HEALTHY HOMES PROJECT: Challenges

The challenges to properly managing the Healthy Homes project were numerous, but clearly not insurmountable.  The professional isolation was the most difficult aspect of the project for me because the responsibility to drive interest and participation in the project among community members and health workers fell completely on my shoulders.  This was not an easy task, given that the profession of public health does not exist in Peru and prevention work was an entirely new concept for my Peruvian colleagues.  I introduced them to the idea of setting goals and objectives, and measuring progress toward them.  I taught them about proper data collection and analyzing the results to identify trends and determinants of health.  I showed them how to develop programmatic interventions, organize educational sessions and evaluate the programs’ effectiveness.  Not easy tasks, given that the health center staff were often overwhelmed with patients and last-minute urgent requests from the regional health department and from the local municipal government.  Meetings were often cancelled and nothing happened until very last minute, but the project was completed on time, under budget, and with outstanding results.

 There were additional unforeseen issues to tackle.  One involved the unfortunate passing of my main contact at the Municipality only a few short months after my arrival.  Losing my biggest cheerleader at the Municipality created a vacuum of support for my funding request, which was denied.  I was provided with material support for the educational sessions, but no financial support to purchase the necessary materials to construct the improved cook stoves.  I scrambled to quickly find funding, as the delay in moving forward with the project could have pushed it past the deadline.  Fortunately, my grant application for small project assistance funds from USAID was approved and the project continued with only a short delay.

Another challenge arose when the Municipality launched an initiative very similar to my Healthy Homes project which competed for funding and resources with my project.  My project utilized a group of volunteer health promoters to organize educational sessions and conduct house visits.  The municipal initiative also utilized the health promoters to organize educational sessions, some of which covered the same topics as mine.  The overlap stretched thin the health promoters’ ability to properly organize and attend all sessions, and I had problems with health promoters not following through and not showing up.  In addition, there was confusion among the participants of my project, some of which were obligated to attend the other educational sessions, and they didn’t understand why it was necessary to attend two sessions.  I worked very closely with the health promoters to avoid overlap and confusion, and I notified participants of the change.

After completing the four educational sessions, we reviewed the attendance records of the educational sessions and discovered that only about one-third of participants had completed the requirements of the program.  After discussing with my colleagues, we decided to repeat the four sessions a second time and offer a second chance for participants to complete the program.  After repeating the sessions, we reached 83% attendance.

Please continue reading to find out the results and discover the exciting conclusion of the Healthy Homes Project.