter go to each house in the community, noting the number of people in each family, with special care for mothers, infants and those with chronic diseases.  Using this data, they create a map of their community and identify the most vulnerable people.


Often when aid is given, it goes to the strongest and most able-bodied – those who have the resources to ask for help or travel to a distribution point.  This can magnify the disparities in a community, with certain families receiving an inordinate amount of goods and services while others are left in the dark.  By taking a census, the health committee can help to ensure equity and fairness.  They can ask, “Who is missing here and what can we do for them?”  When special care is given to the most vulnerable people, it makes it possible for all boats to float - ie. the entire community benefits.  

Communities making a difference with their own data
A vital part of successful change is community ownership and knowing whether our efforts are bearing fruit.  With the accompaniment of AMOS staff, health promoters collect information on the health of their communities. By teaching communities to create and maintain their own records, AMOS builds capacity in communities to track their own health indicators including child death rates, diarrheal disease rates, malnutrition rates and respiratory infection rates. This knowledge gives communities the power to act and make a difference to improve community health.


For example, an average community clinic gets 2 or 3 cases of diarrhea a month.  If the cases suddenly increase to 15, the promoter knows there is an epidemic and can mobilize the health committee to take concrete actions, such as making home visits to teach families how to prevent and control the epidemic.  The data collected by health promoters not only gives a current picture of the community, but also allows them to plan for the future.  Each year, the health committee meets to set goals - areas of growth that they will emphasize in an effort to continually improve the quality of life.  All of this is part of the ultimate goal of empowerment: communities standing together, identifying their own issues and taking actions that are meaningful and effective.  

Accompaniment – walking with communities 
It’s been said that supervision and accompaniment are the frontier of public health.  Time and numerous studies have shown that it’s simply not enough to provide training and medicines for a community and then leave.  Ongoing supervision and care must be an integral part of any primary healthcare program to ensure that local healthcare providers receive the proper support and ongoing training.  Accordingly, AMOS maintains a regular supervision circuit where trained doctors and nurses visit the 27 communities and their health promoters, providing medicines, checking records, and helping with any questions the promoters may have. 


Health and hope for all 
AMOS is founded on the idea that all people deserve access to adequate healthcare.  We believe that the best treatment is prevention – helping people to avoid sickness in the first place.  This is the foundation of community based primary healthcare: walking alongside communities as they move toward a place of knowledge and strength, training local leaders to provide education and treatment, and eventually raising the level of understanding and ownership to create a place where there can be health and hope for all.  

If you resonate with this mission of bringing health and hope to those who lack access to adequate healthcare, we invite you to consider a donation, which goes directly toward providing these vital services: