Community Health Program, Cruz Alta, Lempira, Honduras
Background of the Region
The community of Cruz Alta is located in the town of La Campa, in the department of Lempira, in western Honduras. 95% of the population is indigenous and belong to the Lenca ethnic group.
According to recent diagnostics, the most prevalent diseases facing the people of Cruz Alta are respiratory illnesses, and easily preventable water borne diseases: IRAS (31.8%), diarrhea (2%), other (0.8%), alcoholism, disability in children, skin (0.6%) and hemorrhagic dengue (0.4%). 74% of children under 6 years is treated at the health center. 84.9% of the population is served by water through aqueduct, 14% by public well sources and 1.2% from own well. 61.6% have latrines, of which 9.3% did not use it. Service coverage of electricity is 33.72%.
97.7% of households own their own homes that are fully paid, 1.2% are renting and 1.2% live with another relative. The homes are small and combined with an overall average of 5.8 persons per household, the level of overcrowding is considerable. In fact, 46.5 % of the households have between one and three rooms. 77.9 % of households use only one or two rooms as bedrooms. On the other hand, the problem of overcrowding is even worse as in some homes 18.6 % house two or more families, and 22.1 % of these do not have an indoor bathroom in favor of outdoor latrines.
Most of the houses in the community are deteriorating. Most of the families are low-income, which limits their ability to provide proper maintenance for the homes. Only 14 % of households are in good condition, 59.3 % in poor condition and the rest in fair condition.
The main problems in homes are that 80.2% of them were built with plaster, 67.4% have dirt floors, 73.3% do not have ceilings and 5.8% have ceilings in poor condition. As we consider the ceiling critical for maintaining family health, and the condition of the home in general as an element of significance in terms of family health, we believe that significant improvements in the region could be made with home improvements as there is a significant amount of homes in disrepair.
Another important subject to analyze is the type of fuel used for cooking. 96.5% of the households used wood as fuel for in-home, inefficient, unventilated stoves depleting the forest and causing debilitating upper respiratory illnesses. Only 3.5% use electricity for cooking.
Justification… include statement of the problem
Poverty and extreme poverty are the realities in Cruz Alta. The reality of life there vacillates between these two determinants of being either poor or extremely poor, which more than any other characteristics, has a profoundly negative influence on the health of the people. In the poorer families, a low level of education is all too common, combined with an inadequate level of nutrition, and the limited availability and/or access to basic services. It is well recognized that most of the health problems people have in Cruz Alta are related to poor living conditions. Added to extremely poor housing are high levels of violence and social exclusion. These factors weigh heavily on the health of the family.
While there is an obvious need to improve housing, it is even more important to start a process that helps the community of Cruz Alta to recognize the impact that poor housing is making on their community, and then taking the initiative to improve those conditions. The project will provide guidelines for action steps and some basic tools to address issues of sanitation inside the home, such as cement floors, clean water among other factors that affect the health of the family.
Clean, safe housing has a major impact on the preservation of health in the family and provides an environment for creative activity and learning. Therefore, it has been determined that improved sanitation and a healthy home environment will be the foundation upon which the programs in Cruz Alta will be built.
Description of the Project Objectives and Activities
Objectives: General & Specific
General Description: Improve the overall sanitation conditions in the home providing the foundation for the development of healthy families and the strengthening of the community.
- Develop local capacity for healthy homes and healthy families.
- Promote healthy behaviors and develop knowledge and skills for self-health care in the family.
- Recover and rehabilitation of risk factors in homes.
- Construct clean cement floors for kitchens.
- Provide water filters
- Change traditional stoves to efficient stoves.
Summary Description (Summary of the Methodology)
The family is the component fundamental to human and community development and is the area where the processes of health and disease have their most significant impact. This is where habits and practices for healthy living begin. The housing conditions have been recognized as a major social determinant of human health, and either promote or limit physical, mental and social health of its residents.
The project includes an integrated set of actions designed to promote healthy behaviors that encourage healthy lifestyles among family members. It focuses on providing preventive health awareness and skills for family members to improve their health, housing and the environment. The project promotes the construction of a culture of health, based on solidarity, respect, development of values and principles.
Project Description (Methodology)
To address the project, first a survey of socioeconomic indicators was conducted with the community’s involvement and with the participation and involvement of young volunteers. Responses from the community were shared with Amigos del Cafe who supervised the process, and edited and coded the responses, which formed the basis of analysis.
The families were selected based upon a statistical analysis. The analysis’s considered the poverty level and the level of health risk in the home. The families’ income was considered (from 1,000.00 to 2,000.00 Lps). The number of family members in the home and the conditions of the house was also considered.
The implementation of the program consists of four phases; awareness, planning, implementation and follow-up, which includes monitoring and evaluation.
In this first phase we proceeded to inform the community of our intentions and raise awareness of the program. We explained the objectives and results that we hoped to Achieve, which was to promote the interest, motivation and commitment of the community in the program.
As the initial part of the planning stage, we hold a meeting with the community and share information about family health in the region and the causes of some of the problems. We followed that stage by discussing some of the needs and healthy behaviors that could promote improved health. The analysis serves as a base to build community participation.
The plan is executed according to the problems prioritized by the community groups. Furthermore, the plan is refined by selecting the sectors where the project will be implemented as well as the process by which there will be cross-sector analysis to benefit from the perspectives of all participants. Responsibilities are differentiated and disseminated among the families, the health facility, the community, the municipality and other actors involved. The stages of training are based upon the implementation and provision of wood-saving stoves, the implementation of water filters in the home, and the improvement of the floors, walls and bathroom in the homes.
Project Duration: two years
- The Cooperative, Empresa Cafetalera Camapara, is Established and Certified
- An agreement made between Amigos del Café and Empresa Cafetalera Camapara on the structure of the program, the process of working together, roles and responsibilities.
- The first group is selected
- A Manual for constructing the floors, stoves, etc, is developed
- a promoter is selected from the first group
- Construction on the first home begins
- Construction on the first 5 homes is completed
Cruz Alta, an aldea in the community of La Campa, Lempira in western Honduras
The Empresa Cafetalera Camapara is a small coffee cooperative recently established by a group of men and women from the community of Cruz Alta, Camapara, Lempira and nearby villages.