Cooperative agreement no. PDC-0520-A-00-6144-00 to Esperanca

PVO, to implement a child survival program emphasizing oral rehydration therapy (ORT), immunizations, nutrition education, and other primary health care (PHC) services, for children 0-3 and women of child-bearing age in the isolated jungle region of Bolivia called the "Chaco." Esperanca will expand its existing health care system by establishing 20 health posts to be staffed by one or two trained auxiliary nurses, who will be supervised by five program monitors especially trained for this purpose. The auxiliary nurses will: (1) provide at least 80% vaccine coverage for vaccine-preventable diseases; (2) dispense ORT packets to mothers of children with diarrhea and instruct mothers in their proper use, as well as in proper sanitation and feeding during diarrhea; (3) provide iodine injections to pregnant women and to infants born to goiterous mothers and educate communities about the dangers of goiter; (4) provide such pre-natal care as tetanus texoid immunizations, identification and referral of high-risk pregnancy, and nutrition education; (5) combat malnutrition in children 0-3 by instructing communities and individuals during home visits about improved weaning practices, proper feeding during diarrhea, the use of home gardens, the introduction of new foods into the diet, growth monitoring, and follow-up and referral of children at risk; and (6) strengthen the existing system for referral of high-risk cases to the regional hospital. Local communities will be responsible for selecting the auxiliary nurses and eventually for paying their salary, as well as for upkeep of their community"s health post.