Abstracts: ISEE 21st Annual Conference, Dublin, Ireland, August 25–29, 2009: Oral Presentations
In developing nations, the impact of disease-oriented health services on community health is relatively small compared to structural interventions designed to improve living conditions, including nutrition, sanitation, housing, education, and access to health care. La Pita is an isolated coffee-growing cooperative of 143 inhabitants and 150 day-laborers in Matagalpa, Nicaragua. A community health assessment was conducted to evaluate community needs through community-based participatory research, and to design interventions that integrate engineering and public health components.
The cross-sectional survey was conducted by the Engineers without Borders-University of Hawaii chapter (EWB-UH), using standardized demographic household surveys, key informant interviews, and focus-group meetings. Data was collected on health outcomes and socio-demographic population characteristics, including nutrition, sanitation, housing, education, and access to health care. Data analysis was performed using SAS 9.1.
The response rate for the household surveys was 95.5%. Chronic respiratory symptoms due to poor ventilation and indoor air quality; diarrhea resulting from poor sanitation and personal hygiene; severe injuries; lack of health education; and limited access to health services were identified as the most important community concerns. The prevalence of chronic difficulty breathing was 21, dry cough was 14.9, and persistent wheezing was 6.4 per 100 persons in the last year. Evident socioeconomic disparities and barriers to community participation were identified among households with the least active participation.
Interventions were proposed to target the need for increased access to health services and improved indoor air quality. The following intervention programs were developed for implementation in 2009/2010: a “train the trainer” capacity building program of first aid and general health education; ventilation and asthma prevention program; and improved access to health care services through building new bridges. Standardized program evaluation procedures will be used to evaluate the longitudinal effect of the proposed interventions.