Almost 5,000 community health promoters were working in the rural areas of El Salvador in 1995. After years of continued funding, a nationally representative sample household survey of approximately 2,000 rural women of reproductive age was conducted to assess the effectiveness of their services on basic maternal and child health knowledge and practices, especially with the Ministry of Health (MOH) program. Data were analyzed according to "exposure" to a health promoter and whenever appropriate, broken down by type of program (MOH, IPPF affiliate or other NGO). Results analyzed through bivariate and multivariate analyses revealed a positive net effect of exposure to a health promoter on family planning use, including the use of reversible methods of contraception, as compared to non-exposed women: 56.1% vs. 43.5% respectively. This effect is critical in a country known for the extremely high use of female sterilization as a family planning method. Similarly, other positive behaviors such as prenatal care, use of oral rehydration for acute diarrhea and professional care seeking for acute respiratory illness were significantly higher among "exposed" women. Analyses confined to the MOH promoter segment gave at times even more striking results. The survey was complemented by a qualitative study highlighting their need for continuous training, supervision and logistics in order to support their performance.
Results of this nationwide study confirm the importance of this community health program on affecting the health behavior of the population in a sustainable way. In contrast to other volunteer workers the MOH promoters are paid employees.
Learning Objectives: At the end of the presentation, the audience will have acquired a better understanding of the potential for impact at the national level front-line providers of MCH care can have in a given country, provided they are properly trained and supported
Keywords: Family Planning, Reproductive Health
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.