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Building community-based health programs in three urban poor communities in Cebu

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The Visayas Primary Healthcare Services, Inc. is currently implementing a project to build community-based health programs (CBHP) in three urban poor communities in Cebu.

The project sites include Purok Tambi, Barangay Umapad, Mandaue City, Sitio Sawsawan, Barangay San Roque, Talisay City, and Sitio Intramuros, Barangay Poblacion, Cordova. The project is supported by the Committee of German Doctors for Developing Countries, Inc. (CGD) and starts on May 2016.

The project areas are among the 16 areas in where the CGD has rolling clinics in order to provide health services to the poor residents for them to attain good health and maintain healthy lives. The rolling clinics are served by batches of volunteer doctors from the Federal Republic of Germany who come and stay here and render their services for six weeks. Such program has benefitted thousands of beneficiaries.

The project aims to establish CBHPs using the primary health care approach so that the communities are self-reliant on primary health care. It aims to develop the capacity of community health workers (CHWs) to address common and preventable communicable and non-communicable diseases in the communities, to raise awareness and develop good health-seeking behavior on primary health care among the residents, and to establish five health programs that address priority needs in the communities.

Capacity building shall be achieved through two levels of basic health skills trainings (BHST) for CHWs to teach them about simple home remedies to treat common ailments including herbal medicine, acupressure, cupping therapy, and water therapy, taking of blood pressure, weight, height, temperature, pulse rate and respiratory rate, nutrition, environmental sanitation, simplified anatomy and physiology of the human body, simplified history taking and physical examination, control of acute respiratory infections and diarrheal diseases, and control of tuberculosis and hypertension.

Monthly health education classes on topics to address the common health problems in the communities shall also be conducted.

Medical services shall be conducted by the trained CHWs during the rolling clinics as their practicum of the knowledge and skills that they acquired during the trainings. The CHWs shall also render medical services through home visitations. Herbal medicine processing will be done to treat common ailments. Patients’ records shall be made and kept by the CHWs.

Health programs shall be launched to include establishment of patients support groups on hypertension and diabetes mellitus, nutrition program for malnourished children, environmental sanitation, tuberculosis control program, and maternal and child health care program.

Three members of the staff of the Visayas Primary Health Care Services, Inc. (VPHCS) were assigned to take charge in implementing the project.

In May 2016, community organizing was initiated in order to familiarize the project team with the community residents in the areas. Meetings with the existing volunteers of the German Doctors rolling clinics were held in order to discuss with them about the project and solicit their opinions and insights on how to make the project respond effectively to the needs of the residents. The volunteers, numbering 11 in Cordova, five in Sitio Sawsawan, and four in Purok Tambis, Umapad, expressed their openness and enthusiasm in working with the VPHCS in implementing the project, in being trained and to serve their respective communities as community health workers.

Through home visits, health education and health services of the project team together with the volunteers, more residents were identified and invited to become CHWs, which they accepted, after seeing the need to contribute their time and efforts to serve the health needs of their communities without any remuneration or reward except the self-fulfillment of being of service.

At present, there is a total of 21 CHWs in Cordova, including the existing 11 volunteers in the rolling clinic, and 10 CHWs from Sitio Intramuros who were newly identified. In Sitio Sawsawan, from the existing number of five volunteers in the rolling clinics, with an additional number of eight newly identified CHWs, there are now 13 CHWs. In Purok Tambis, from the existing four volunteers in the rolling clinics, with an additional number of 14 newly identified CHWs, there are now 18 CHWs there.

Through community integration and consultations with the CHWs, problems of cough, diarrhea, need for knowledge on birth control methods to address the large family size situation in Sitio Intramuros, hypertension and dengue fever, were identified. Thus, tarpaulins measuring 3 feet by 4 feet were made as visual aids for health education. Using these tarpaulins, groups of mothers’ classes were held in the three sitios, hand in hand with one-on-one conversations with residents in their homes to talk to them about their health problems and good health seeking behaviour.

To promote the use of herbal medicine to address skin infections common among the children and osteoarthritis among the adults, the health educations were complemented with herbal cooking of temple flower (kalachuchi), moringa (kamunggay) and hemlock (panyawan) (KKP) ointment and garlic (ahos), ginger (luy-a), red pepper (sili) (ALS) liniment in the communities. The project team provided the ingredients and the CHWs and interested mothers were taught how to process them into the ointment and liniment. The finished products were then shared among all of them who went home very happy.

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