Health promoters as practitioners: Lessons from Guatemala

Background: A literature review revealed a surprising lack of information about health promoter programs in which promoters provide primary care. This study is currently in progress. Purpose: Based on data collected during clinic days, this descriptive study provides an overview of the work of health promoter practitioners (HPPs) trained by Concern American and working within the Catholic Church's Social Programs in Guatemala. The study addresses various factors, including patient perceptions, scope of practice, efficacy, safety, and affordability. Methods: Patients from three clinic sites attended by health promoters will be interviewed three times. Interview questions focus on scope of practice, safety, and efficacy with specific attention to diabetes, an important health concern in this area. Data will be analyzed using descriptive and qualitative methods. Patient confidentiality is assured. Results: Results are pending. Although free government services are available, patients consult with HPPs because of trust and what they perceive as efficacy. Up to the point of this study HPPs effectively attend a wide variety of health issues which are affordable and have positive results, based on anecdotal patient perceptions. A substantial reduction in fasting blood glucose has already been shown among diabetic patients. Discussion/Conclusions: Well trained, supervised, continually supported HPPs can provide safe, effective, affordable health care services. By focusing on primary care, limiting medicine availability to a small, consistent list of essential medicines, providing a network of support throughout the region, and continuing education, HPPs are able to provide primary care to otherwise marginalized communities in Peten, Guatemala.