Understanding CBHPs is not as easy as translating words. The community based health program is often mistaken as simply having a medical clinic staffed by hired health workers within the community. But, CBHPs are so much more. When they were first conceptualized in the early ‘70s, it pushed for advancement of primary health care in communities by local people long before the Alma Ata Declaration in 1977. Through the years, CBHP concept was enriched by the experiences of volunteer community health workers and CBHP staff members. How did they accomplish such a feat?
Let’s do social investigation
During social investigation, or community diagnosis, people gather and analyze data they have collected on economic, political, social and cultural aspects of their community. All data is needed to help assess community health concerns. Health is not simply an isolated entity. It is affected by different factors – the individual and the community he or she lives in. A community’s health status is a product of the interplay of the existing beliefs, levels of education and technology, financial capability and [political will. There are communities where it is taboo to use a contraceptive. There is even a religion which forbids blood transfusions. For most, there is not enough money to spend for food or medicines, causing deteriorating health or even death. And now with a devolved government health services set-up, public officials see health as minuscule priority. The result? Communities are continually plagued by even the most preventable diseases- malaria, measles, dengue, tuberculosis, etc. During rainy season when many people get sick, there is decreased work force which lowers the people’s productivity rate. Knowing all these peculiar but important aspects of a community helps assess strengths and limitations in carrying out the program, maximizing resources available in each community.
A people’s organization (PO) is essential in sustaining the community’s programs. Without it, there will be no one left to continue whatever has been started. It is through the efforts of the people’s organizations that people are educated about the roots of the community’s problems and possible solutions. The organization discusses all the concerns of the community like food, production output and health care; and then plans, coordinates and evaluates all programs necessary for holistic development of the community. To complement their commitment to serve the community, PO leaders undergo leadership training seminars.
Who joins health committee?
In some areas where there is an existing people’s organization, there is no need to organize another PO. What might be needed would be to add another committee to oversee the community’s health concerns. When health committees of a PO are already established, the CBHP staff or volunteer resource persons will provide them with advanced health skills and other trainings according to their own local needs. Sometimes, a community could be so small that most leaders of the people’s organization are the ones also heading the health committee. No problem. A health committee’s task is to oversee health work in the community. Participation of the whole community ensures proper implementation of plans.
The Community Health Workers (CHW)
Unlike most health professionals, the community health workers (CHWs) give their services for free. They are different from most government barangay health workers who typically stay in health center every day, waiting for patients to come to them. In this case, the CHWs go to their assigned family groups and re-echo whatever training they have attended. These trainings may include a short course on common illness, traditional medicines, differential diagnosis, pharmacology and first-aid, among others. This is the way all family members within the community learn to take care of their own health. If there are individuals who need special help, either the CHWs go to a CHW’s house. CHWs do not have a center where they wait for patients the whole day. This is too impractical for them, since most are mothers themselves and peasant farmers. CHWs are volunteers, able-bodied and willing to help at any hour of the day or night when they are needed. By this time, you have reached the end of the cycle. This cycle continues within other communities through the initiative of the people’s organization and CHWs. Starting a CBHP is only one-third of the work. The bigger challenge is keeping it active and alive and always growing.##