Identifying Communities’ Perspectives on their Health Needs in Impoverished Villages to Guide Non-government Organizations’ Health Promotion Efforts in Guatemala

2020 ◽  
Vol 7 (5) ◽  
pp. 9-20
Author(s):  
Claudia Bale
Keyword(s):  
Health Promotion ◽  
Community Health ◽  
Health Care Access ◽  
Family Health ◽  
Community Based Participatory Research ◽  
Health Needs ◽  
Health Conditions ◽  
Personal Health ◽  
Structured Interviews ◽  
Non Profit

Objective: The aim of this mixed-methods study is to capture and understand impoverished Guatemalan community members’ perspectives of their own health needs on a community level in order to guide Hope of Life (HOL) Non-Profit organization’s health promotion interventions in the villages they serve. Methods: A modified health needs assessment survey was conducted with 96 participants from four impoverished villages in the department of Zacapa, Guatemala. Survey responses were analyzed for significant differences in 4-item individual, family, and community health scores across demographic variables and significant correlations with reported personal health conditions and children’s health conditions. Five semi-structured interviews were also conducted with community leaders from three of the villages surveyed. Interviews were audio recorded and responses were transcribed verbatim and translated from Spanish to English. Thematic analysis using HyperRESEARCH qualitative analysis software version 4.5.0. was conducted to identify major themes. Results: The mean age of the 96 participants surveyed was 40.4 years and the majority were women, married or in Union, and have children. Women reported a significantly lower individual and family health score than men. The most rural village included in the study had significantly lower family health scores than the three sub-urban villages in the study. Among the personal health problems reported by participants, alcohol consumption, dental problems, and malnutrition were significant predictors of lower individual health scores. Themes that emerged from the interview analysis included the greatest community health needs, perceived negative community health behaviors, barriers to health care access, HOL’s impact, and suggestions for community health promotion.   Conclusion: The results of this study reveal many unmet health needs and barriers to healthcare that Guatemalan village communities face. Community-based participatory research using a mixed approach voices communities’ perspective on their perceived needs and is an important tool to guide non-profit aid and intervention serving impoverished communities.

scholarly journals 4309 Ascertaining the Medical Needs of Galveston County

2020 ◽  
Vol 4 (s1) ◽  
pp. 79-79
Author(s):  
Sharon Croisant ◽  
Krista Bohn ◽  
John Prochaska
Keyword(s):  
Health Care ◽  
Prenatal Care ◽  
Educational Attainment ◽  
Community Health ◽  
Preventive Care ◽  
Health Care Access ◽  
Non Profit ◽  
Care Access ◽  
Galveston County ◽  
Lower Educational Attainment

OBJECTIVES/GOALS: Data were collected or abstracted from a wide variety of sources related to health and health care needs to determine the current health status of the Galveston community including: DemographicsSocial Determinants of HealthHealth Care Access and Insurance StatusPoverty and Socio-Economic Indicators Impacting HealthHealth BehaviorsChronic DiseaseCommunicable DiseaseBirth OutcomesMortalityCancerData on Services Provided at UTMBData on Services Provided through the Galveston County Health DistrictData on Services Provided through the St. Vincent’s House Clinics, student-led clinics operated at a local non-profit organizationPrevious Galveston County Community Health Needs AssessmentIdentifying Gaps in ServicesPrevention Quality Indicator DataMETHODS/STUDY POPULATION: In addition to collection and analysis of secondary data, we also interviewed key stakeholders to solicit their input and recommendations. We met with leadership from St. Vincent’s House regarding current services provided, perceived issues and concerns, and needs for improvements. We met with leaders from UTMB’s academic enterprise to discuss the operation of our current student-led clinics as well as ways in which clinical practice experiences might be expanded and included more formally in the student curricula should the clinical capacity of St. Vincent’s House also be significantly expanded. This would increase the number of services that could be offered at St. Vincent’s and greatly increase the capacity for enrolling patients without relying on faculty volunteers to staff the clinics. We also met with UTMB leaders in a position to provide insight to issues that bridge the UTMB practice arena and public health and with Community Health leaders from the Galveston County Health District and Teen Health Clinics. Information Services leadership and Institute for Translational Science informatics faculty and staff were instrumental in determining what data could be abstracted from the Electronic Medical Record (without patient identifiers) to determine the specific need for services at St. Vincent’s. RESULTS/ANTICIPATED RESULTS: The City of Galveston has a population just under 50,000. Since 2010, the proportion of elderly has increased, and the proportion of families with younger children has decreased. Poverty is high at 22.3% for all people, and especially high for children at 32.1%. Poverty disproportionately affects racial and ethnic minorities, with 36.5% of the Black population living below the poverty level, compared to 25.5% Hispanic, 30.5% Asian, and 14.7% White. Home ownership is decreasing, and median rent costs have sharply increased. The percentage without health insurance is considerable, driven by educational attainment, age, and race. In 2017, >40% of renters spent more than 35% of their income on housing. Upwards of 2,650 reported not having access to a vehicle for transportation. While residents of Galveston County as a whole are less impoverished, those that are impoverished share marked similarities. Lower educational attainment, in particular failure to complete high school or obtain a college degree, are correlated with race. Lower educational attainment then is highly predictive of poverty and low income. The income inequality ratio, i.e., the greater division between the top and bottom ends of the income spectrum in Galveston County is higher than in Texas or the nation and has increased every year but one since 2010. Issues of concern for Galveston County include obesity, Type II diabetes, and disability. These are exacerbated by built and social environment issues such as food insecurity, limited access to healthy foods, and food deserts in some neighborhoods. Pre-term birth rates are higher in Galveston than in the state or nation, and approximately 40% of women do not receive prenatal care until the 2nd or 3rd trimester or receive no prenatal care at all. 8.4% of births are low-birth weight. Marked disparities by race and ethnicity exist for each of these indicators. Age-adjusted death rates for all-cause mortality are higher in Galveston County than they are in Texas or the United States. Perhaps of most concern are the rates of death from septicemia, which are nearly triple that of the U.S. and nearly double that of the state, and cancer. Cancer incidence is not particularly remarkable, however, cancer age-adjusted mortality rates for many specific cancers well exceed state rates. DISCUSSION/SIGNIFICANCE OF IMPACT: With a clearer picture of the medical and other needs impacting health or health care access for our community, all stakeholders and experts can provide more detailed recommendations about prioritizing care and especially, preventive care—much of which could conceivably be provided in St. Vincent’s House clinics. Opportunities exist for enhanced practice and education opportunities for UTMB students from all schools. Preventive Care and Population Health practices can be brought to bear in novel practice settings that could serve as models for provision of integrated services. Social and other services provided by non-profit organizations can be coordinated and streamlined. It is our hope that the considerable data presented herein will enable stakeholders to begin to prioritize issues and to make some evidence-based decisions about the next steps in this process. Throughout the interview and data collection process, all stakeholders have expressed both enthusiasm and hope at the prospect of re-visioning how they can contribute to a process that will improve how we as a community care for our most vulnerable members. CONFLICT OF INTEREST DESCRIPTION: The authors have no conflicts of interest to disclose.

Evaluation of the effectiveness of community health workers in the fight against malaria in the Central African Republic (2012–2017)

2019 ◽  
Vol 114 (3) ◽  
pp. 173-184
Author(s):  
Djerandouba Yotobumbeti Ferdinand ◽  
Bessimbaye Nadlaou ◽  
Nzalapan Samuel ◽  
Bekaka Youlet Oscar ◽  
Mbailao Raphael ◽  
...  
Keyword(s):  
Health Services ◽  
Community Health ◽  
Community Health Workers ◽  
Health Care Access ◽  
Central African Republic ◽  
Health Workers ◽  
Preventive Health Services ◽  
Structured Interviews ◽  
Adequate Treatment ◽  
Care Access

Abstract Background This last decade’s ongoing conflict in the Central African Republic (CAR) has led to gradual and continuous destruction of health services. With severe gaps in qualified health professionals, community health workers (CHWs) have become essential to ensuring health care access to the affected population. This article aims to evaluate the effectiveness of a 10-y CHW program in the CAR. Methods Routine case management data from CHWs were collected in the Paoua district from January 2012 to December 2017 and analysed. Structured interviews were conducted in the Paoua and Carnot health districts among individuals from three different groups (health service beneficiaries, CHWs and health facility managers). Results From 2012 to 2017, 353 948 people consulted for malaria suspicion with CHWs and 86% were found to be malaria positive after a rapid diagnostic test. Among those diagnosed patients, 98.5% received adequate treatment and nearly 1.5% were referred to health facilities. Also, 94.5% of respondents identified fever as the major malaria symptom. About 70% of the population could identify three malaria signs/symptoms and 84.4% accepted and used CHW services. Interviews with CHWs revealed that 45.8% of them received at least four training sessions per month as part of their capacity building. Conclusions CHWs can be a resourceful solution when other health professional are scarce. This study showed that CHWs are not only able to deliver curative and preventive health services, but they are also well accepted by the served communities.

scholarly journals Barriers to Maori sole mothers' primary health care access

2013 ◽  
Vol 5 (4) ◽  
pp. 315 ◽  
Author(s):  
Rochelle Lee ◽  
Nicola North
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Services ◽  
Health Care Access ◽  
Single Parent ◽  
Health Needs ◽  
Personal Health ◽  
Care Access ◽  
Primary Health ◽  
Barriers To Access

INTRODUCTION: International research consistently shows that sole mothers experience poorer health and suboptimal health care access. New Zealand studies on sole mothers’ health report similar findings. The aim of this exploratory research was to better understand the experiences of Maori sole mothers’ access to health services, particularly primary health care, for personal health needs. METHODS: This qualitative study employed a general inductive design informed by a Kaupapa Maori approach, providing guidance on appropriate cultural protocols for recruiting and engaging Maori participants. Distributing written information and snowballing techniques were used to purposively recruit seven Maori sole mothers. Data collection involved semi-structured interviews which were digitally recorded and transcribed verbatim. Data were analysed using general inductive thematic analysis to identify commonalities and patterns in participants’ experiences. FINDINGS: The dominant themes that emerged captured and described participants’ experiences in accessing health care. The major barrier to access reported was cost. Compounding cost, transport difficulties and location or scheduling of services were additional barriers to health service accessibility. Child-related issues also posed a barrier, including prioritising children’s needs and childcare over personal health needs. CONCLUSION: The findings illuminate Maori sole mothers’ experiences of accessing health care and the complex socioeconomic inequalities affecting access options and uptake of services. Further investigation of barriers to access is needed. The study has implications for addressing barriers to access at policy, funding and practice levels to improve health outcomes and equitable health care access for Maori sole mothers. KEYWORDS: Health services accessibility; Maori; primary health care; single parent; single-parent family; socioeconomic factors

scholarly journals Competences in health promotion in the environmental education practices of community health agents

2021 ◽  
Vol 42 ◽  
Author(s):  
Kelly Fernanda Silva Santana ◽  
Lucas Dias Soares Machado ◽  
Maria de Fátima Antero Sousa Machado ◽  
Maria do Socorro de Araújo Dias ◽  
Lucilane Maria Sales da Silva ◽  
...  
Keyword(s):  
Health Promotion ◽  
Environmental Education ◽  
Community Health ◽  
Capacity Building ◽  
Statistical Significance ◽  
Professional Standards ◽  
Data Organization ◽  
Structured Interviews ◽  
Environment And Health ◽  
Communication Planning

ABSTRACT Objective: To recognize the domains of competencies in promoting health in the environmental education practices performed by community health agents. Method: A mixed study, which adopted the Developing Competencies and Professional Standards for Health Promotion Capacity Building in Europe (CompHP) as a theoretical framework, conducted in Crato, Ceará, with 16 community health agents, based on semi-structured interviews and data organization through the ALCESTE software. Results: The following domains of competencies in health promotion were evidenced: partnership, possibility of changes, and diagnosis. We recognize evidence signaling other domains, although with less statistical significance, such as: communication, planning and implementation, with a view to developing environmental education activities. Final considerations: There is a mobilization of a limited number of health promotion competences in the environmental education practices developed by community health agents, which requires the wholeness of these elements to implement health promotion practices and, thus, positive transformations on the environment and health.

The Benefits of Crowdsourcing to Seed and Align an Algorithm in an mHealth Intervention for African American and Hispanic Adults (Preprint)

2021 ◽  
Author(s):  
Neil Jay Sehgal ◽  
Shuo Huang ◽  
Neil Mason Johnson ◽  
John Dickerson ◽  
Devlon Jackson ◽  
...  
Keyword(s):  
Mental Health ◽  
African American ◽  
Family Health ◽  
Amazon Mechanical Turk ◽  
Health Conditions ◽  
Personal Health ◽  
Health Issues ◽  
Health History ◽  
Health Goals ◽  
Hispanic Adults

BACKGROUND The lack of publicly available, culturally relevant data sets on African American and bilingual/Spanish-speaking Hispanic adults’ disease prevention and health promotion priorities presents a major challenge to researchers and developers who want to create and test personalized tools for the preventive health behaviors intervention space. Personalization depends on prediction and performance data. To develop such a ‘recommender system’ (RecSys) that predicts the most culturally and personally relevant preventative health information and serve it to African American and Hispanic users of a novel smartphone application while also avoiding the ‘cold start’ problem, we needed population appropriate seed data that aligned with the app’s purposes of setting health goals and finding associated articles and topics in healthfinder.gov, a federally supported database of health conditions and disease prevention information. OBJECTIVE To address the lack of culturally specific preventive personal health data and sidestep the type of algorithmic bias inherent in a RecSys not trained in the target population, we created a novel dataset on prevention-focused health goals by collecting a large amount of data quickly and at low cost from members of the target population. We seeded our RecSys with data collected anonymously from self-identified Hispanic and self-identified non-Hispanic African American adult respondents utilizing Amazon Mechanical Turk. METHODS We developed an online survey in which respondents completed a personal profile, health literacy assessment, family health history, and personal health history. Respondents then selected their top three health goals related to preventable health conditions, and for each goal reviewed and rated the top three healthfinder.gov information returns by importance, personal utility, whether the item should be added to their personal health library, and their satisfaction with the quality of the information returned. RESULTS We collected data from 985 self-identified Hispanic (49%) and self-identified non-Hispanic African American (51%) adult respondents utilizing Amazon Mechanical Turk over only 64 days at a cost of $6.74 per respondent. Respondents rated 92 unique articles. Both African American and Hispanic groups noted physical fitness (62.9%), healthy eating (43.2%), and nutrition and weight (24.0%) as their most frequent personal goals for health. Both African American and Hispanic groups noted mental health issues (34.6%), hypertension (31.0%), and vision or hearing impairments (24.4%) as their most frequently experienced health conditions, and hypertension (55.0%), diabetes (46.1%), and obesity (39.6%) as their most frequent family health conditions, although there are statistically significant differences when considering prevalences of goals, personal health, and family health conditions. Though both groups note experiencing mental health issues more frequently than any other condition, neither respondent group identified mental health as a high priority personal health goal. Respondents’ personal goals align with potentially preventive conditions they report in their family health history. CONCLUSIONS Researchers have options, such as Amazon Mechanical Turk, for quick, low-cost means to avoid the ‘cold start’ problem for algorithms and sidestep bias and low relevance for an intended population of app users. Seeding a RecSys with responses from people like the intended users allows the development of a digital health tool that can recommend information to users based on similar demography, health goals, and health history. This approach minimizes potential initial gaps in algorithm performance, allows quicker algorithm refinement in use, and may deliver a better user experience to individuals seeking preventative health information to improve health and achieve health goals. Additionally, this approach allowed investigating the correlation between personal health goals and known health history in a sample of African American and Hispanic participants. Health goals for African American and Hispanic adults are more likely to reflect self-reported somatic health conditions, and less likely to reflect psychological health conditions, even when experiencing mental health issues.

scholarly journals Promoção da saúde articulada aos determinantes sociais: possibilidade para a equidade

2019 ◽  
Vol 13 (4) ◽  
pp. 943
Author(s):  
Daniella Santos Figueredo ◽  
Ivonete Teresinha Schulter Buss Heidemann ◽  
Gisele Cristina Manfrini Fernandes ◽  
Aline Megumi Arakawa-Belaunde ◽  
Lays Souza De Oliveira ◽  
...  
Keyword(s):  
Health Care ◽  
Health Promotion ◽  
Primary Health Care ◽  
Social Determinants ◽  
Health Care Professionals ◽  
Family Health ◽  
Lifestyle Changes ◽  
Structured Interviews ◽  
Primary Health ◽  
Recursos Humanos

RESUMO Objetivo: conhecer as práticas de promoção da saúde articuladas aos determinantes sociais e desenvolvidas por profissionais da Atenção Primária à Saúde. Método: trata-se de estudo qualitativo, descritivo, exploratório. Realizaram-se 19 entrevistas semiestruturadas com profissionais de saúde inseridos em duas Unidades Básicas de Saúde. Avaliaram-se os dados a partir da técnica de Análise de Conteúdo na modalidade Análise Temática. Resultados: desenvolvem-se as práticas de Promoção da Saúde, em sua maioria, em grupos de educação em saúde, com orientações sobre mudança de estilo de vida durante as consultas agendadas. Apontaram-se, como potencialidades, o adequado processo de trabalho das equipes de saúde, o apoio e o incentivo da gestão atual e o vínculo com a comunidade. Citaram-se, como principais desafios, a demanda excessiva de usuários para consultas individuais e a falta de recursos humanos, apontando algumas fragilidades da gestão. Conclusão: ressalta-se a pertinência da Promoção da Saúde na Atenção Primária como forma de cuidado e autonomia do indivíduo e da comunidade, considerando os determinantes sociais, mas requerendo investimentos na educação permanente frente aos desafios apontados. Descritores: Promoção da Saúde; Estratégia Saúde da Família; Determinantes Sociais da Saúde; Atenção Primária à Saúde; Enfermagem; Equidade em Saúde.ABSTRACT Objective: to know the practices of health promotion articulated to social determinants and developed by Primary Health Care professionals. Method: this is a qualitative, descriptive, exploratory study. Nineteen semi-structured interviews were conducted with health professionals enrolled in two Basic Health Units. Data were evaluated using the Content Analysis technique in the Thematic Analysis modality. Results: health promotion practices are developed, mostly in health education groups, with orientations on lifestyle changes during the scheduled consultations. As potentialities, the adequate work process of the health teams, the support and the incentive of the current management and the bond with the community were pointed out. The main challenges were the excessive user demand for individual consultations and the lack of human resources, pointing out some management weaknesses. Conclusion: the relevance of Health Promotion in Primary Care as a form of care and autonomy of the individual and of the community, considering the social determinants, but requiring investments in the permanent education facing the challenges pointed out. Descriptors: Health Promotion; Family Health Strategy; Social Determinants of Health; Primary Health Care; Nursing; Equity in Health.RESUMEN Objetivo: conocer las prácticas de promoción de la salud articuladas a los determinantes sociales y desarrolladas por profesionales de la Atención Primaria a la Salud. Método: se trata de un estudio cualitativo, descriptivo, exploratorio. Se realizaron 19 entrevistas semiestructuradas con profesionales de salud insertados en dos Unidades Básicas de Salud. Se evaluaron los datos a partir de la técnica de Análisis de Contenido en la modalidad Análisis Temático. Resultados: se desarrollan las prácticas de Promoción de la Salud, en su mayoría, en grupos de educación en salud, con orientaciones sobre cambio de estilo de vida durante las consultas programadas. Se señalaron, como potencialidades, el adecuado proceso de trabajo de los equipos de salud, el apoyo y el incentivo de la gestión actual y el vínculo con la comunidad. Se citaron, como principales desafíos, la demanda excesiva de usuarios para consultas individuales y la falta de recursos humanos, apuntando algunas debilidades de la gestión. Conclusión: se resalta la pertinencia de la Promoción de la Salud en la Atención Primaria como forma de cuidado y autonomía del individuo y de la comunidad, considerando los determinantes sociales, pero requiriendo inversiones en la educación permanente frente a los desafíos señalados. Descriptores: Promoción de la Salud, Estrategia de la Salud Familiar; Determinantes Sociales de la Salud; Enfermería; Equidad en Salud.

‘No time for health:’ exploring couples’ health promotion in Indian slums

2018 ◽  
Vol 35 (1) ◽  
pp. 70-81 ◽  
Author(s):  
Shivani Mathur Gaiha ◽  
Katja Gillander Gådin
Keyword(s):  
Health Promotion ◽  
Health Information ◽  
Contraceptive Use ◽  
Urban Poverty ◽  
Family Health ◽  
Joint Involvement ◽  
Sources Of Information ◽  
Structured Interviews ◽  
Community Based ◽  
Health Related

Summary Joint involvement of couples is an effective strategy to increase contraceptive use and improve reproductive health of women. However, engaging couples to understand how their gender attitudes affect their personal and family health is an idea in search of practice. This mixed-methods study explores opportunities and barriers to couples' participation in health promotion in three slums of Delhi. For each couple, surveys and semi-structured interviews were conducted with husbands and wives individually to contrast self and spousal work, time, interest in health, sources of information related to health and depth of knowledge (n = 62). Urban poverty forces men to work long hours and women to enter part-time work in the informal sector. Paid work induces lack of availability at home, lack of interest in health information and in performing household chores and a self-perception of being healthy among men. These factors inhibit men's' participation in community-based health promotion activities. Women's unpaid work in the household remains unnoticed. Women were expected to be interested in and to make time to attend community-based health-related activities. Men recalled significantly less sources of health information than their spouse. Men and their wives showed similar depth of health-related knowledge, likely due to their spousal communication, with women acting as gatekeepers. Health promotion planners must recognize time constraints, reliance on informal interpersonal communication as a source of health information and the need to portray positive masculinities that address asymmetric gender relations. Innovative, continuous and collaborative approaches may support couples to proactively care about health in low-resource settings.

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