Community Care: Networking for Health

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By Christine Ennulat, with reporting from ChildFund Honduras
Posted on 4/7/2011

Lesly zips her little girl’s jacket and smiles. She’s just finished this month’s meeting with the ChildFund-trained volunteer health monitor in her rural Honduras community, among the poorest in the Americas. Once again, Lesly is gratified that 1-year-old Estefany’s health chart has another blue mark acknowledging satisfactory weight gain since the last check.

The good feeling comes from more than just the blue mark; Lesly knows that if Estefany is growing well, her health is solid. At every month’s meeting, the 22-year-old single mother learns more about how to keep it that way: how to balance her baby’s nutrition, what to watch for should illness arise, what vaccinations Estefany needs. The AIN-C (“Integrated Child Attention,” translated from Spanish) health monitor also provides her with vitamin, zinc and iron supplements.

 Midwife Dominga with husband, children and grandchildren, including daughter Lesly and granddaughter Estefany.

Midwife Dominga (fourth from left) with husband, children and grandchildren, including daughter Lesly and granddaughter Estefany, far right.

“A red mark on the card means she did not gain enough weight this month,” Lesly explains. “I am very happy when the monitor tells me Estefany is growing well, because she doesn’t get sick, and she is also very pretty.”

Together, this young, proud mother and her thriving baby are one of many examples of the benefits community-based health initiatives can bring to poor people living with nominal access to health care. Malnutrition does its worst damage in a child’s first thousand days, and preventing malnutrition in turn averts a host of other illnesses and disabilities. The combination of basic health education and preventive care that Lesly gets through this USAID-funded and ChildFund-run program will allow Estefany to reach her full potential.

Lesly lives with her parents and siblings, nieces, nephews and in-laws — nine in all — in a two-room adobe house with no electricity and, at the moment, no functioning latrine (it flooded). Her mother, Dominga, is the midwife for their small community, which is an hour’s bus ride away from the nearest health center, in Lepaterique.


Dominga, 59 and illiterate, became a midwife 20 years ago so she could deliver her children’s children — distance and bad roads made it nearly impossible to get help whenever a baby arrived. Soon, other women in her community began to ask her to attend their births. She delivered Estefany and her other three grandchildren.

“The good part of being a midwife is that families love me,” she says. “They ask for my help in their births, and I think they trust me, because many people in neighboring communities ask for my services.”

The not-so-good part is that sometimes families come calling for her in the middle of the night. Sometimes it is raining and she must walk a long way.

 Betty, the community health volunteer, with her husband, three sons and one daughter.

Betty, the community health volunteer, with her husband, three sons and one daughter.

In September 2010, Dominga had her first formal training as a midwife, through ChildFund’s Child Survival Project (also USAID-funded). Now she is more equipped for obstetrical emergencies and knowledgeable about the danger signs that indicate that she needs to refer a mother to the health center in Lepaterique.

“I am very happy with what I have learned,” she says. “Every weekend, I ask my grandson to read the handbook for me to remember what I learned and to always keep it in mind.”

It was Dominga who referred Lesly to the community-based health center for prenatal care and the subsequent AIN-C community health monitoring meetings.


Betty has volunteered as a monitora in her community for the last five years. Her husband took ChildFund’s health monitor training first, but when his farm duties kept him in the field and away from the monthly AIN-C meetings, he asked Betty to attend in his stead. The 35-year-old mother of four learned how to weigh children and to fill out growth and health charts.

When another opportunity for training arose, Betty took all the modules: growth monitoring, care for the sick child, care for pregnant women and newborns, information systems, feeding children under 2, feeding pregnant women.

“What I enjoy most is the home visits to the newborns,” she says. “One thing I don’t like to see is children losing weight because mothers don’t follow my recommendations.”

Lesly’s is one case where she needn’t worry.