Community Health Agents in Peru Strengthen Their Communities

Near Cusco and Machu Picchu in the district of Pitumarca, community health agents (CHAs) work closely with community leaders and government to improve maternal and child health. In 2009, the government recognized Pitumarca as a “Best Practice in Public Management” that has improved health and living conditions in one of the poorest districts of Peru.

In March 2011, students of the Future Generations Graduate School visited this district  and witnessed firsthand the successes that CHAs have achieved with their communities. Speaking in Quechua, an indigenous language of the Andean people of South America, Casimiro Huaraya-Mendoza recounted the past and present situation.  Casimiro is an active CHA and is president of the Association of Community Health Agents of Pitumarca.

In the past Casimiro, his wife and their several children slept in a one-bedroom house without a bathroom. Their patio was full of garbage due to the lack of municipal garbage collection. Smoke from the open-fire cookstove filled the air, and their kitchen lacked a sink, table, and cabinets and also housed the family’s chickens. Casimiro’s fellow community members faced similar situations.

Today, due ín part to a three-way partnership of the community, municipal government primary health care services, Future Generations Peru (whose role is to provide training and materials), and other NGOs that support infrastructure projects, current community circumstances have improved dramatically.

Using the “Healthy Families and Homes” strategy to improve living conditions, houses are built from local resources and contain many ecological features. The strategy addresses the issues of health prevention, food and nutritional diversity, neighborhoods/housing, water and sanitation.

Today families prepare their food in a cleaner environment (resulting in reduced diarrhea in children) with kitchen sinks, tables, and cabinets and eco-friendly, clean cook stoves (resulting in reduced respiratory illnesses). Some families have solar-heated showers. In addition, the municipality acquired an ambulance and wheelchair for their primary health care center.

CHAs mainly focus on educating pregnant women and mothers of children under two years of age. Some activities include: making regular home visits to teach healthy home practices, identify danger signs and make referrals, encourage mothers to visit health facilities for preventive services, and assist pregnant mothers in creating a birth plan for their upcoming delivery. In their birth plan, mothers decide things like where they will go for the delivery, who will accompany them to the health facility to give birth, and who will take care of their older children and animals while they are away giving birth, etc. 

CHAs encourage better health by showing mothers the changes that they can make in their homes. As a result, customs are changing. Community members utilize latrine facilities instead of the fields and display knowledge of sanitation practices.  Mothers learn how to wash hands and to store, handle, and treat drinking water, food, and eating utensils to reduce illness.  CHAs work with health personnel to give demonstration sessions of weaning food preparation to ensure healthy child nutrition.

Casimiro painted his vision for the future inside of his houseAfter highlighting all the successes to the students, Casimiro culminated his speech by sharing personal and community goals.  Casimiro aspires to cultivate a kitchen garden and build separate bedrooms for his children, a household storage room, and a place to raise guinea pigs.

With improved health practices and housing, the community hopes to profit from experiential tourism and home-stay programs, capitalize from a new recycling program, and continue to produce textiles, an increasingly large industry in Peru.

The technical assistance provided by Future Generations Peru to the district of Pitumarca was made possible by a grant from the Child Survival and Health Grant Program (CSHGP) of the United States Agency for International Development (USAID).   This project, called the NEXOS Project, operated from 2005 to 2009 and strengthened community health and development in a total of 17 districts with 258 communities and 28 primary health care facilities. Future Generations Peru is currently implementing a new CSHGP project in the Huánuco Region which started in 2010 and will continue through 2014.