June 2: CHC with HOMBRE

Going into the trip, a first priority was learning as much as we could about the history and inner workings of the Community Health Committee. There are five members that make up the CHC, four of which are women from Esfuerzo, while the fifth is a health promoter and liaison from a local clinic. As drafted last year by SOMOS and the original CHC members, the structure and goals of the CHC are:

1.       Elected and representative via processes that ensure inclusiveness.

2.       Informed about the health issues and health care problems of the community through both clinical and empirical data.

3.       Closely aligned with official/governmental agencies and offices (mayor’s office, MINSA, etc.) through formal liaison relationships.

4.       Organized to ensure deliberation in advance of decisions, including polling of groups/communities.

5.       Access to NGOs and other potential service providers, including foundations and organizations that sponsor health care brigades, medicine, food, etc.

6.       Explicit, transparent, and written evaluation of current health care services, including assessment of critical needs for service.

7.       Explicit, transparent, and written periodic plan (one-year minimum; ideally, at least 5-year plans) for maintaining, managing, increasing, and improving health and health care.

This January, when the entire SOMOS team came down, the CHC initiated a pilot project, which involved collecting information on chronic illnesses within the community. When we arrived to the community, we met with CHC members individually to hear about the progress that they had made, as well as discuss how to use the information they collected going forward.

The decision was made to have one member of the CHC present for each interview conducted by HOMBRE’s research team. There interviews were conducted with individuals of the community that were identified by the CHC as suffering from hypertension or diabetes. SOMOS went along to 1) encourage and facilitate this partnership and 2) help provide context to community members on the work being done by HOMBRE, the CHC, and SOMOS, and how it all fits together. During the interviews, members of the CHC clarified questions asked by HOMBRE researchers, often rephrasing them in order to more accurately and effectively deliver them to interviewees. This attention put into providing context and well-phrased questions made a noticeable difference in the quality of participant responses. Last, taking advantage of the opportunity to gain information on community understandings of the CHC, CHC and SOMOS members followed up HOMBRE’s interview with questions such as, “How do you visualize the CHC’s role in bettering community health and healthcare? What project or program would you like to see the CHC take on to address these needs?”

In watching these interviews unfold, we were excited to see the sense of partnership between members of the CHC and HOMBRE begin to solidify, as HOMBRE researchers became more conscious of the value of this committee and this level of community involvement in general. The CHC played a crucial role in assisting with HOMBRE’s research due to its general knowledge of the community and specific knowledge of community health and health-care. As HOMBRE was only in Esfuerzo for five days, SOMOS focused the beginning of our trip on this work. Once HOMBRE left, we began to look forward to the CHC’s other potential projects.