Formación de promotores para la prevención y control de la tuberculosis en la región fronteriza de Chiapas, México
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Fecha
2014
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Población y Salud en Mesoamérica, Volumen 11, número 2 (enero-junio 2014)
Páginas
1-16
Resumen
Objetivo: Diseñar y evaluar un programa de formación de promotores, con componentes educativos y participativos, que permitan desarrollar procesos locales hacia un mayor control de la tuberculosis en comunidades de alta incidencia de tuberculosis en Chiapas, México. Métodos: Se elaboró un programa basado en un diagnóstico epidemiológico y sociocultural de la tuberculosis en la región; se diseñaron y aplicaron cursos-talleres participativos para una mejor comprensión de la enfermedad y capacitación para la formación de promotores en el diagnóstico y tratamiento de la tuberculosis, con aportes de la biomedicina y de las teorías de participación comunitaria y constructivista. Resultados: Se enfatiza que la participación comunitaria fue esencial en la reflexión y definición del problema de la tuberculosis, así como los posibles caminos a seguir. Se demostró que fue una forma de generar un alto compromiso en la obtención de resultados en el diagnóstico y tratamiento de la enfermedad y en la eficacia de la comunicación con la población. Las localidades incluidas fueron Verapaz, Tres Maravillas y Nuevo México del municipio de Frontera Comalapa, Chiapas. Encontramos que la participación de la población en programas de salud, en especial sobre la tuberculosis, había sido de forma pasiva, pues había tomado el papel de receptora solamente en pláticas informativas, sin confirmar aprendizajes. Estas localidades se ubicaban en los primeros lugares de incidencia por tuberculosis a nivel nacional. El curso fue planificado para capacitar a 15 personas como promotores: 10 de Nuevo México, 4 de Verapaz y uno de Tres Maravillas, quienes trabajaron en beneficio de su comunidad y fueron bien recibidas por los pacientes y familiares. Conclusión: La participación comunitaria para reflexionar y definir el problema de la tuberculosis, así como los posibles caminos a seguir, demostró generar un alto compromiso en la obtención de resultados en el diagnóstico y tratamiento de la enfermedad y en la eficacia de la comunicación con la población. Se evaluaron los aprendizajes, la planificación y resultados del programa y un primer monitoreo en la población, a través de la estructura de contexto insumos-procesos-productos y resultados. Se demostró la eficiencia de la capacitación para promotores y su utilidad en la supervisión del tratamiento de la tuberculosis a nivel comunitario.
Objective: Design and evaluate a community health worker training program with educational and participative elements, for better tuberculosis control in communities with a high incidence of tuberculosis in Chiapas, Mexico. Methods: The training of communit y health workers in the diagnosis and treatment of tuberculosis was a proposal that came out of a sociocultural needs assessment that used participative workshops to generate a better understanding of the disease, with biomedical and community -based underp innings. Results: Community participation was essential to reflection and understanding the problem of tuberculosis in the community context as well as possible solutions. It has proven to be an effective form of communication with the community and way of gaining investment in obtaining results in the diagnosis and treatment of the disease. The project was implemented in Verapaz, Tres Maravillas and Nuevo México of Frontera Comalapa Municipality, Chiapas. We found that previous community “participation” in health programs and particularly tuberculosis prevention and control programs had been as passive recipients of informative talks without confirmation of learning. These localitieshave the highest incidences of tuberculosis in Mexico. The course trained 15 community health workers: 10 from Nuevo Mexico, 4 from Verapaz, and one from TresMaravillas, who went on to serve their respective community and were well-received by patients and family members. Conclusion: Community participation in order to reflect on and define the problem of tuberculosis as well as possible next steps, proved to be effective in yielding diagnostic and treatment results and improve communication with the community. Impact on knowledge, program planning, population monitoring, and results were evaluated through an output-process-outcomes framework. The training proved efficient and useful in the supervision of tuberculosis treatment at the community level .
Objective: Design and evaluate a community health worker training program with educational and participative elements, for better tuberculosis control in communities with a high incidence of tuberculosis in Chiapas, Mexico. Methods: The training of communit y health workers in the diagnosis and treatment of tuberculosis was a proposal that came out of a sociocultural needs assessment that used participative workshops to generate a better understanding of the disease, with biomedical and community -based underp innings. Results: Community participation was essential to reflection and understanding the problem of tuberculosis in the community context as well as possible solutions. It has proven to be an effective form of communication with the community and way of gaining investment in obtaining results in the diagnosis and treatment of the disease. The project was implemented in Verapaz, Tres Maravillas and Nuevo México of Frontera Comalapa Municipality, Chiapas. We found that previous community “participation” in health programs and particularly tuberculosis prevention and control programs had been as passive recipients of informative talks without confirmation of learning. These localitieshave the highest incidences of tuberculosis in Mexico. The course trained 15 community health workers: 10 from Nuevo Mexico, 4 from Verapaz, and one from TresMaravillas, who went on to serve their respective community and were well-received by patients and family members. Conclusion: Community participation in order to reflect on and define the problem of tuberculosis as well as possible next steps, proved to be effective in yielding diagnostic and treatment results and improve communication with the community. Impact on knowledge, program planning, population monitoring, and results were evaluated through an output-process-outcomes framework. The training proved efficient and useful in the supervision of tuberculosis treatment at the community level .
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TUBERCULOSIS, ENFERMEDADES CONTAGIOSAS, MEXICO