Dear friends and colleagues with an interest in primary health care and community health:
You are receiving this email because of your interest in primary health care and community health.
If you know of anyone that you think would like to be included in the listserv, just sent me the person’s name and email address.
I am delighted to finally be able to share with you 10 articles that form a journal supplement that describe the work of an NGO that I have been working with for four decades now, Curamericas Global. This supplement describes a maternal and child health project that was implemented from 2011 to 2015 in an isolated, mountainous area of the Department of Huehuetenango, Guatemala. Here is the link <https://equityhealthj.biomedcentral.com/articles/supplements/volume-21-s... to these articles.
We call the methodology used CBIO+ -- an expanded version of the census-based, impact-oriented approach that arose from the work of Curamericas Global (then Andean Rural Health Care) in Bolivia in the 1980s. CBIO was later expanded in Guatemala to include Care Groups and local birthing centers.
We think this supplement is important for a number of reasons.
1. It describes a comprehensive approach to implementation research that involves, among other things, measuring changes in population coverage of evidence-based interventions and changes in child nutritional status. It also includes a mortality assessment – elucidation of risk factors for and causes of both child and maternal mortality as well as measurement of changes in mortality. It include an assessment of the management of obstetrical complications at local birthing centers, assessments of the project’s impact on women’s empowerment, an assessment of the CBIO+ methodology by field staff, and a set of policy recommendations arising from the research.
2. Although CBIO was developed four decades ago, and in spite of considerable evidence of its effectiveness, it has not been adopted fully by any other organizations or programs beyond Curamericas Global. However, a number of components of CBIO are now gaining growing application (e.g., routine visitation of all homes, prospective measurement of mortality by means of routine home visits, use of verbal autopsy to assess cause of death, the use of KPC (knowledge, practice and coverage) household surveys to measure baseline and endline levels of coverage of evidence-based interventions), and Care Groups. The addition of Care Groups and local birthing centers makes this an even more powerful methodology for improving the health of children and their mothers in areas where health systems are poorly developed and access to services is difficult – which is to say a major portion of the world’s population! We think that CBIO+ deserves serious consideration for scaling up in Guatemala as well as for implementation in other parts of the world.
3. This research was carried out on a shoestring budget, with essentially all of the quantitative data being collected by program staff. This means that other projects and programs could carry out similar program monitoring and evaluation without relying on expensive technical assistance.
We hope you will take time to take a look at this – especially the final paper which summarizes all the other papers, reports an assessment of the cost-effectiveness of CBIO+, and provides broad policy recommendations.
Feel free to share this email with anyone else or with any relevant listserve you may have access to.
Warm regards,
Henry
Henry B. Perry, MD, PhD, MPH
Senior Associate, Health Systems Program
Department of International Health
Johns Hopkins Bloomberg School of Public Health
Baltimore, MD, USA 21205
Hperry2@jhu.edu; 443-797-5202
HIFA profile: Henry Perry is a Senior Scientist at the Johns Hopkins Bloomberg School of Public Health, USA. Professional interests: Community health and primary health care. hperry2 AT jhu.edu
