COMMUNITY HEALTH PROMOTER TRAINING AND ASSOCIATION

1
COMMUNITY HEALTH PROMOTER TRAINING AND
ASSOCIATION IN THE RURAL DOMINICAN
REPUBLIC Kimberly Cole, Department of Global
Health, SPHCM, University of Washington

• Organization Name
•  Secretary of State for Public Health and Social
  Assistance (SESPAS), Dominican Republic. The
  student was a Peace Corps Volunteer while
  completing her Practicum experience.
• Organizations Location
• Site Supervisor
• Dr. Crisela Zorilla, Provincial Health Director
• Goals of the planned intervention

 
Impact of the intervention The impact this
project makes is sustainable first and foremost
because it is completely community-based and a
grassroots effort by dedicated individuals in the
rural area. Because the promoters live there as
compared to the doctor and nurse who travel from
the closest town, the promoters are stakeholders
in the communitys development, they will provide
institutional memory for future promoters as they
will be in charge of future trainings, and they
will enjoy a position of respect and authority in
the community. The direct beneficiaries of this
project are the health promoters themselves, who
gained the skills and abilities to monitor the
communitys health and act as a link between
families, offering them health education and
information so as to better access medical
services. These women also gained experience in
public speaking, in working with their peers,
many of whom lack formal education, leadership
skills and improve their training techniques.
The indirect beneficiaries, the rural residents,
saw an improvement in family health, and were
able to seek information and advice from the
health promoters. Access to medical services and
programs improved, and the community was able to
depend on the health promoters as advocates for
their communitys health. This project built
upon the assets that already existed in this
community and filled an obvious need that also
existed. However ,it must be stated that due to
the extremely stressful and labor-intensive
nature of the lives these women lead, this
program is at risk of discontinuation if the
leadership loses motivation. Health promotion is
an additional service that will benefit the
community as a whole, nevertheless, if a womans
own personal needs (due to the extreme poverty
that they live in) supersede the communitys, she
cannot be depended upon to always be available to
respond to public health issues. It is hoped
that there are enough safety nets in place to
support the promoters as they undertake the
community service that they have been trained to
do.
Vicentillo
Population Studied In Health Region V where
the student worked, the general population in
2003 was 890,000 inhabitants. The regional
public health system had registered 181,199
inhabitants with the state-sponsored health
security program, and saw 95,607 of those
individuals in the public health centers. The
Hato Mayor provincial health department works in
an area with a poverty rate of 78.9. This
region has the highest HIV/AIDS prevalence rates
of the country at 2.1 largely due to tourism,
free trade zones, mobile population, commercial
ports and bateyes (sugar cane plantations).1 2 3

• Outcome The final product is an association of
  rural health promoters who communicate with the
  provincial public health department and are
  capacitated to aid public health interventions in
  their remote communities.
• Accomplishments
• Trained 23 health promoters in three rural
  communities so that by December 2007 they had the
  authority to give relevant and reliable health
  information during health education sessions and
  home visits.
• Created communication system between community
  health promoters and the governmental
  (SESPAS/DPS) and non-governmental organizations
  in the region that is utilized every three
  months, beginning in December 2007. Created a
  referral system between the rural health post and
  the urban medical centers.

1 SESPAS and CERSS. Informe de Situación de Salud
de República Dominicana, 2003. Santo Domingo,
2006. 2 ONAPLAN Estrategia para la Reducción de
la Pobreza en la República Dominicana 2004-2015.
Santo Domingo, 2003. 3 Encuesta Demográfica y de
Salud Republica Dominicana, ENDESA 2002. (DHS
2002). October 2003.