Abstract
BackgroundIn 1978, the Alma-Ata declaration on primary health care (PHC) recognized that the world’s health issues required more than just hospital-based and physician-centered policies. The declaration called for a paradigm change that would allow governments to provide essential care to their population in a universally acceptable manner. The figure of the community health worker (CHW) remains a central feature of participation within the PHC approach, and being a CHW is still considered to be an important way of participation within the health system.MethodsThis study explores how the values and personal motivation of community health workers influences their experience with this primary health care strategy in in the municipality of Palencia, Guatemala. To do this, we used an ethnographic approach and collected data in January-March of 2009 and 2010 by using participant observation and in-depth interviews.ResultsWe found that the CHWs in the municipality had a close working relationship with the mobile health team and with the community, and that their positions allowed them to develop leadership and teamwork skills that may prove useful in other community participation processes. The CHWs are motivated in their work and volunteerism is a key value in Palencia, but there is a lack of infrastructure and growth opportunities.ConclusionAttention should be paid to keeping the high levels of commitment and integration within the health team as well as keeping up supervision and economic funds for the program.
Highlights
In 1978, the Alma-Ata declaration on primary health care (PHC) recognized that the world’s health issues required more than just hospital-based and physician-centered policies
We explore how the values and personal motivation of community health workers influences their experience with this primary health care strategy in Guatemala
For the 17 communities located more than two hours walking distance away, the SIAS has contracted one non-governmental organizations (NGOs) to provide care through a network of twenty community health worker (CHW) that act as facilitadores de salud for the health team
Summary
In 1978, the Alma-Ata declaration on primary health care (PHC) recognized that the world’s health issues required more than just hospital-based and physician-centered policies. Community health workers can be defined as individuals with no formal or professional training, delivering basic health services in the context of an intervention [4]. Studies show that successful CHW programs contribute to continuity of care and to increased compliance with treatments, even in isolated areas They may improve communication levels between a health center and the population it provides care for by giving community members a voice and role in health promotion processes [3,4,5,6,7]
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