المؤلفون: Quillian Jp

المصدر: Journal of the American Academy of Nurse Practitioners. 5:219-225

مصطلحات موضوعية: Community Health Workers, medicine.medical_specialty, education.field_of_study, Primary Health Care, business.industry, Community participation, education, Population, Primary health care, MEDLINE, Developing country, Health problems, Honduras, Nursing, Family medicine, Health care, medicine, Humans, Community health workers, Community Health Services, business, General Nursing

الوصف: Community participation and utilization of community health workers (CHWs) are essential components of the primary health care model. The success of CHWs is dependent on their training and subsequent community support. Community-prepared nurses are ideal CHW educators. A training program for CHWs was implemented in Honduras emphasizing the principles of adult learning and problem-based learning. Following a 4-month program of training a primary health care clinic was opened and managed by CHWs for a population over 10,000. Approximately 80% of local health problems were managed by the CHWs proving that well-trained CHWs can have a significant impact on the delivery of health care.In 1986, a nurse practitioner was in San Pedro Sula in northern Honduras as a Catholic lay missionary. She conducted a community assessment of various semiurban areas called colonias to learn their health care needs. Next, she arranged for teaching sessions on community health in the homes of several local women. Based on the assessment and the sessions, the lay missionary and local women set up a mobile health clinic. During January-May, 1987, the lay missionary designed and taught a community health worker (CHW) training class for 3 local women. Its curriculum covered common illnesses, communicable diseases, first aid, ear and eye problems, maternal and child health, medicines, nutrition, sanitation, and skin problems. The learning methodologies were popular, adult, and problem-based learning theories. The training culminated in a primary health care clinic in the colonia San Jose, which began in May, 1987. CHWs ran the clinic. In September, 1987, they added a nutrition program, because more than 25% of the less than 5-year-old children were severely malnourished. In early 1988, a pharmacy joined the clinic. A formal laboratory later joined the clinic. New recruits graduated from CHW training in 1989. The CHWs provided curative and preventive care and health education, trained other health team members, collaborated with other health and community development sectors, and conducted self-assessments. The clinic staff charged 2 lempiras ($1) for each consultation. People who could not afford the fee were treated free of charge. The clinic reached financial self-sustaining status by May, 1989. Despite earnest attempts, the CHWs were unable to motivate patients to attend health teaching sessions, perhaps because the patients suffered from intense poverty. Otherwise, the clinic was successful, because the CHWs were committed and dedicated and had received adequate training and support.

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https://doi.org/10.1111/j.1745-7599.1993.tb00875.x