Issue 50 | Social Innovations in Community Empowerment for Health Across the Globe

Dear Reader,

In coordination with The Network: Towards Unity for Health (The Network) 2018 Conference, we are excited to launch this edition titled “Social Innovations in Community Empowerment for Health Across the Globe.”   

The Social Innovations Journal is driven by the belief that “the potential for good ideas to inspire more good ideas cannot be underestimated,” this aligns perfectly with The Network’s mission to foster equitable, community-oriented health services. Through education, research, and policies The Network is bringing together innovative health care organizations, educational institutions, and individuals from around the world in their shared commitment to improving the health of their respective communities.

The current need for innovation in community empowerment for health is evident, and though difficult, a path forward has been laid out. By creating spaces of encounter for academia, state, the private sector, and civil society the next steps towards more sustainable, innovative models and necessary policy adoptions are crystal clear.

Bill Burdick, Vice President for Education at FAIMER, captured the essence and importance of this edition by stating, “Empowerment implies listening and shared decision-making with an emphasis on communication and partnership, without which empowerment is not possible.” 

We hope you read these articles (summarized below) to gain a greater sense of the promise of community empowerment for health initiatives across the globe. These articles cover topics including how community members are generating their own solutions to complex medical and psychosocial challenges; strategies for community-based participatory research; embracing cultural and ethnic diversity in mainstream health advances; developing strategies to create sustainable partnerships among university, local, and global communities to improve the health of populations through engagement and entrepreneurial collaboration; as well as strategies to adapt a government’s general practitioner system to meet the diverse and complex health needs of its communities. 

We’d like to extend a special thank you to FAIMER for their collaboration on this edition and for providing access to the amazing individuals, initiatives, and ideas that will be presented at the 2018 TUFH Conference.  

Sincerely,

Nicholas Torres
Tine Hansen-Turton  
SIJ Co-Founders

William Burdick
Vice President for Education
FAIMER

 

“Social Innovations in Community Empowerment for Health Across the Globe” 

Article Summaries 

Mobile Health Clinics: Providing Free Health Care and Support to Vulnerable Individuals and Families in Communities Neighboring a University 

Maryellen D. Brisbois PhD, RN PHCNS-BC University of Massachusetts Dartmouth College of Nursing

Challenges in reaching the most vulnerable in the community were identified at collaborative community forums held in Southeast Massachusetts, United States (US) in 2014 with University of Massachusetts

Dartmouth (UMass Dartmouth) leaders, social service agencies and providers of healthcare services. The barriers to accessing care and health maintenance among this aggregate were associated with lack of transportation, transient status, and being uninsured or underinsured. UMass Dartmouth College of Nursing students and faculty created a Global Health Collaborative (GHC) university student club to identify the vulnerable footprint in Fall River and New Bedford, and neighborhoods adjacent to UMass Dartmouth.

The mission was to create sustainable partnerships among the colleges in the university, local community, and global community to improve the health of populations through engagement and entrepreneurial collaboration. The purpose of the Collaborative was to develop global partnerships, increase global awareness of health-related issues, establish intercultural relationships, deliver culturally competent care to diverse populations, and respect the beliefs, values, cultures, religions, and practices of the populations the College collaborates with.

 

Safe Survival of Adolescent Girls with Unwanted Advanced Pregnancy

Dr. S. Chhabra, Emeritus Professor, Obstetrics Gynecology, Mahatma Gandhi Institute of Medical Sciences, Sewagram; Officer on Special Duty, Dr. Sushila Nayar Hospital, Utawali, Amravati Melghat; and Chief Executive Officer, Akanksha, Shishu Kalyan Kendra, Sewagram, Wardha, Maharashtra, India

Adolescents with unwanted advanced pregnancies who seek a late-term abortion are in danger of getting killed and the babies are in danger of dying in utero, immediately after birth, or shortly after during infancy. Complications from unsafe interventions remain a major public health issue globally. Social responsiveness can help mothers with unwanted advanced pregnancy. Girls who reported abortions for pregnancy beyond 20 weeks (India’s abortion law) were counseled, offered medical, social, and financial help to safely deliver and legally surrender their baby to the Babies’ Home under the legal system. It was a long journey full of obstacles until a system of local legal adoption was finally established. Over three decades 547 girls were helped, with the youngest only 12 years of age. Of the girls helped, 147 were victims of rape who were in consensual relationships but under 18 and unable to give consent under Indian law, while 26 girls were victims of sexual assaults. In addition, abandoned babies were brought in by police from temples, railways, hospitals, and farms. The mission of preventing deaths and disabilities, honor killings, and dangerous interventions to terminate unwanted pregnancies is enabling young women to lead normal lives and providing a means of safe survival for babies who are being welcomed with open arms by parents across globe. 

 

Establishment of General Practitioners’ System via Refactory of Interest Pattern Based on “Internet+”

Wei Dong-hai, Feng Xinxian, Zhang Chen-fu, Gu Yan-jue, Cao Xiao-wen, and, Tang Kailin. 

Establishing a general practitioners’ system is a significant and difficult point of medical reform in China. The key problem of establishing a general practitioners’ system is that qualified general practitioners who have undergone the standardized training will be the gatekeepers of health. Presently, the general practitioners in China are short-handed and the training and employment of general practitioners are out of line. This will cause an impasse in the establishment of a general practitioner system. There are many reasons for the impasse, but this paper argues that the core reason is the traditional pattern of interests is solidified and the new pattern of interests has not been established. The authors suggest that the government in the process of pushing grading diagnosis and treatment, could be refactoring the pattern of interests via fusion between Internet and medicine based on “Internet +” to create a win-win situation, in order to push the establishment of a general practitioner system.

 

Role of Medical Students in Empowering Community and Health Promotion in Wad-Abuoshar Cillage, Gezira State, Sudan (2016-2018)

Yassein Elhussein, 4th year medical student at University of Gezira-faculty of Medicine, Sudan 

This project was designed in an integrated approach, which helps a lot in project success and the huge improvement of community health. The project works because it was achieved through applying the primary health care concepts in community lead initiatives and community empowerment, it also enhanced the role of the multi-sectorial approach in project success. The project was implemented using a clear methodology and strategic planning and the community was involved in all stages of the project: selection, planning, implementation, supervision, monitoring, and evaluation. The public has been mobilized and empowered by strengthening and encouraging its involvement in solving its various problems, while also enhancing the role of sector integration in the success of the project and creation of relationships between different institutions and society. It demonstrated that health promotion and disease prevention have a role in socioeconomic development and can also solve the village’s basic problems. This article reflects a great effort by medical students, it also serves as a model of community empowerment for health promotion. Students have an impact on community health as they help lead community initiatives towards health promotion throughout different programs, projects, and opportunities. 

 

The Prevalence of Dental Caries and Periodontal Diseases Among Children with Special Needs at Children with Special Needs Centers in Wad Madani City -Al Gazera State 2017

Hiba Allah elnima Elkhwad, M.Sc Public Health

This article covers the oral health of disabled children and advocates for the promotion of dental health care among children with special needs.

 

Affirm and Acknowledge: Social Innovation through Culturally Appopriate Research with Communities

Dr. Lorenza Fluks, Chief Researcher in the Human and Social Development Research Program at Human Sciences Research Council and Professor Heidi Van Rooyen, Executive Director in the Human and Social Development Research Program at the Human Sciences Research Council

Community-based participatory research approaches can be useful for stimulating social innovation. Such approaches involve community members at various phases of the research process and have several positive outcomes for the research and communities. This paper discusses the community mobilization approaches that are at the heart of research on HIV and related issues conducted in a rural community in KwaZulu-Natal, South Africa. We present affirmation and acknowledgement as an innovative and empowering strategy in community mobilization, as it affirms community members’ voices, dignity, and agency concerning issues that affect their lives.

 

The Solutions Studio: A Physician-Run Social Innovation Lab

Dr. Christine Gibson, MD FCFP MMedEd, University of Calgary Department of Family Medicine

Social innovation in the context of a community health center that serves marginalized populations can achieve agency and empowerment of community members. Through a social innovation lab process at The Solutions Studio, a physician of The Alex Community Health Centre in Canada has launched a series of such processes. Community members with specific lived experiences are invited to generate solutions to their own complex medical and psychosocial challenges.

 

The Power of the University and the Community Working Together

María de la Paz Grebe, Angel Centeno, Soledad Campos, Claudia Lascano, Facultad de Ciencias Biomédicas, Universidad Austral, Argentina

La Posta las Lila is the promotion project developed by a private university that for more than 10 years has become a primary care center where the community actively learns, develops, and improves their quality of life. The university has built a model of social commitment that arises from its institutional mission.

 

Strengthening Primary Health Care and Response to Tropical Disease Epidemics in Remote Areas: RockHealth Integrated Care Organization (RICO) EIRA Model

Hakeem Rabuka Kiboi and Dr. Tirus Wachira Ndegwa, Kenyatta University and RockHealth Integrated Care Organization

Infections have had a compelling act in human history with one of the predominance of infectious diseases being the unpredictable nature they tend towards and the potential for an explosive effect. According to experiences from pandemics such as the 2009 H1N1 influenza they presented a public health emergency, but most importantly exposed a couple of deficiencies and vulnerabilities in not only the global approach to the outbreak, but also the national and local public health capacities. It is for this reason that RockHealth Integrated Care Org. (RICO) Epidemiology-Informed Resource Allocation (EIRA) Model to Strengthening Primary Health Care and Response to Communicable Disease Epidemics was designed. Through the RICO EIRA model, epidemiological data provides insight and intelligence to improve the response and preparedness beyond planning. Such data, when available at local health facilities, helps in improving the primary health care system and strengthening an evidence-based response (Brownstein JS et al, 2).

 

The Influence of Physical Growth and Related Factors in Age of Attaining Menarche in Rural School Girls

Riya Mariam Jacob, final year MBBS student, MOSC Medical College; Dr. Miriam G. Fenn, Assistant Professor of Department of Gynaecology and Obstetrics, MOSC Medical College; and Dr. Anna Mathew, Professor of Department of Pharmacology, MOSC Medical College.

“The Influence of Physical Growth and Related Factors in Attaining Age of Menarche” was a cross-sectional study of 227 rural school going girls. It was found that there was prevalence of 37 percent of early onset of menarche with physical parameters like weight, waist circumference, and BMI having a significant impact on the early onset of menarche. Time spent using computers and watching television had an even more significant impact on girls attaining early onset of menarche due to a sedentary life style. This article’s purpose is to initiate efforts to change life style activities to promote a healthier life for girls entering adolescence.

 

Mobile Health Clinics: Providing Free Health Care and Support to Vulnerable Individuals and Families in Communities Neighboring a University 

Dede Atsu Kobla Latey, final year medical student, University of Ghana School of Medicine and Dentistry and Founder, MindIT Mental Health Service.

Challenges in reaching the most vulnerable of the community were identified at collaborative community forums held in Southeast Massachusetts, United States (U.S.) in 2014 with University of Massachusetts Dartmouth (UMass Dartmouth) leaders, social service agencies, and providers of healthcare services. The barriers to accessing care and health maintenance among this aggregate were associated with lack of transportation, transient status, and being uninsured or underinsured. UMass Dartmouth College of Nursing students and faculty created a Global Health Collaborative (GHC) university student club to identify the vulnerable footprint in Fall River and New Bedford, and neighborhoods adjacent to UMass Dartmouth. The mission was to create sustainable partnerships among the colleges in the university and the local and global community to improve the health of populations through engagement and entrepreneurial collaboration. The purpose of the collaborative was to develop global partnerships, increase global awareness of health-related issues, establish intercultural relationships, deliver culturally competent care to diverse populations, and respect the beliefs, values, cultures, religions, and practices of the populations the College collaborates with.

 

Responding to the Call of the Community; an Opportunity for Interprofessional Student Engagement?  

Fiona McDonald, Dip COT, MSc OT, Regional Placement Facilitator, Occupational Therapy Practice Education Team, School of Allied Health in the University of Limerick; Tanya McGarry, BSc OT, MSc OT, Regional Placement Facilitator, Occupational Therapy Practice Education Team, School of Allied Health, University of Limerick; Donal O’Leary, Access Campus Coordinator in Student Affairs, University of Limerick; and Dr. Nancy Salmon, BSc OT, MSc OT, PhD, Lecturer in Occupational Therapy in the School of Allied Health in the University of Limerick

Practice Education is a core component in the training of healthcare professionals, with fieldwork providing important opportunities to consolidate curriculum-based teaching through the integration of theory with practice. The School of Allied Health (SAH) in the University of Limerick (UL), has a long history of engagement in innovative community-based student placements; developed to expand placement capacity and offer a different learning opportunity to students. Research conducted by SAH demonstrates that the outcomes of these collaborative fieldwork placements had been predominantly positive, but host organizations also requested the establishment of a more sustainable model of university engagement with services and communities. Responding to this call, the Occupational Therapy Practice Education Team (OT PET) engaged in an extensive process of face-to-face collaboration to map community need and identify opportunities for sustainable engagement through on-going student fieldwork placements. On completion, it was identified that a funded community-based student-led clinic was an optimal means of meeting the needs of all stakeholders and maintaining a continual HEI presence in the local regeneration areas of Limerick City.

 

The Street Children Project

Faith Ubi Okoi

This article is centered on the plight of street children and how they can be salvaged from the street through the support of a foundation providing clothing, vocational training, and medical services to help them achieve a better quality of life and better tomorrow today.

 

Global Sharing-Local Caring: Promoting Best Practices in Local Communities Through International Dialogue Among Nurses

Helder Rocha Pereira PhD, RN, Coordinator Professor University of the Azores School of Health (UAc) Alberto C.M.; Duarte MS, RN, Adjunct Professor UAc School of Health; Maryellen Brisbois, PhD, RN, Assistant Professor UMass Dartmouth College of Nursing; Barbara Quintanova, RN Post-Graduate Student, UAc School of Health; Raquel Dutra, MS, RN, Post-Graduate Student, UAc School of Health; Rita Marques, MS, RN, Post-Graduate Student, UAc School of Health; Sara Raposa, MS, RN, Post-Graduate Student, UAc School of Health; and Sofia Cordeiro, RN Post-Graduate Student, UAc School of Health

The Global Sharing-Local Caring project emerged from the dynamics of specialized training in community nursing between the University of the Azores (UAc), Portugal, and the University of Massachusetts Dartmouth (UMass Dartmouth), United States (U.S.). Considering today’s globally minded health care environment and the increased importance of nurses' knowledge and skills to meaningfully interact with people from different cultures and ethnic backgrounds, this project represents a unique learning opportunity that allows improved health benefits at the local level and advancements in the provision of nursing care in both regions involved.

 

Comparing the Efficacy of Active and Passive Distraction for Reducing Pain and Fear During Intravenous Cannulation in Children: A Randomized Control Trial

Lisa Elizabeth Pius, Final year MBBS student; Linda Jacob, Final year MBBS student; Dr. Simi P. Varghese, Senior Resident, Department of Pediatrics; Dr. Reenu Raju, Assistant Professor, Department of Pediatrics; Dr. Anna Mathew, Professor, Head of the Department, Department of Pharmacology; Mr. John Micheal Raj, Bio-statistician; Elizabeth Susan Varghese, final year MBBS student; Gopika S.S., final year MBBS student; and Justy J. John, Final Year MBBS student

Invasive medical procedures induce pain and fear in children. Although distraction reduces pain, certain types of distraction may be more effective, so comparison becomes important. The objectives of the study were to assess the effectiveness of listening to music (passive) compared to interactive play with an electronic toy (active) for pain relief [rated on FACES Wong Baker scale (WBS)] and decreasing fear [scored on Children’s Fear Scale (CFS)] in children undergoing venous cannulation in the pediatric ward of MOSC MCH. The methods employed in the study included parallel group, single blinded, and a randomized controlled trial were undertaken on children between the ages of two to seven years admitted to the pediatric ward of MOSC MCH. This article covers the process of the study, the results and the conclusion that active distraction relieves pain more effectively, while both active and passive distractions reduce the associated fear equally. Therefore, these methods can be easily implemented to alleviate pain and fear during intravenous cannulation in children.

 

The Effect of Body Weight on Peak Expiratory Flow Rate (PEFR) in Adolescent School Children from a Rural Area in South India

Navia Isaac, Medical Student at MOSC Medical College, Kolenchery, Kerala, India; Sanoop Kumar Sherin Sabu, Medical Student at MOSC Medical College, Kolenchery, Kerala, India; Dr. M.C. Mathew, Professor of Developmental Pediatrics and Child Neurology at MOSC Medical College, Kolenchery, Kerala, India; Dr. Anna Mathew, Research Coordinator MOSC Medical College, Kolenchery, Kerala, India; and Dr. John Thomas, Professor in the Department of Developmental Pediatrics and Child Neurology at MOSC Medical College, Kolenchery, Kerala, India

This study was conducted to find out the effect of body weight on Peak Expiratory Flow Rate (PEFR) in adolescent school children from a rural area in South India. The study population was 347 school-going adolescent children in the age group of 13 to 15 years attending a private school in a rural area. Obesity is increasing worldwide at an alarming rate in both developed and developing countries. Childhood obesity can lead to increased airway resistance and respiratory muscle dysfunction as a result of excess fat deposition. One of the major health problems is respiratory disorder induced by obesity especially in childhood. Central obesity carries more health risks compared to total obesity. Waist-to-height ratio (WHtR) is a very good indicator of central obesity. Peak Expiratory Flow Rate (PEFR) is accepted worldwide as the objective indicator of ventilatory capacity and is helpful for the diagnosis of respiratory illness. Several studies have shown that PEFR is lower in individuals with obesity. We planned this study to screen for pulmonary function in school going children and to assess the increased body weight in these rural adolescent school children.

 

Barriguda Project: Incorporating Cultural Competence into Education of Health Professions

Carolina Araújo Damasio Santos; Lilian Lira Lisboa; Ana Karla Monteiro Santana de Oliveira Freitas; George Dantas de Azevedo; Reginaldo Antonio de Oliveira Freitas-Júnior; and Anita Garibaldi

The need to address issues of cultural and ethnic diversity in health professions' education has been suggested as a means to improve the quality of care and reduce disparities in health care. “Quilombolas” are the descendants of enslaved Africans that maintain their ancestors culture, livelihood, and religious traditions. They commonly live in rural areas with low availability of basic infrastructure and limited access to health care. The elective module for undergraduate health courses with the subject "Cultural Competence in Health Care for Quilombola Women" was implemented, being the first discipline in Brazil to address the study of cultural competence with Quilombo remnant populations. The program inserts the students in the process of a collective prenatal care service involving health professions students from Federal University of Rio Grande do Norte (UFRN), and a multidisciplinary team with anthropological and educational resources on history and culture of African-Brazilian communities. In 2017, the project was one of six winners of the competition "Innovation Laboratory on Social Participation in Integral Care to Women's Health" being a successful case in the area of vulnerability and equity in women's lives and health.

Issue 50