Describe the need affecting the community.
Access to healthcare is the greatest need for many rural, and urban isolated Nicaraguan communities. Our primary target families live on less than $1 a day, which accounts for more than 95% of people in urban barrios and rural villages. Nicaragua's Ministry of Health (MINSA) allocates medical and dental care funds by population and providing most funding to the largest population centers, such as the Department of Managua (not just the city). Rural villages receive little to no government sponsored medical or dental assistance; essentially abandoning those who can least afford health care. The government in Nicaragua has built clinic facilities throughout the country, but with the current national funding priorities few rural clinics are staffed and fewer have medications available. I recently visited six of AMHC's client communities in the San Francisco Libre region, all six communities are at least a 45 minute drive beyond the clinic? but with unreliable or no bus service, people walk a long road that is rocky in the dry season and muddy in the wet season. Returning to our base in Masaya we picked up one woman who had been carrying a sick child in her arms the entire distance to the San Francisco Libre MINSA Clinic. In addition, there is virtually no continuity of care for chronic diseases such as diabetes and hypertension and no community education programs to eliminate the continual problems with mosquito borne diseases and parasites. Inadequate patient records are also a significant problem for instituting a quality heath program.
How will this Advance project help to address the need?
In order to promote a self-sustaining community health program, we are empowering the community by training two Community Health Workers (CHW or brigadistas) in each community when funds are available. Each brigadista community is equipped with a small pharmacy that contains essential medications and supplies. The brigadistas are also trained in disease prevention education and given the tools for basic community health screenings. We feel that well trained brigadistas are the key to developing a community based health care system. The wellness clinics for diabetes, hypertension and maternal/infant care will go far in providing continuity of care for chronic diseases. The parasite eradication program is also showing demonstrable results in the 12 communities where it has been implemented. To address the needs of pregnant women and children under 5, professional development training for our medical staff is planned for 2016. This training will include the use of a field portable sonogram machine that will allow the AMHC to improve the quality of pre-natal care. Additionally, vitamins are now being widely distributed to women and children, and a parasite eradication study is underway in 12 communities. To address the needs of all community members, an expansion of the full holistic model (health care access, clean water & sanitation, and brigadistas) to additional communities will continue to diminish the impact of chronic diseases on the served population.
Describe the primary goal of the project.
Our broad goal is to become the ?family doctor and dentist? to 30-35 extremely poor, rural and urban barrio Nicaragua communities. In addition, empowering the community to have some control over the health of the community. We will accomplish this by increasing the number of communities that we visit as well as increasing the scope of the services that the AMHC provides to the communities. The dramatic impact that this long term project has had on the communities has been demonstrated by the significant reduction in the mortality and morbidity rates in the communities. The continued addition of two brigadistas, with community pharmacies, in each community is also key a component for long term self-sufficiency. This is a long term, continuing project with no end date.
Describe the change you would like to see in the community as a result of this Advance project.
We expect to see: (1) A significant decrease in morbidity and mortality from the most common ailments seen by the clinic. (2) A reduction in complications from chronic diseases such as diabetes and hypertension. (3) A reduction in maternal and infant mortality and morbidity. (4) A significant reduction in the incidence of parasites in the 12 communities participating in the eradication program. (5) The population becoming more involved in the health of their community as a whole and not just individually.
Budget and Financial Information
Annual Advance Financial Goal
Local Financial Support
NE Annual Conference
Together for Tomorrow fund
Admin, Mgt, CANI Support
CANI support and AMHC Emlpoyees
Transportation, Training, meds, equipment