COMMUNITY HEALTH
Health Needs Assessment
The Health Status & Risk Factors of Nomadic Pastoralists in
Southern Qinghai Province project -- a survey of health needs in the project
area, undertaken jointly by the University of Montreal and Plateau Perspectives
in collaboration with the Yushu Tibetan Autonomous Prefecture Health Bureau and
the Upper Yangtze Organization -- was the necessary first step to address health
needs in the project area. Information was gathered on people's health
status, cultural perceptions of health and health care, household conditions,
people's livelihoods and the natural environment. Preliminary findings show that
50% of households report at least one member with illness rendering them unable
to work in the last 3 months; people regularly see
their village health worker; there are high rates of illness, especially among
women; there is a very high rate of infant loss; there is need of better
understanding of tuberculosis among village doctors and other health care
workers; and there is urgent need for immunization against several diseases.
Such information was used to help inform Plateau
Perspectives' subsequent community health work in the project area, including
doctor training and midwifery training, improvement of rural health service
provision through the construction of community health centres, and support
given to the local CDC immunization program.
Village Doctor Training
Village
doctors have been trained in patient
assessment, diagnosis and treatment, as well as in the broader aspects of health
including linkages with community development, education and environmental
protection. Priority was given to TB and other diseases that were found by the
health survey and/or through focus group work with village doctors to be common in the area. As
de facto
community leaders, these doctors were also encouraged to take a lead role in preventing
disease and taught about immunizations. After completion of one month training
course, the doctors were given a blood
pressure machine and stethoscope. In total, around 50 village doctors were trained in
three courses. Feedback was very positive.
In the light of the positive response, the Health
Bureau also asked that we train a group of young women, each selected by their
own communities, in
women's health and in mother and child health (MCH). This has recently been
undertaken (see below) and will help further address some of the health needs
described above.
Women's Health
Training
Twenty-four young women have been given additional training
in women's health and in mother and child health, following a training course
they completed a few months earlier. The main purpose of the training was not
only to improve their knowledge base, but also to help them apply their
knowledge and improve their practical skills. The county governor in charge of
health opened the health training workshop. The students participated well and
their knowledge increased greatly in a short time. They were given opportunity
by means of role-play and modelling to learn how to apply their knowledge. The
women also enjoyed composing and singing songs about health issues.
It is planned that these women will work in new community health centres,
some of which Plateau Perspectives will help to build.
Rural Health Services
Plateau Perspectives has
helped build a community health centre in Jiongqu village.
Staffed by a trained village doctor and a women's health worker, the centre will provide
accessible health care to both women and men in this remote herding community. The clinic will also enable the establishment of a
government health
insurance scheme, a revolving fund for the provision of medicines, and good
storage for medicines and vaccines. The centre will include public toilets and
disposal units for needles and other waste products such that healthy practices
can be modelled.
In discussion with the Health Bureau, we believe that such health centres, at the village level,
are the best way to
enhance accessibility and quality of health care for
the greatest number of people in remote pastoral areas. This approach also
appears to be popular with local communities. We have therefore begun to raise
additional funds for the construction and management of several other community health
centres in the remote western areas of the project area.
Many communities also hope that such health centres can become more general
community centres with broader purpose, such as to encourage and facilitate
vocational training, general education, environmental protection and ecotourism
development.
Immunization Program
One local leader recently drew our attention to several cases of
measles. In discussion with the local CDC and Health Bureau, a plan of
action was agreed and measles vaccines ordered from the
provincial capital. Township and village leaders enthusiastically arranged to
immunize many young people, with funding provided by Plateau
Perspectives. The logistics of this immunization trip were organized by local leaders
to gain maximum
cover and lay a long-term foundation for future campaigns. It is planned that
other immunization trips will soon follow.
