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Promotoras de Salud Comunitarias - 1,100 and Counting

Sunday, July 24th, 2011


FEMAP's Promotora program, a women's volunteer movement operates at the grassroots level to teach about topics such as reproductive health issues and self-esteem, while providing awareness and access to health care throughout Juarez colonias.

The program started in 1972 with a handful of women teaching their neighbors about the importance of family planning and prenatal care.

Today, more than 1,100 women volunteer to continue educating about family planning and prenatal care, but also about diabetes, nutrition, and obesity. Promotoras also coordinate health fairs at homes, community centers and schools to provide cervical and breast cancer detections, diabetes and cholesterol testing and nutrition assessment.
"The secret of our success comes from having a genuine interest in the individuals that we serve," explains Graciela De Leon, a 27 year veteran and director of the FEMAP/SADEC Promotora program, who with the help of one social worker, oversees the 1,100 volunteers that reach out to the individuals in their immediate neighborhoods on a daily basis.

The individual: it's that focus on the individual that has changed the numbers dramatically. According to SADECs (Salud y Desarollo Comunitario de Cd. Juarez/Health and Community Development of Cd. Juarez), in the 1970s, 39% of women within the population FEMAP/SADEC work with received prenatal care. Today, 85% of women receive prenatal care. In 1981, infant mortality rate was 90 per 1,000 live births. In 2007, it's 20 per 1,000 live births while that number is still high, it's a significant difference in lives saved.

With over 30 years in existence FEMAP/SADEC's use of citizen volunteers was one of the first in North America and looks especially at reproductive issues and stands as one of the most successful Promotra programs in the world. As the middle person to formal healthcare, Promotoras such as Reyna Palacios, 43, and Marta Angelica Fernandez Romo, 34, organize educational health outreach programs that include reproductive health, cervical and breast cancer detection, nutrition, vaccine and oral re-hydration campaigns, high risk disease detection and educational sessions in their neighborhoods. In 2010, with the help of promotoras, nursing students and employees 251,398 educational health outreach programs were conducted.

To date, some 80 cervical cancer detections have been conducted in Palacios' own bedroom at her urging. In her case, the exams happen in her home. She tells of a woman in her neighborhood that resisted her offers of getting the exam for years until she heard about her neighbor who came back with a larger health problem and had to undergo surgery. Seeing her neighbor receive treatment is all it took for this woman to attend the next round of examinations at Palacios' home.

Its supply and demand, once Palacios has signed up 10 women who are interested in an exam, Palacios notifies her social worker who then makes arrangements with the doctor and nurses from Hospital de la Familia, and a grass roots health fair is born, "We have a good time convened in my patio waiting for our turn asking the nurses questions about cancer, nutrition, menopause, " said Palacios. Once the women in the neighborhood have undergone examination, the data is collected and goes to the lab; the results are then sealed and delivered for Palacios to return to the women in her neighborhood. The ones that need further investigation are flagged for Palacios to advice they seek medical treatment for further examination. Exams cost $3 but are currently underwritten through a generous grant from Johnson & Johnson and Our Father's Foundation.

The Promotoras have served as a catalyst for change in their community, "They've become empowered. When you arm these women with knowledge, you empower them to make assertive decisions that generate change in themselves, their families and in turn on society," says De Leon.