Our overall goal is to provide the University of Nicaragua (UNAN) with more accurate and detailed health information about the Sahsa area to help in designing future health interventions. In addition, students conducted health education sessions in Sahsa and surrounding communities. They also worked alongside UNAN medical students and UNC preceptors in the clinic in Sahsa.
Priorities in summer 2009
(1) Assessing maternal and reproductive health levels in the area using an abridged version of the CDC's Reproductive Health Assessment Toolkit. We focused on four components of the toolkit to assess:
- General health of mothers and their families
- Maternal health
- Women's knowledge about STI's
- Women's knowledge and attitudes about family planning as well as access to resources.
(2) Assessing the distribution of Rotateq(r) rotavirus vaccine among infants in the Sahsa area, as well as other mandated childhood immunizations.
(3) Utilizing and expanding the household GPS surveillance system developed by last year's team.
Setting up a yearly surveillance system will go a long way to helping the clinic in Sahsa better serve the region’s needs. However, in some communities a trip to Sahsa is an impossibility even for the sickest children. The barriers to care run deeper than the enormous cost, the inaccessible transportation, and the nonexistent or flooded roads. I met a woman with three dying children who declined our offer to take her to the clinic. Many of the people we talked to have never stepped foot outside their community. Others had heard horror stories of poor treatment by doctors or traveling all that way just to be turned away at the clinic doors. Even after we had arranged for transportation, food and accommodations for her children, this woman was too scared to make the journey.
These experiences gave us a chance to think in a broader way about what the needs are in these communities and what we can bring to the table. In the end this was the most valuable part of CSHI. One of the UNC medical students was fond of saying, “We are not simply cogs in a well-oiled machine.”
The project is only in its second year of existence so we were actively involved in not just applying the instrument, but designing the survey and planning the fieldwork. There were many kinks to work out, problems to solve, and logistics to organize. Working together with University of Nicaragua and clinic staff, we initiated contact and forged relationships with the community health leaders. We engaged our community member guides and empowered them to take ownership of the survey.
~Leah Gordon, UNC-UNAN Coordinator 2009