making cities work: reproductive and environmental health in the peruvian andes
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Making Cities Work: Making Cities Work: Reproductive and Reproductive and
Environmental Health in Environmental Health in the Peruvian Andesthe Peruvian Andes
Delicia FerrandoDelicia Ferrando
American Public Health Association132nd Annual Meeting
Washington, D.C.November 7-11, 2004
Background:Peru’s Internal Armed Conflict: Internal Refugees and Deaths,
1980-2000Total Refugees: 460,920
Women 87% Peasants 70%
Total Deaths: 70,000 Men 80% Quechua-speaking 54% Education below
secondary school 70% Peasants 80%
Source:Peru´s Comission of Truth and Reconciliation. Chapter I. 2003
132nd Annual APHA Meeting, 2004
Internal Migration to Huancayo
132nd Annual APHA Meeting, 2004
•JUNINLIMA
HUANCAYO
HUANCAYO
OC
EAN
O PA
CÍFIC
O
50,000 refugees displaced to Huancayo, settling in peri -urban areas surrounding the city.
The average family earns no more than 100 USD a month.
Living conditions rife with environmental and health problems, including overcrowding, lack of drinking water and sewage systems, high fertility rates, high incidence of untreated STIs, and lack of access to MCH services.
Women’s health among displaced communities
132nd Annual APHA Meeting, 2004
No access to reproductive health services
Large family size (7 to 10 members)
High incidence of unwanted pregnancies
High prevalence of clandestine abortions
Domestic violence is common (physical, psychological, sexual)
Living conditions Refugees settled
in an area used as a waste-dumping site.
It was common to throw garbage in the river or burn it in the street.
No access to drinking water or sewage systems.
Use of chemicals in surrounding fields contaminated the soil and water.
132nd Annual APHA Meeting, 2004
The Huancayo Project: Reproductive and Environmental
Health Education
132nd Annual APHA Meeting, 2004
Components:
Information Education and Communication (IEC) Activities
Promotional Activities and BCC
Reproductive and General Health Services
Community Mobilization
Partners The CATALYST Consortium is a global
reproductive health activity initiated in September 2000 by the Office of Population and Reproductive Health at USAID, and comprises 5 organizations: Pathfinder International, the Academy for Educational Development (AED), Center for Development and Population Activities (CEDPA), Meridian Group International, Inc., and PROFAMILIA/Colombia.
COOPERANDES is a Huancayo-based NGO that works with hard-to-reach and marginalized populations.
132nd Annual APHA Meeting, 2004
IEC Activities 26 Informative Sessions
were held, where 1,082 adolescents and 3,243 adults were reached with information on reproductive and environmental health.
4 Adolescent Fairs were organized.
44 workshops were held on RH/FP involving 1,428 attendees
Main messages include:
Personal hygiene, e.g. washing hands before eating and/or after using the bathroom
Basic reproductive health routines, e.g. encouraging annual Pap smears to prevent cervical cancer
Waste disposal, such as use of trash cans to store and transport garbage
Increase knowledge of and access to contraceptive services
132nd Annual APHA Meeting, 2004
IEC activities cont’d
Promotional Activities (BCC)
132nd Annual APHA Meeting, 2004
25 Wall Panels12 Murals11 Radio Broadcasts 14 TV Programs (68 hours)
Reproductive and General Health Services
Health Center La Esperanza:2,285 patients for RH care4,397 patients for general healthcareAchievementsContraceptive prevalence ratesFemale: increased from 15% to 45%Male: increased from 2% to 9%Prenatal care attendance increased from 10% to 16%Delivery care attendance increased from 9% to 31%Unwanted pregnancy decreased from 68%to 45%STI prevalence decreased from 90% to 44%132nd Annual APHA Meeting, 2004
Community Mobilization
132nd Annual APHA Meeting, 2004
26 “Action Fairs” were sponsored featuring mobile clinics at environmental and RH fairs involving over 1,000 attendees.
COOPERANDES employs community leaders and volunteers as community health “agents” to reach marginalized residents and refer them to RH/FP services, as well as inform the organization about emergency health situations.
132nd Annual APHA Meeting, 2004
Environmental Health 24 Environmental Health
fairs involving over 1,300 attendees
8 fairs held for water treatment, general environmental health and
domestic animal de-parasiting
Initiated campaign to reduce toxic car emissions through media
How They Live Now
132nd Annual APHA Meeting, 2004
Families use purified water. Their water canals are clean
and a new sewage system was installed partly financed by the community itself.
Negotiations with the municipality guaranteed turning a waste-dump area into a community park.
COOPERANDES Staff in“La Esperanza” Health Center
Community Health Promoter
La Esperanza contributes to COOPERANDES’ sustainability efforts in the peri-urban communities in Huancayo.
This clinic was initiated through the ALCANCE project funded by USAID 1998-2002
132nd Annual APHA Meeting, 2004
Conclusions Local NGOs can scale up successful projects
through creating links with national organizations and municipalities to improve the reproductive and environmental health of marginalized populations.
Community health agents are key in determining efficacy of mobile clinics, action fairs and outreach strategies.
Community activism and awareness are now appreciated as legitimate negotiating tools.
The project is now self-sustaining and COOPERANDES is scaling up in other peri-urban areas in Peru.
Thank you!!Pathfinder InternationalAlameda La Floresta 285
San BorjaLima, Peru
www.pathfind.orgWith funding from the United
States Department of International Aid
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