In Guatemala, Shifts in Health Care Strand Communities

...When Pop Pop became a community health worker back in 1997, the Guatemalan government had just adopted a new regulatory framework – the Programa de Extension, or PEC — that allowed the Health Ministry to contract out health services to private not-for-profit organizations. This included NGOs, church-backed charities and international development agencies. Their primary goal was to lower the child and infant mortality rate by increasing the number of hospital deliveries, rates of immunization, and access to medication for common and easily treatable illnesses such as diarrhea.

At the time, Pop Pop was 26 years old, was newly married and had just had his first child. He says he simply wanted to help. “There were no nurses, no help at all in our community,” he says. Over the years, he took training courses from three NGOs so he could attend births and give injections. His certificates are framed on the wall of his home, which serves as a makeshift clinic. “I always try to get as much information as I can, to learn.” In 2012 he was one of 460 community health workers in Alta Verapaz, his department, or state, recruited to take part in an innovative new tele-health program. Managed by a local nonprofit, TulaSalud, and funded by a Canadian charity, the Tula Foundation, the program gave health workers smartphones with unlimited data and calling plans.

Downloaded on the phone was an open-source app, Kawok, that allowed the community health workers to create patient profiles and access educational videos and best-practice protocols. They had direct lines to a doctor who worked for TulaSalud, whom they could call any time of day or night in an emergency, and the numbers of auxiliary nurses at nearby health centers. The idea was to create a network of professionals, resources and emergency services that community health workers could reach at the touch of a button. “Anytime I could call and ask for help, and they gave it to me,” says Pop Pop. “It was a really useful tool.”...