Experiencia fonoaudiológica con niños y niñas para la promoción de derechos: análisis desde el enfoque comunitario / Speech-language therapy experience with children for the promotion of rights: analysis from a community-based approach

El artículo analiza, desde los planteamientos del enfoque comunitario, una experiencia fonoaudiológica para la promoción de derechos de niños y niñas, efectuada en una organización social, con participación de un grupo de estudiantes de la carrera de Fonoaudiología de la Universidad de Chile en el año 2013. En los abordajes comunitarios, la comunidad construye conocimientos y realiza acciones para lograr el fortalecimiento de sus relaciones, bienestar social, justicia, autonomía y emancipación. El análisis de la experiencia se realiza a partir de una selección de las bitácoras de campo del equipo de estudiantes participantes, en base a los principios y dimensiones del paradigma de la construcción y transformación crítica de Maritza Montero (2004). Los resultados se dividen en tres momentos (inicio, transición y reconfiguración del trabajo), los cuales dan cuenta del grado de complejidad del proceso y los alcances obtenidos en base a las dimensiones: ontológica, epistemológica, metodológica, ética y política del enfoque comunitario. La discusión enfatiza la importancia de la reflexión crítica sobre los fundamentos y las prácticas de la Fonoaudiología en el abordaje de la comunicación y el desarrollo humano, para aportar a la justicia social desde el enfoque comunitario.

This paper analyzes, from a community-based approach, a speech, language and hearing sciences therapy experience for the promotion of children's rights, carried out in a social organization, with the participation of a group of speech, language and hearing sciences therapy undergraduate students at the Universidad de Chile in 2013. In community approaches, all community members build knowledge and take actions to build stronger social relationships and welfare, justice, autonomy and emancipation. The analysis of this experience was conducted by selecting sections from the fieldwork diaries of the team of participating students, based on the principles and dimensions of the paradigm of construction and critical transformation of Maritza Montero (2004). The results were divided into three moments (beginning, transition and reset of the work), which account for the level of complexity of the process and the goals achieved basedon the ontological, epistemological, methodological, ethical and political dimensions of the community-based approach. The discussion emphasizes the importance of critical reflection on the foundations and practices of speech, language and hearing sciences therapy in the approach to communication and human development, to contribute to social justice from a community perspective.

Community-based approaches for malaria case management in remote communities in the Brazilian Amazon

Abstract INTRODUCTION Malaria case management is a pivotal intervention in malaria elimination. However, many remote areas in Brazil still lack access to basic health services. This study describes a community-based approach (CBA) for malaria case management in the large remote area of the Jaú National Park (JNP), Amazonas, Brazil. METHODS In 2001, a general health CBA was initiated with a motor group (MG); a participative community health diagnosis (PCHD) was subsequently implemented between 2001 and 2005. In 2006, a CBA for malaria case management started with an expanded MG including all sectors with a stake in malaria control, from the local residents to the federal government. In 2008, community microscopists were selected and trained to diagnose hemoparasites. A full malaria strategy was implemented in 2009 with subsequent quality control follow-up. RESULTS Two educational materials were co-created with local communities. The MG identified malaria as a major health problem and the malaria MG planned the control activities. Ten communities selected a resident to become malaria microscopists, and ten solar-operated health centers were built. The number of slide readings increased from 923 in 2006 to 1,900 in 2009, while malaria infections decreased from 354 cases in 2005 to 20 cases in 2015. The excess time (≥ 48 hours) between first symptoms and diagnosis/treatment decreased from 68.9% of cases in 2005 to 14.3% in 2010. CONCLUSIONS While many factors were likely involved in the reduction of malaria transmission in the JNP, the CBA played an important role in the sustained success of the initiative.

Development-assistance Strategies for Stroke in Low- and Middle-income Countries

While communicable diseases still pose a serious health threat in developing countries, previously neglected health issues caused by non-communicable diseases such as stroke are rapidly becoming a major burden to these countries. In this review we will discuss the features and current status of stroke in low- and middle-income countries (LMICs). Overall the global burden of hemorrhagic stroke is larger than ischemic stroke, with a disproportionately greater burden, measured in incidence and disability-adjusted life-years, regionally localized in LMICs. Patients in poorer countries suffer due to insufficient primary care needed to control risk factors such as hypertension, and inadequate emergency care systems through which sudden events should be managed. In light of these situations, we emphasize two strategic points for development assistance. First, assistance should be provided for bolstering, integrating, and coordinating both the primary health and emergency care systems, in order to prevent stroke and strengthen stroke management, respectively. Second, the assistance needs to focus on programs at the community level, to reduce life-style risks of stroke in a more sustainable manner, and to improve stroke outcomes more effectively.

Community-based approach as an innovation in mental health care in India

Mental health issues and its respective domains have been at back burner ever since independence of India. The national policy on mental health was focused on states effort. In the last decade the work done by voluntary sector and NGOs has done significant work across the country. Community care program is the innovative approach that has helped the different stake holders in dealing with mental health and mental illness. The article highlights the stages of development and the major shift in approach in the last few years. The main idea is to develop a view point on community’s participation in the field of psychiatric work.