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Social innovation to provide healthcare in remote areas: Community Health Actions in the Tapajos National Forest, Brazil

dianagosalvez Diana Gosálvez Prados — 1/10/2012

Other Organization

This programme serves 1100 families living across 600,000 hectares in 143 rural settlements along the Tapajos River in the Amazon Basin. The area suffers from persistently high maternal and infant mortality and morbidity. The programme delivers interventions through a combination of community mobilisation and outreach. It links happiness to health, and is delivered through paid and volunteer staff, including health professionals, educators, community organisers, and specialists in social communication, employment and income generation. Central to the programme is a series of interventions to improve the living conditions of residents.

Fragility, pluripathology/polipathology and/or complex chronic diseases

Goals Prevention:
Funding for detection programs , Creates healthy environments , Promotes health and wellbeing in schools and early years , Promotes adecuate understanding levels on the community about the importance of prevention , Focuses on social inequalities
Goals Detection:
Advances public education on the importance of early detection , Shows new evidence on the importance of early detection, including guidelines of effective practices , Promotes early intervention through primary health care measures
Goals self-management:
Promotes patient involvement in planning services

The programme combines three strategies. The first involves education, prevention and
community mobilisation. Volunteers treat common ailments, give advice to families, and monitor
community health. Education campaigns focus on family hygiene and sanitation. Hygiene and
proper disposal of garbage are at the core of community participation. Local participation is
encouraged through a circus – using happiness and health as its themes – games, theatre,
dance, poetry, and various mass media.

The second strategy is that of providing access to safe water. The Tapajos River is
contaminated. The programme gives financial and technical help to supply clean water, and
local committees create and manage sewage-treatment facilities.

The third strategy involves a range of interventions supplying ambulatory prevention and
community health services. Community-health agents use radios to alert medical personnel.
An Ambuboat provides both emergency care and less urgent medical and dental treatment.
A floating clinic provides clinical services and vaccinations. Each community has a Local Health
Commission, comprising a person who prays for healing, a healer who uses medicinal plants, a
bonesetter, and a traditional birth attendant. Traditional practitioners command respect among
local residents, and are often the first to be consulted.

The annual cost per person is about $70, but there are additional costs for sanitation and
training. Costs are higher than for programmes located in more compact geographies. Thanks
to the emphasis on popular participation, the programme has been developed and expanded
across the region.




Practices Map



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