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Home > Media Center > News > UCOS Program in Honduras Allows for Better, Community-Based Health Care

UCOS Program in Honduras Allows for Better, Community-Based Health Care


Mother and son, ChildFund Honduras

As the U.S. health care system undergoes its own reform, ChildFund knows that the children and families in the countries where we work are still in need of better, proactive health care.


In many of our program areas, children walk miles for fresh, clean water. In others, a family’s only hope for a doctor and medical care is found in a distant town.

In Honduras, the 12 municipalities of the Francisco Morazan are among the poorest communities in one the poorest countries of the Americas. The health care system currently in place provides inadequate protection for the population against the financial consequences of becoming ill.

Women alone spend almost 6 percent of their annual income for safe delivery of a healthy baby.

“Poor health outcomes are increasingly concentrated geographically among poor and indigenous populations,” says Alfonso Rosales, the Americas Regional Health Advisor for ChildFund International.

“Less public investment translates to higher private investment. High out-of-pocket expenses for those living in poverty, means lower health coverage and, therefore, a worse population health status for the country,” Rosales notes.

The solution: ChildFund has implemented community health units called UCOS (Unidades Comunitarias de Salud), which support a community-based maternal, neonatal and child health initiative for improved health care access, equity and quality in a cost-effective manner.

Currently, ChildFund Honduras supports 25 UCOS, with 230 community volunteers trained in the integrated management of childhood illnesses. Another 162 community volunteers function on community health committees, which support the management of each institution, having been trained in basic managerial and administrative skills.

These 25 UCOS provide services to a growing population of 20,573 people across 70 communities. In a period of just six months, these units provided health care services to 261 children age 5 years and younger.

“Out-of pocket expenses for people with access to health services at UCOS in 2005 were 32 times lower than the average out-of-pocket expenses among the population living in Santa Barbara, Honduras,” says Rosales.

On average, where a person would have to pay 519 Lempiras (L) ($27.43) out of pocket for hospital care or 201 L ($10.75) at a rural health center, at UCOS, the average out-of-pocket expense would be only 17 L, or $0.89 in U.S. dollars.

“Utilizing community members as health extenders is not original,” says David Shanklin, senior health specialist for ChildFund International, “but strengthening community systems in the context of decentralization is a logical and potentially powerful means to improve the health of large populations.”