Department of Public Health, St. Catherine University, 2004 Randolph Ave, St. Paul, MN, 55104, USA.
Catholic Medical Mission Board, Lima, Peru.
J Community Health. 2022 Oct;47(5):806-813. doi: 10.1007/s10900-022-01107-2. Epub 2022 Jun 24.
Community health agents (CHAs) play a critical role in primary healthcare delivery and health promotion in low-resource settings. Though there is substantial evidence of the benefits of CHAs in achieving targeted community health outcomes, there is limited research into the impact of empowerment experienced by CHAs themselves. This study examined how working as a CHA impacts the lives and self-perceptions of women in Peru volunteering with Catholic Medical Mission Board's (CMMB) markedly successful robust CHA model. We conducted six focus group discussions (FGDs) of 53 CHAs who implement CMMB programming in Trujillo and Huancayo, Peru. The FGDs were designed to explore themes related to empowerment, changes in women's lives, and perceptions of themselves. We identified four major themes related to women's empowerment: achievements, agency, meaningfulness, and resources. The most common empowerment theme was achievements, expressed through subthemes of changes in family behavior, self worth, education, health and nutrition, and rights and politics. The second most common empowerment theme was agency, with subthemes related to increases in using their voice, confidence, decision making, and participation. CHAs also reported experiencing empowerment through enhanced meaningfulness. CMMB's CHA model is an example of how well-structured community programs can facilitate women's empowerment. Providing meaningful community leadership opportunities can have far-reaching effects on women's perceptions of themselves as valuable, capable, and empowered leaders. This work deepens our understanding of how to practically improve community health through empowering women to catalyze gender equality in communities with disproportionate barriers and limited opportunities burdening them.
社区卫生工作者(CHAs)在资源匮乏环境下的初级卫生保健服务和健康促进中发挥着关键作用。尽管有大量证据表明 CHAs 在实现社区卫生目标方面的益处,但对 CHAs 自身经历的赋权影响的研究有限。本研究考察了作为 CHA 对秘鲁志愿参与天主教医疗传教会(CMMB)明显成功的强大 CHA 模式的妇女生活和自我认知的影响。我们对在秘鲁特鲁希略和万卡约实施 CMMB 项目的 53 名 CHA 进行了六次焦点小组讨论(FGD)。FGD 的目的是探讨与赋权、妇女生活变化和自我认知相关的主题。我们确定了与妇女赋权相关的四个主要主题:成就、能动性、意义和资源。最常见的赋权主题是成就,通过家庭行为、自我价值、教育、健康和营养以及权利和政治的变化等子主题来表达。第二个最常见的赋权主题是能动性,与使用声音、自信、决策和参与的增加有关。CHAs 还报告说,通过增强意义感体验到赋权。CMMB 的 CHA 模式是一个很好的例子,说明结构良好的社区计划如何促进妇女赋权。提供有意义的社区领导机会可以对妇女对自己作为有价值、有能力和赋权领导者的看法产生深远影响。这项工作加深了我们对如何通过赋权妇女来促进社区中不成比例的障碍和有限机会使她们负担过重的性别平等的理解,从而实际改善社区健康。