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Supporting innovative rural community health systems: Partners in Health

Active Since: 2016

Contributing to SDGs…

The AbbVie Foundation supports Partners in Health’s innovative rural community health programs, which strengthen the capacity of community health workers in Chiapas, Mexico and Peru to improve local health care access and outcomes.

MEMBER COMPANIES

PARTNER ORGANISATIONS

  • Local NGOs

    Compañeros en Salud

    Socios En Salud

  • Private foundation or development organization

    Partners in Health (PIH)

Objectives

Improve access to quality health care in rural regions of Mexico and Peru through an innovative community health worker model.

Chiapas is the poorest state in Mexico.  Its rural location sits among rainforest covered mountains with isolated communities connected by dirt roads and many residents living below the national poverty level.  Partners in Health launched their sister organization, Compañeros en Salud, in 2011 to improve access to quality healthcare for Mexico’s poorest citizens.

Partners in Health recruits first year physicians to staff rural Compañeros en Salud clinics during their mandatory year of service. To complement the clinics, they train and mobilize non-physician community health workers – primarily women – to provide grass-roots primary care and health education and to link community members to the physicians and clinics in the region when needed. Regular house calls from these acompañantes, as they are known locally, has resulted in increased adherence to treatments for chronic diseases, mental health and maternal and postpartum support.

Separately, in the Carabayllo District of Lima, Peru, extreme poverty means families often face tough choices and live under constant stress. Most families live in a depleted physical environment, with inadequate housing and limited access to drinking water and poor sanitary conditions.  Malnutrition, domestic violence, teen pregnancy, and chronic illness are among their daily challenges.

The combined effects of poverty, lack of early stimulation and poor nutrition put 71% of young children in Carabayllo at significant risk to their motor, physical and language development. This in turn limits their ability to succeed in school and obtain gainful employment.  The CASITA program was developed by Partners in Health’s sister organization, Socios En Salud (SES) to address the lack of stimulation and learning opportunities for vulnerable children in Carabayllo.  The program identifies children ages 6 months to 18 months at risk of developmental delays and trains caretakers in activities that encourage age-appropriate development. Sessions occur in community spaces and are facilitated by trained and certified Community Health Agents (CHAs), who are women from the same neighborhood. Activities include simple yet powerful play interactions that caregivers can weave into daily life, with no special materials required. In some cases, CHAs also make home visits between sessions.

A successful pilot demonstrated that the CASITA program can halt and often recuperate developmental delays among children aged 0-2 living in extreme poverty.  Support from AbbVie Foundation enabled the expansion of an early intervention health pilot targeting underserved children, with the goal of making the program an integral part of the municipal and national early childhood development strategies.

Quote
"We believe this community health worker model is not just a solution for resource-poor communities. A primary care program with a community health worker as part of the multidisciplinary team is an incredible structure…this is just a better way of delivering health care.”
Dan Palazuelos, M.D.
Co-founder, Compañeros en Salud

SDGs THE PARTNERSHIP CONTRIBUTES TO

SDG 3: Good Health and Wellbeing

  1. 3.1: Reduce Maternal Mortality
  2. 3.2: Reduce Under-5 Mortality 
  3. 3.7: Access to sexual and reproductive health-care services 
  4. 3.C: Health workforce

SDG 17: Partnerships for the Goals 

RESULTS & MILESTONES

Support from the AbbVie Foundation has enabled Partners in Health to add four new clinics to its community health worker program in Mexico, expanding from 6 to 10 villages in the region. Nearly 100 community health workers are making regular home visits to support people with chronic disease and mental health needs, as well as maternal and child health, to ensure adherence and access to care. The model has helped to enable significantly better rates of control for diabetes and hypertension in the program area than the national average.

In Peru, the CASITA program has screened over 1,700 children and enrolled 1,200 in the intervention. Based on lessons from the pilot intervention, a strategy has been developed to further encourage paternal involvement in parenthood with specific emphasis on early child development, to be implemented going forward.

The program has also provided a unique mechanism to identify hard-to-reach populations and retain them in care. Additional services and referral programs have been added address other health problems commonly found in families of at-risk children, such as anemia and maternal depression.

Partners in Health facilitates best practice sharing between its programs. For instance, the Compañeros en Salud team made a site visit to Peru to observe the CASITA program and have since collaborated with the SES team to adapt modules for use in the rural Mexico context.

ADDITIONAL INFORMATION