Decreasing the incidence of Chagas disease, Chaco endemic region, Chuquisaca, Bolivia Phase II

The project wants to contribute to the reduction of vulnerability conditions and the incidence of Chagas Disease in the municipalities of San Pablo de Huacareta and Monteagudo; within the framework of the United Nations Sustainable Development Goals 3, 1 and 5.


CONTEXT

The intervention area of the prooject is limited to 28 communities in the municipalities of Monteagudo and Huacareta that are part of the Chaco region of the Department of Chuquisaca, with geographic, physiographic, environmental characteristics and common economic and productive potential, with the presence of Guaraní and peasant population; the first originating from the place and the second conformed by a migrant population from high areas and valley headlands of mainly Quechua and mestizo origin, which as a whole are identified as Chaco.The main productive vocation of the population in these municipalities is agriculture such as cattle, pig, traditional agricultural crops such as corn, peanuts, chili, citrus production and lately beekeeping; the region becoming the main supplier of these products for the urban consumer markets of the department and the southern region of Bolivia; potential and activities that are harmed by the gradual reduction in the level of productivity of human resources, affected by chagas; corresponding to strengthen the health system in the Chagas component to improve its capacity to resolve and strengthen community and inter-institutional organization for participatory health management.

Socio-political and health situation:

According to the evaluation of the Chagas Departmental Program, the indicators of vector infestation for the municipalities of Chaco, report for Villa Vaca Guzmán: 11.18%, Huacaya: 8.87%, Macharetí: 7.65%, Huacareta: 2.84% and Monteagudo: 1.70% being the latter the municipality certified for implementation of the diagnosis and treatment process.

On the other hand, the seroprevalence indicators in pregnant women for Chuquisaca reported for 2017, 24.5% and the fetal maternal transmission rate of 2.7% (3 out of 100 births are infested by the vertical route).The health system in the municipalities of Chaco has First-level services, still with many technical limitations, due to the low knowledge of health personnel to care for patients with Chagas disease, the limited availability of supplies and reagents for mass diagnosis, high implementation of treatment protocols and patient monitoring and the absence of specialties for cases with cardiological and gastrointestinal complications. On the other hand, it is necessary to reinforce the surveillance system with the permanent training of community PIV promoters and the IEC (Information, Education and Communication) strategy for the region.

The Dermatological Hospital in the city of Monteagudo has been identified as the reference center to enable it for the treatment of patients with Chagas (etiological and non-etiological) and the implementation of diagnostic and treatment services with a specialty in cardiology in cases of complications for the Chaco population.

PROJECT

General objective:

Contribute to reduce Chagas vulnerability and incidence in the municipalities of San Pablo de Huacareta and Monteagudo; within the framework of Goals 3, 1 and 5 of Sustainable Development.

Specific goal:

Strengthen municipal health systems, in components of prevention, control, diagnosis and treatment of Chagas, with a participatory and community management approach, under the precepts of the SAFCI Community and Intercultural Family Health policy and a successful model developed in the context of Chaco.

The implementation of the project will involve carrying out the following activities:

-Validation workshops on the pillars of the participatory model, aimed at the social structure of health, medical personnel, Red V Management and municipal authorities

- Municipal health tables, regional CAI and accompaniment of 2 Social Networks for inclusion of the model's strategies in sectoral and municipal health plans

- Implementation of the training plan for medical, nursing and laboratory personnel in diagnosis, treatment and monitoring of patients with Chagas disease, especially pregnant women, newborns and early treatment in children.

- Improvement of housing in communities at high risk of vector infestation and environmental and hygiene measures intra and peri domiciliary

- Protocol validation workshops and technical monitoring of its application, for early detection, initial treatment and referencing of special cases for respective treatment.

- Diagnosis, referral, treatment and monitoring of women of childbearing age at the Monteagudo Dermatological Hospital- Organization and training workshops on the roles and functions of 30 community health workers

- Implementation and massive dissemination of the IEC strategy for the prevention of Chagas disease, differentiated by social actorsThe expected results are the structuring and implementation of the participatory management model strategies in health services according to the precepts of the SAFCI policy and the strengthening of public health services in their capacities for prevention, early detection, diagnosis, treatment and monitoring of patients with Chagas.

BENEFICIARIES

Direct beneficiaries:

The direct beneficiaries are 5,155 inhabitants, of whom 2,397 are women, 2,758 are men and 1,550 are boys and girls under the age of 15.

Indirect beneficiaries:

Indirectly, there are 4,400 beneficiary families that constitute 17,500 people, of whom 8,869 are women and 2,513 are girls and boys from the communities surrounding the intervention área.