Community-Based Primary Health Care

Community-based primary health care is about promoting good health, as well as treating and preventing illnesses. The model embraces coordination between local leaders, public organizations, and private NGOs. It is health care for and by the community, working together to achieve health for all.

Maternal Care

maternal care cbphcWomen in their childbearing years have many special needs, and are especially vulnerable during pregnancy, childbirth, and the postpartum period.

AMOS health promoters keep a register of all pregnant women in their communities and prioritize home visits to see these women and assess their health needs. During home visits, health promoters:

  • Check for any signs of danger during the woman’s pregnancy to be able to refer her for further medical care if necessary and prevent potential maternal deaths or complications during birth.
  • Provide basic health education to the mother regarding pregnancy, birth, and breastfeeding.
  • Encourage her to receive prenatal care from the local health clinic and make a plan for how and when to travel to the nearest clinic or hospital to give birth.
  • Talk with the mother about her wishes regarding future pregnancies and her family planning choices.

Health promoters also act as a support liaison between the Nicaraguan Ministry of Health (MINSA) and any woman in the communities who has decided to use family planning methods and signed up through a MINSA program. Her local health promoter makes sure she continues to receive the access she needs to the family planning methods she has chosen.

AMOS also trains volunteer mothers in numerous communities to support other women during pregnancy and in the postpartum period. These women work hand-in-hand with the health promoters to support pregnant women and new mothers in the best way possible.

Learn more about the impact of AMOS’ programs HERE.

Child Care

child careIn communities where access to health care is difficult, children are the most vulnerable to many common, preventable illnesses that can lead to high child mortality rates. Every day, 20,000 children in the world die of completely preventable and treatable diseases as simple as diarrhea or pneumonia.

Therefore, both prevention and treatment of the most common illnesses in infants and young children is a primary focus of the health promoters’ work. The types of activities that health promoters carry out and help organize in the community include:

  • Immunization – ensuring that children receive vaccinations against the major infectious diseases such as hepatitis, tetanus, diphtheria, measles
  • Anemia and growth monitoring – As part of our Community Nutrition Program, promoters perform a simple blood test to test children for anemia, as well as take their height and weight measurements to determine whether they are malnourished.
  • Deworming program – Twice a year AMOS organizes a deworming campaign in the communities in which children ages 2 to 12 receive a dose of albendazole deworming medication to treat intestinal parasite infections.
  • Health Stations – Once a year in a community, AMOS, the health promoter and health committee organize and coordinate an all-day event. Through a series of tests for children ages 5 and under, we obtain baseline information on malnutrition, anemia, parasite infections, and vision problems. Parents receive health counseling if their children have anemia or are malnourished. All this data is then revised and shared by the health promoter with the whole community.
  • Home based neonatal care – Health promoters work with moms to recognize when babies are sick and teach them when their babies need to be referred to higher level care.
  • Infant nutrition – Mothers receive education and support to encourage exclusive breastfeeding until 6 months and complementary feeding after 6 months to prevent malnutrition. In multiple communities that we work with, the health promoters also work with volunteer mothers to provide all local moms with even better support.

Learn more about the impact of AMOS’ programs HERE.

Holistic Health

“A health promoter is a person who helps others in their community. Since I am from the community, I know the needs of the people. I serve because of the love I have for the people in my community.” – Gioconda Jarquin, health promoter

holistic health cbphcsmHealth is much more than the absence of disease. AMOS health promoters work to promote mental, emotional, and spiritual health in addition to physical health. They receive trainings in communications and counseling skills which they put to use especially during house visits in their communities. The delivery of quality medical care depends greatly on a patient-caregiver relationship which should be based on trust and genuine care and service to others. Because the health promoters are chosen by members of their own community, they are not strangers offering care. They are neighbors, friends, and relatives of the people who live in their community who can relate easily to the problems, social and medical needs, and existing cultural values that affect people’s overall health. These qualities make a health promoter the key ingredient for the effectiveness and ultimate success of the community based primary health care model.

Learn more about the impact of AMOS’ programs HERE.

Clinic Care

cbphc - clinic carebIn the rural communities where AMOS works, each health promoter is in charge of a community clinic. The health promoters receive training on clinic management topics, such as:

  • Appropriate diagnosis and treatment of common diseases such as diarrhea, childhood pneumonia, allergies, asthma, and skin infections
  • Provision and proper dosage of essential medication
  • Coordination and management of a community clinic

Two days a week, health promoters offer patient care visits to members of the community who need clinical care. When necessary, health promoters make appropriate use of referrals or emergency transport to the nearest MINSA health clinic or hospital.

Learn more about the impact of AMOS’ programs HERE.

Safe Water and Sanitation

safe water and sanitation cbphcbWhen communities have access to clean water and good sanitation practices, people do not get sick as often and are able to go to work and go to school.

AMOS, the health committees, and the health promoters work together to help ensure that communities have access to clean drinking water and sanitation services through a series of activities that include the following steps:

  1. A community diagnosis of the availability and contamination levels of water sources.
  2. Interviews with members of the community to determine who is most in need of access to clean drinking water – The information obtained in these interviews combined with the data from the community diagnosis will help the health committee and health promoter select who in the community will benefit by receiving a biosand water filter.
  3. Each selected beneficiary must attend 3 trainings on the use and maintenance of the biosand water filter that they will use in their home.
  4. Volunteer teams who visit Nicaragua for short periods of time, partner with AMOS to contribute to specific projects in various communities where AMOS works. Members of the volunteer teams are involved in the construction and assembly of the water filters while they are here.
  5. Health promoters provide supervision and follow-up with families who receive the biosand water filters to make sure that they are being used correctly and are being maintained.
  6. AMOS accompanies communities in identifying their sanitation needs, especially in terms of waste disposal with latrines being the most accessible solution. The communities are then able to make plans and reach out (link to story of Timotea’s community?) to work with other non-governmental organizations and their local government to find solutions to these needs.

Learn more about the impact of AMOS’ programs HERE.

Health Education

health education cbphcbSome of the most simple methods of preventing disease and promoting health are things that everyone in a community can learn how to do.

AMOS trains health promoters to be educators in their communities. They are able to share information with families about what they can do to prevent and control prevailing health problems. Health promoters visit people’s homes and local schools to give short educational talks for families and children to learn about topics such as:

  • Promotion of hygiene (especially hand-washing and teeth brushing)
  • Clean water habits
  • Use of latrines for sanitation
  • Breastfeeding and common issues for moms
  • Good nutrition and foods for a balanced diet

Learn more about the impact of AMOS’ programs HERE.

Community Development

comm empowerbCommunity-based primary health care has a greater impact for lasting change when a community works together.

AMOS puts the community at the center of the research, analysis, and planning for the work that health promoters, health committees, and the AMOS supervisors will carry out throughout the year. Community systems are developed that are supported by continuously trained health workers, who in turn receive consistent supervision from AMOS staff.

The community census is the foundation of the system which makes sure that “everyone in a community is counted because everyone counts.”

When communities can see a real improvement in the health of the family members, neighbors, and friends, they become invested in making sure the positive impact can continue and grow. Other AMOS programs that also help promote community organization and development are the Youth Empowerment and Photovoice programs.

Learn more about the impact of AMOS’ programs HERE.

Lay Epidemiology

lay epidomologybEpidemiology is the study of the distribution and patterns of health-events, health-characteristics, and their causes or influences in well-defined populations.

Even though the health promoters and health committee members do not have an academic degree in epidemiology, they know how to use community census data to look for patterns of disease in their community and make plans to respond. The annual census they perform also helps them identify the people who are the most vulnerable in their community, including children, pregnant women, people with chronic diseases, and the elderly. The health promoters maintain a map of the community in the health clinic so that they know where these people live and can plan their monthly house visits to see them accordingly.

Each month, health promoters also keep track of data in their communities that helps them prevent and control the most common diseases. The data they collect each month includes:

  • Number of home visits made
  • Number of pregnant women visited
  • Number of babies born
  • Number of respiratory infections or pneumonia registered
  • Number of diarrheal infections
  • Number of deaths in the community

Learn more about the impact of AMOS’ programs HERE.

Environmental Health

environmental health cbphcbNicaragua is a country rich in natural resources such as fresh water and dense forests. Unfortunately, industrial pollution of freshwater, deforestation for lumber production or cattle grazing, and inefficient disposal of waste is very common in Nicaragua. AMOS advocates for environmental preservation by first examining our organization’s practices and then engaging outwardly with local areas that surround us.

In the rural communities we work with, AMOS has actively promoted reforestation with nutritional trees such as moringa and ojoche to both help the environment and improve the nutrition of children.

Learn more about the impact of AMOS’ programs HERE.