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Expanding Medical Education for Local Health Promoters Among Remote Communities of the Peruvian Amazon: An Exploratory Study of an Innovative Program Model

Authors Ebbs D, Hirschbaum JH, Mika A, Matsushita SC, Lewis JH

Received 10 January 2020

Accepted for publication 2 March 2020

Published 19 March 2020 Volume 2020:11 Pages 215—223

DOI https://doi.org/10.2147/AMEP.S245491

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Professor Balakrishnan Kichu Nair


Daniel Ebbs,1 Julian H Hirschbaum,2 Amanda Mika,3 Starr C Matsushita,4 Joy H Lewis5

1Resident Physician Valley Children’s Hospital, Madera, CA, USA; 2Resident Physician Los Angeles County USC Medical Center, Los Angeles, CA, USA; 3Resident Physician Saint Joseph Hospital, Denver, CO, USA; 4Resident Physician Samaritan Health Services, Corvalis, OR, USA; 5Still University, Mesa, AZ, USA

Correspondence: Daniel Ebbs
Resident Physician Valley Children’s Hospital, 9300 Valley Childrens Place, Madera, CA 93636, USA
Tel +1-559-353-3000
Email debbs@valleychildrens.org

Purpose: Community health workers (CHWs) play integral roles in primary health care provision in low- and middle-income countries (LMICs). This is particularly true in underdeveloped areas where there are acute shortages of health workers. In this study, we evaluated the development and community utilization of a CHW training program in the Loreto province of Peru. Additionally, a community-oriented training model was designed to augment access to basic health information in underserved and isolated areas of the Amazon.
Methods: Health resource utilization was compared in each community by surveying community members before and after implementation of the CHW training program, which utilized a community participatory program development (CPPD) model.
Results: All communities demonstrated significantly increased CHW utilization (p = 0.026) as their initial point of contact for immediate health concerns following CHW training implementation. This increase in CHW utilization was accompanied by trends toward decreased preferences for local shamans or traveling to the closest health post as the initial health resource.
Conclusion: The community-focused, technology-oriented model utilized in this study proved an effective way to promote the use of CHWs in the Amazon region of Loreto, and could prove valuable to CHW capacitation efforts within other Peruvian provinces and in other LMICs around the world.

Keywords: community health worker, promotores, human resources for health, mobile health technology, expanding access to healthcare, rural health

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