Submission: Johana Mercedes Rivas
AIN/AIEPI is a health project being implemented in the municipality of Jinotega, department of Jinotega targeting nine communities within the sector of Datanlí. It is assisting a total population of approximately 5,967, of which 2,875 are direct beneficiaries. The focus group is children under the age of five with emphasis on children under the age of two, women of childbearing age, and pregnant women.
Within the focus group, we are currently working with seventy children under the age of six months; 315 children from six months to twenty-three months; 400 children from 25 to 59 months; 351 mothers with children under the age of five; 44 pregnant women; and 1,695 women of childbearing age.
The project is focused on the strengthening of the Integrated Community Childcare Strategy, obstetric emergencies, neo-natal care, and family planning through the strengthening of the network of health volunteers, promoters, midwives, and committees.
In order to accomplish our goals and objectives, we propose that we:
- coordinate with the Ministry of Health and community health agents;
- train and reinforce in AIN/AIEPI, obstetric emergencies, neo-natal care, and family planning among volunteer staff and the community;
- perform biannual updating of the census of mothers with children under two years of age;
- complete a census of pregnant women;
- perform monthly weigh-in sessions and consult with mothers on the results;
- create mothers groups in support of breastfeeding and children's health care as well as small group training sessions with field and health personnel;
- consolidate the Reference and Counter Reference Systems for Community with continued analysis of the system with health and field personnel and community agents;
- distribute educational supplies including information regarding the importance of breastfeeding and the danger signs of diarrhea and pneumonia;
- perform house to house visits and referrals by community agents for children under the age of two;
- accompany patients on visits to the MINSA clinic;
- support the National Health Campaign established by MINSA.
Infant Health
Infant health is the primary focus of this project. Utilizing the model strategies mentioned above, this process is considered to be a very effective intervention method and has been shown to contribute to the avoidance of the one-in-three deaths of children under the age of five that occur annually in this region of the Americas.
The main purpose of the implementation of the AIN/AIEPI strategy is to improve the quality of care provided to children under the age of two in the participating communities. This is achieved in large part through the work of a "Trained Health Community Agent," who promotes and dispenses preventions procedures as well as provides training in recognizing and handling the signs of illnesses including diarrhea, malnutrition, fever, and respiratory infections. This allows for the reduction of morbidity and mortality among the children involved.
The AIN/AIEPI model stresses the promotion of preventative factors such as nutrition and vaccination. Participants are required to monitor the satisfactory growth of each child. Where abnormal growth is noted, counseling and training are provided to the mothers. It is important that participating mothers guarantee appropriate practices for the maintenance or recovery of growth and the proper development of each child. The ACS promotes participation of health personnel and government and non-government institutions in meetings every four months. The purpose of these meetings is to search for solutions to problems that impact abnormal weight or growth trends and to reinforce the commitment to those solutions.
Maternal Health And Family Planning
There is an emphasis on the promotion of information regarding the necessity of pre-natal, childbirth, and postpartum care for women throughout the community and institutional environment. This promotion is made in direct coordination and collaboration with MINSA and PRIME I authorities. Coordination is essential between the medical, institutional, and volunteer personnel in order to increase the ability of the program to self-manage within the community.
The individual components of the project are being implemented based on the current norms and priorities of MINSA. An entire training process has been developed and is monitored by them. Follow-up and additional support is also provided for health care personnel, community agents, and mothers to allow for increased knowledge and skill levels. Vital to this process is the use of interactive learning, informal adult education, and interinstitutional coordination.
Community And Institutional Strengthening
The team is working to strengthen the health committees, Casas Bases, Community Unit of Oral Rehydration, and Community Health Agents in each one of the involved communities. The Casas Bases and UROCs are equipped with basic materials. They are also supplied with oral serum and chlorine, subject to the ability of MINSA as the main health manager to dispense them.
An additional project component is to encourage integration between the community and MINSA. Toward that goal, the project is involved in training the personnel of this institution, specifically those assigned to health posts and municipal health centers. The desire is to improve the capacity within the health unit of MINSA in the use of basic equipment as well as the promotion of health service knowledge and skills related to mothers and children.
Future Strategy Development
Activities being planned for use in the future include:
- monthly community monitoring sessions of child growth and development;
- home visits to children with insufficient growth;
- frequent reminders for pregnant women to attend the AIN-C monthly, pre-natal sessions;
- the creation of community information standards through the establishment of specific learning objectives for the prioritized groups' achievement using an agreement process and a variety of educational methods;
- supervision, monitoring, and community evaluation
- the utilization of the "Multiplier Effect" by training small yet socially active groups so that their knowledge can then be shared across a much larger population segment;
- an increase in the amount of available educational materials and a well structured training process;
- the involvement of the entire community in each phase of the process.
Comments From The Parents And Committee Members
Rio Mena (Community): There is a favorable opinion about the project in this community, which shows a lot of enthusiasm for the benefits that children under six years old will receive as well as from the creation of the square meter gardens. The square meter gardens will contribute to the change of nutritional habits in the community.
Fabiola Roa (Promoter): This is a good opportunity to work with the community and improve our knowledge with regard to the care offered to children under age six. It is important to have the participation of the community in activities that benefit their health and to develop the knowledge of those who live in these communities to improve their standard of living.
José Palma (Municipal Technical Team): Community change is very interesting especially when the residents are optimistic and support the effort. The people in the community want to do something different to change their lifestyle and to increase health indicators, nutrition, hygiene, and quality of life of each member of each of the communities benefiting from the project.
