The work can be challenging, but it’s highly rewarding - The role of community health agents in Peru

Background: Peru has among the highest prevalence of iron-deficiency anemia in young children and breastfeeding mothers in Latin America, a condition that is both a direct and indirect contributing factor for death and disability. “Taking Care of your First Thousand Days” project implemented by Catholic Medical Mission Board (CMMB) Peru partners with women community health agents (CHAs) to promote the health of mothers, pregnant women, and their newborn children centered on the prevention and treatment of anemia and chronic malnutrition. The organization has seen substantial decreases in anemia in the peri-urban areas they serve. This project is the result of a collaborative partnership between St. Catherine University investigators and CMMB, whose goal is to spread awareness about how best to deliver care in peri-urban communities in Peru where healthcare access is limited. The purpose of this project is to document the robustness of the CHA work with CMMB to be used as a successful CHA model of healthcare.Methods: In July, 2019, we conducted field research to gather information on CMMBs CHA model. Through direct semi-structured interviews with two CMMB staff members, five CHAs, along with observational notes from CHA shadows, we documented five component of their CHA program: recruitment, training, retention, incentivizing, and support. Findings: CHAs are women recruited from within the communities in which they serve, the majority of whom were once recipients of CMMB services and identified as potential leaders. All CHAs attend bi-monthly day-long workshops which vary based on level of experience. CHA with less than one year of experience accompany veteran CHAs on health counseling visits before facilitating their own. CHAs volunteer for at least one year and are provided a small stipend for their work. However, most indicate their motivation to work is their contribution to their community. The Ministry of Health has awarded a number of CMMBs CHAs certificates recognizing their training and work and indication of their success and commitment. Interpretation: CMMBs anemia program is highly successful in reducing anemia. CHA healthcare delivery is not unique to this organization. However, the robustness of their CHA model may directly impact their success. Evidence of CMMB’s small-scale CHA program can foster the collaboration and development of a national-scale CHA model in Peru