6 September 2012

The community of Acaraymi is located 38 kilometers from the city of Hernandarias, with an indigenous population known as the Ava Guarani. At the center of the community is a family health unit staffed by Dr. Paola Aguero, Nurse-Midwife Leticia Alonso and Nurse Assistant Nelly Acosta.

One of the main health problems that Paola, Leticia and Nelly see in their daily work is diarrheal diseases caused by the community’s water, which is drawn from a source that is contaminated by agricultural toxins commonly used in soy bean plantations. The Acarymi population is also at high risk of malnutrition.

In Paraguay, local health councils serve as the major link between households and facilities. Recognizing the importance that these health councils play in getting the families of Acarymi the health care they need, MCHIP works closely with these councils to identify the priorities of the community and to mobilize resources to help bring about healthy changes.

As a first step, MCHIP coordinated with the Ministry of Health and the Hernandaerias Health Council to hold a forum on MNH issues, entitled Aty ñemonguetara sy ha mitakuera tesai porave hagua (a term in the local language of Guarani that means “meeting to talk about maternal and infant health”). Managers from the Family Health Units, known locally as the Unidad de Salud Familiar (USF), along with community representatives and health council members, came together at this forum to identify their concerns, establish priorities, and prepare an action plan. They concluded with the development of an action plan to be implemented with the assistance of a community-based support network.

Participants’ main concerns included the impact of diarrheal diseases (one of the main causes of child mortality) on women, newborns and children, due to the use of water exposed to agrotoxins. Thanks to this dialogue and action planning process, authorities from the Decima Region de Salud ("Tenth Health Region") have visited the area to conduct a feasibility study for the construction of water wells to provide healthy drinking water. In addition, USF managers moved forward with training on water purification.

Meanwhile, the Ministry of Health also recognized that the Acarymi population was at high risk of malnutrition and included this community in the PANI Program (Nutrition Subsidy Program). Beginning earlier this year, all children and pregnant women have begun receiving 4.4-pound bags of milk powder every month. The day that the unit received the first load of packets of milk, a happy text message was sent to the MCHIP Community Interventions Advisor celebrating these great strides in working toward a healthier community.

As a beneficiary of PANI, the USF now needs storage room for the supplies provided by the Ministry of Health. The Health Council is providing construction materials to expand the USF facilities to provide more storage space. In a follow-up activity, a team visited the area of Independiente, one of the most remote areas in Acarymi. They used the visit to build on the activities from the forum, delivering health care services for pregnant women, providing vaccinations, doing growth and development exams for children, and holding training on water purification techniques and preparation of milk powder for at-risk populations.

The participation of key stakeholders is critical to improving health conditions for women and their families. Maternal and child health forums (like that of Hernandarias) are helping to strengthen the role of health councils in improving the health of mothers and their families in both the Centro and Alto Paraná Regions of Paraguay.

Following the successful participation of 10 family health units and community representatives in the forum of Hernandarias, there are now six additional family health units and community representatives participating in similar MCHIP forums in the area around Minga Guazu. Building on the strengths of the communities, these forums will strengthen the role of local councils and promotes actions at each of these communities.


Maria Peña, MCHIP/Paraguay