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Tuesday, April 28, 2009
Refik Saydam (The Hilton Istanbul Hotel )
Purpose of the Study
Decentralizing health system strives to improve equitable access to and the quality of services. Under the current sector wide approaches in health, two complementing health programme interventions are underway: (i) government-led Health Extension Programme (HEP) and; (ii) non-governmental organization driven and locally owned Community-based programmes (CbP). This study explores their impact in improving health care in this resource-limited region.
Methods
Aim was to capture the experience of health programmes primarily from the perspective of the community. Study adopted qualitative research: focus group discussions with community-based health workers, community women and men and; in-depth interviews with government and NGO service providers. Consequently, social and spatial analysis, and gender analysis were applied for data analysis.
Results
Deteriorating infrastructure, shortage of trained health workers and unreliable health supplies challenges the HEP. To meet these challenges, government deploys health extension workers who provide basic curative and preventive services in communities. Complementarily, the CbP trains elected community volunteers to help bridge where access to health services and information are weak. Collectively, they create 'health corridors'; bringing non-clinical care, counselling and imparting knowledge of health-related issues directly in communities. In doing so, they strategically breech socio-economic, gender disparities and spatial barriers that adversely affect community's health, including: early marriage, female genital mutilation, traditional birth delivery and abortion. However, they are confronted by the lack of cooperation between their implementing agencies (government and non-governmental), limiting working environment and skewed community perception of health service utilization.
Conclusions
In the absence of a strong health infrastructure, strengthening primary health care and innovative community-based health strategies within 'health corridors' help in improving equitable access to health services in resource-limited areas; and can have positive social and spatial transformational impact.
Decentralizing health system strives to improve equitable access to and the quality of services. Under the current sector wide approaches in health, two complementing health programme interventions are underway: (i) government-led Health Extension Programme (HEP) and; (ii) non-governmental organization driven and locally owned Community-based programmes (CbP). This study explores their impact in improving health care in this resource-limited region.
Methods
Aim was to capture the experience of health programmes primarily from the perspective of the community. Study adopted qualitative research: focus group discussions with community-based health workers, community women and men and; in-depth interviews with government and NGO service providers. Consequently, social and spatial analysis, and gender analysis were applied for data analysis.
Results
Deteriorating infrastructure, shortage of trained health workers and unreliable health supplies challenges the HEP. To meet these challenges, government deploys health extension workers who provide basic curative and preventive services in communities. Complementarily, the CbP trains elected community volunteers to help bridge where access to health services and information are weak. Collectively, they create 'health corridors'; bringing non-clinical care, counselling and imparting knowledge of health-related issues directly in communities. In doing so, they strategically breech socio-economic, gender disparities and spatial barriers that adversely affect community's health, including: early marriage, female genital mutilation, traditional birth delivery and abortion. However, they are confronted by the lack of cooperation between their implementing agencies (government and non-governmental), limiting working environment and skewed community perception of health service utilization.
Conclusions
In the absence of a strong health infrastructure, strengthening primary health care and innovative community-based health strategies within 'health corridors' help in improving equitable access to health services in resource-limited areas; and can have positive social and spatial transformational impact.
Learning Objectives: Participants will learn about the innovative health interventions to reach communities in resource-limited areas, and hard-to-reach groups of the population. These initiatives may be applied to other similar contexts. It also introduces new conceptualizing methods of community-based health interventions.
Sub-Theme: Poverty, Health and Development: Achieving the Millennium Development Goals