The health benefits of social mobilization: experiences with community-based Integrated Management of Childhood Iliness in Chao, Peru and San Luis, Honduras

ABSTRACT

This article reviews the implementation of the community component of the Integrated Management of Childhood Illness (IMCI) strategy in Chao, Peru (2001 to 2004) and San Luis, Honduras (2003 to 2005). An evaluation was conducted in 2005 and included a project documentation review, key informant interviews, and a household level baseline and follow up survey of the WHO UNICEF key family practices in each intervention site. The promotion of the key family practices in Chao and San Lu is demonstrated measurable success. In comparison with the initial survey in 2002, the percentage of participant mothers (N equal 78) in Chao in 2004 who knew that they should breastfeed exclusively for at least six months increased from 33 percent to 94 percent; the presentation of complete vaccination records for one year old children increased by 19 percent; the recognition of danger signs for pneumonia increased 18 percent and for diarrhea by 8 percent; and the percentage of mothers who received four or more prenatal check-ups increased by 25 percent. A dramatic reduction in malaria cases was also attributed to the intervention in Chao. In San Luis, a quasi experimental, random household sample (N equal 300) showed that the incidence of diarrheal disease among children under five years old declined by 18 percent between survey rounds (from 44 percent in August 2004 to 26 percent in December 2005). Social mobilization has promoted inter sector consensus building around community health issues, especially those related to maternal and child health. The promotion of the participation of representatives from various organizations via the community IMCI social actor methodology has led to increased civic cooperation. Positive changes in health behaviors have been documented through an increase in preventive health practices, greater demand for primary health care services, and concrete community actions to improve public health. (AU)