Social integration and health behavioral change in San Luis, Honduras.

This study explores the effects of social integration on behavioral change in the course of an intensive, community-based public health intervention. The intervention trained volunteers and mobilized local organizations to promote 16 key family health practices in rural San Luis, Honduras, during 2004 to 2006. A mixed methods approach is used. Standard household sample surveys were performed in 22 villages before and after the intervention. Eight villages were then resurveyed. A household survey, focus groups, and key informant interviews measured health behaviors and several social structural and psychosocial variables. The villages were then ranked on their mean behavioral and social integration scores. The quantitative and qualitative rankings were in close agreement (Kendall's coefficient of concordance = .707, p < .001). Behaviors changed most markedly in the villages where respondents participated in local organizations, observed that others performed those behaviors, and depended on their neighbors for support. The results show that social integration conditions health behavioral change. Health interventions can be made more effective by analyzing these features a priori.

Guide for participatory local assessment. Community component of the IMCI strategy

[Presentation and Rationale]. This document is intended for local personnel in the health services, the Red Cross, and other social players involved in the health area, to support them in carrying out an assessment of their local situation and its health problems, especially those related to children under the age of 5. It also seeks to understand why the situation has occurred, so that a plan of work can finally be developed that will be effective in tackling the problem. The World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) promote the world initiative of Integrated Management of Childhood Illness (IMCI), a strategy that has been validated and accepted as one of the primary interventions for improving the health situation of children in the Americas. This strategy is implemented through three operational components: ➤ Improving the skills of health workers by providing them with the knowledge and practices that will enable them to treat children better and on a timely basis; ➤ Strengthening the organization of health services so that they can respond to child health problems effectively through networks. ➤ Incorporate families and communities into the effort to improve family and community practices in protecting and caring for children.