RURAL COMMUNITY HEALTH

This multi-donor project will be implemented by VH in cooperation with the Government of Ecuador (GOE). MAP will provide consultant assistance. The project will be implemented in the target areas of Chimborazo, Pastaza, Loja, and Bolivar Provinces and the Yapi/Macuma region, areas which are inhabited by Shuar and Quichua Indians and are isolated from existing health services. Project activities will concentrate on specific area health needs and will utilize a village health worker (VHW)/referral system. Emphasis will be placed on establishing a community health care system, thereby removing the need of the Indians to utilize a non-community system which often discriminates against them. Each of the 141 participating communities (containing upwards of 45,000 people) will be asked to form a local village health committee and recommend an individual for training as a VHW. Participatory health assessments will be conducted to determine and prioritize the health needs of each community. Results of the assessments will provide the basis for community-specific VHW training. A major focus of the project will be on community education for health issues, including personal hygiene, nutrition, and a healthy living environment. Radio forums and schools will supplement the VHW education efforts. GOE-trained rural health aides (RHA"s) will supervize the volunteer VHW"s and will assist in referrals to health posts or hospitals when necessary. The RHA"s will eventually assume the responsibility for VHW training. As part of an integrated health care system, community development projects designed to create a more healthful environment will be encouraged. Potable water, sanitation, agriculture, and housing projects are examples of activities which communities may, with GOE assistance, initiate. By the project"s end, it is expected that 85% of the population in the five target areas will be receiving preventive care.