Self-Efficacy in Community Led Health Initiatives- Week 1

Though we met a few road blocks along the way, SOMOS summertime has finally arrived in the Dominican Republic. Zoe, Raya, and I are excited to be joined by SOMOS and William and Mary alumnus Kevin Salinas, especially as he happens to be a native speaker. We are comfortably settling into our apart-mansion in La Ciudad Universitario, surrounded by all the dominican comforts- a Pico Pollo across the street, a Bon up the block, and a grocery store nearby well stocked with fresh chinola.

Since I last wrote, we have been working to develop further our protocol for enhancing self-efficacy within the Committee on Health (CdS). This week we had a chance to sit down with each of the committee members to check-in since the last time we spoke, and we’ve gotten a lot of positive feedback on the dengue campaign implemented over the winter. The committee members felt it was well attended and well received by the community. Of particular interest was the capacity in which they were able to work the UNAP, their local clinic. In the past, the community has been grossly underserved by this clinic, so it is of note that the community members were able to bring doctors from this clinic to the community to present an information session on dengue prevention.

In our check-in, we talked a lot about how SOMOS and CdS members see the dengue campaign as a very important step in the development of community capacity. This summer, we hope to work with the committee to build on this success and continue to make progress in self-efficacy and health outcomes. Our first meeting with the CdS as a group will be this Monday. The agenda for this meeting will be to begin working on a protocol for health prioritization in the community. We will start by talking about what we learned from the dengue campaign, and what our goals are for working on this new project. After some lit review, SOMOS has selected 5 models for health prioritization that we will present to the CdS for consideration- The Simplex Method, Nominal Group Planning, The Priority Matrix, The Strategy Grid, and the Hanlon Method. We will present these models to the CdS members for discussion about which they feel are most relevant to their setting and their goals. From there we can work to adapt one or more of these models into a protocol for Esfuerzo. I imagine that we will find it most useful to use a combination of inductive and deductive methods, and think about at what level we should implement each phase of the project- at the individual household level, within block groups, or at the community wide level.

The CdS members have shown enthusiasm for the protocol so far, and I am optimistic for our work together this summer. More than anything, I hope that we can develop a protocol in which the CdS members can feel a sense of ownership. This is a critical stage in the development of both the committee and the community, and if the CdS members are able to find success in this project, I think it could mean big things for the future. However, in addition to the ongoing work of the CdS to address health concerns, the community also recently applied to Engineers Without Boarders for help in reducing the affects felt by annual flooding in the community. This project has also reached a critical point, and what goes on this summer will most certainly determine whether or not the community moves ahead with the engineering project and their partnership with EWB. So I only hope that the CdS does not lose their momentum in the wake of these developments. We will be holding a community meeting this weekend to share the results of the engineer’s hydraulic analysis, and we’re already anticipating some push back from community members. However, despite these developments, I am hopeful that CdS members will be able to get the community interested and invested in what’s to come from the CdS this summer and what it means for the future of community health in Esfuerzo.