Mano a Mano: Improving Health in Impoverished Bolivian Communities Through Community-Based Participatory Research
Mano a Mano International Partners, Mendota Heights, NN 55118, USA. Families Systems & Health
(Impact Factor: 1.13).
12/2011; 29(4):303-13. DOI: 10.1037/a0026174
Mano a Mano (Spanish translation: "Hand to Hand") is a nonprofit organization that is working in partnership with underserved Bolivian communities to cocreate medical infrastructures and to improve health. Using community-based participatory research (CBPR) methods, Mano a Mano engages local government and community leaders, health care providers, educators, and ordinary citizens in a manner that taps local strengths and resources to allow all participants to work together to realize this mission. After describing Bolivia's call for improved access to high quality care in its poor and underserved rural areas, we outline the Mano a Mano's CBPR approach and sequence to answer this call, the culmination of its efforts to date (including the establishment of 119 health care facilities), lessons learned, and next steps in the formal evaluation and extension of this collaborative work.
Available from: ncbi.nlm.nih.gov
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An assessment of self-efficacy and social capital may have the potential to detect an effect of dynamic, complex and comprehensive collective actions in community-based health promotion. In 2003, a healthy village project was launched in Santa Cruz, Bolivia with technical assistance from the Japan International Cooperation Agency (JICA). The originally developed FORSA (Fortalecimiento de Redes de Salud) model accounted for participatory processes in which people could improve their health and well-being through individual behavioral changes and family/community-driven activities. This study aimed to examine the extent of self-efficacy and social capital obtained via project activities by a cross-sectional analysis.
We randomly selected 340 subjects from the healthy village project site and 113 subjects from a control area. Both groups were interviewed using the same structured questionnaire. Self-efficacy was assessed with a General Self-Efficacy Scale (GSES), while social capital was measured as the frequency of formal group participation in community meetings during the past three months, perceived social solidarity, and general trust.
The study results showed that the participants in the project site had higher self-efficacy and social capital compared to those in the control site. The number of times a subject participated in the health committee activities was positively associated with the self-efficacy scale. Regarding social capital, females and lower-educated people were more likely to have had more frequent participation in formal groups; males and higher-educated participants showed less formal group participation, but more generosity to contribute money for the community. The main perceived benefit of participation in formal group activities varied among individuals.
The findings suggest that people in the healthy village project site have higher self-efficacy, especially those with active participation in the health committee activities. To recruit more participants in future healthy village projects, we should consider the gender and level of education, and match the perceived benefits of participants accordingly.
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ABSTRACT: The STARTTerS Early Childhood Programme at the NSW Service for the Treatment and Rehabilitation of Torture and Trauma Survivors (STARTTS) has been developed in response to the complex refugee experiences of very young children, their families and communities. This biopsychosocial and systemic model is informed by neuroscience, attachment theory and current knowledge of the nature and impact of refugee-specific trauma on very young children and their families. It addresses the complex interactions between, social, cultural and political factors within the trauma and recovery environments, as they influence the clients’ presentations and the choice of interventions with families in cultural transition (FICT).
This paper provides a background to the STARTTerS programme, and reports on the results of a Community Based Participatory Research (CBPR) project with the Karen and Mandaean refugee communities. It explores perceptions and cultural views of signs and symptoms related to early childhood trauma. It also explores help seeking preferences in relation to the recovery, settlement and health needs of families with young children. This research has led to ongoing collaborative and consultative processes with those communities, resulting in the development of services and referral systems, which will build a comprehensive and culturally appropriate early childhood programme.
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