A New Way To Leverage Community Assets Sandy Hoar, GWU and

Community Monitoring:
A New Way To Leverage
Community Assets To Meet The
MDGs
Sandy Hoar, PGDip, MPAS, PA-C
Assistant Clinical Professor of Health
Sciences and of Global Health
hoar@gwu.edu
To meet MDGs need to:
•
Choose goal(s) to address
•
Choose a method or program to address the
goal
•
Pick a few specific indicators to monitor
•
Implement the program
•
Periodically monitor indicators & evaluate
effectiveness of program
To meet MDG need to:
•
Continue with & expand program
or
•
Revise program, choose new indicators, if
necessary, then implement & evaluate new
program
The Problem
•
It is difficulut to find resources, personnel &
materials, to implement a new program
•
It is very difficult to find people to help monitor
indicators
The Problem
Those who are implementing a program
•
often feel they are too busy 'doing' to monitor
•
may not be convinced of the importance of
monitoring indicators
•
may feel they 'know' how a program is going
without checking indicators
•
have a vested interest in the results of the
monitoring
A Solution
Leverage unused & underused community assets
Report of the successful use of elementary school
students to search & monitor for standing water
& mosquito larvae in rural Mexico
Objective
Develop a community-based early warning
system for dengue fever
Background
Recent reports of dengue fever in a rural region of
Mexico (Villa Mainero, Tamaulipas)
No official government presence for monitoring &
surveillance or health education in this
community.
Long-standing, twice a year surgery campaigns
with concurrent primary care, public health, &
school health programs.
Setting
•
Rural eastern Mexico
•
Population 584
•
Occupations—farming, animal husbandry,
merchants
•
Agriculture—corn, sorghum, beans,
sugarcane, vegetables, citrus, nuts
•
Sanitation—1/2 households with indoor
plumbing
Background-Dengue Fever
Dengue fever is a mosquito-borne viral disease.
It is debilitating, painful, & sometimes fatal.
No vaccine prevention nor specific treatment-just
supportive.
Mosquitoes require a small amount of water for 35 days as part of their life cycle.
Two decades ago mosquitoes were rarely seen in
this region.
Methods
The entire elementary school & PTA learned the life
cycle of mosquitoes, usual locations of standing
water, & methods to prevent it.
Year 1
5th & 6th graders participated in a regional needs assessment,
identifying trash & dengue fever as problems.
They studied beginning disease epidemiology, the risk of
disease in a population & the value of monitoring & surveillance.
The school was divided into 6 teams, each given a large plot of
land which was mapped & checked for trash & standing water.
Any standing water was searched for mosquito larvae.
4 of the teams simply monitored the standing water
2 of the teams tried to prevent standing water.
Open Drinking Water
Standing Water
Trash Campaign
Year 2
Students from all grades divided into 4 teams & given a
quadrant of the town.
The teams searched for trash & standing water, & if found,
mosquito larvae.
They photographed & completed a site info form,
used a field GPS unit, picked up trash, & explained to
residents the danger of mosqutio-borne disease & how to
interrupt the mosquito life cycle.
Garmin etrex GPS
unit
Observation forms:
lat/long, altitude,
location description,
presence of mosquito larvae, trash, standing water
One Site
Results
Students identified trash & dengue as current regional
problems, understood why trash promotes standing water,
delighted in educating the town adults, & took all the
photographs & GPS readings during non-school hours.
Year 1 the students drew & measured a plot of land.
Standing water was identified, especially in trash, &
insects, though not mosquito larvae, were found.
Year 2 the students identified multiple sites with trash,
standing water, & mosquito larvae.
Outcomes of Model
•
Quality of data was decent
•
28 sites with GPS & mosquito/ trash/ water
observations
•
Children as effective as adults at basic GPS &
public health data collection
•
Children able to advocate & bypass the usual
political protocols
•
Students' data galvanized regional political &
public health officials to institute prevention
efforts
Conclusions
Future campaigns will involve continuing
surveillance for mosquito larvae & establishing a
monitoring system for mosquito-borne disease—
dengue & malaria.
The children will continue to be central to
the program.
Conclusions
Developing countries have few resources for prevention
& surveilllance of mosquito-borne disease but children are
an often overlooked asset as 'public health agents'.
They
-have boundless energy for field work
-are fascinated by the science
-are pleased to serve their community in an important role
-soon will become the adults making decisions
-incorporate lessons into their daily activities, i.e.
preventing standing water, picking up trash, proper
handwashing, or the need for vaccinations.
Conclusions
Communities trying to establish monitoring of public health
indicators should consider working with students of all
ages to help expand effectiveness & participation.
How to Graph Data
Enter the data in an Excel spreadsheet
Each row = one site
Use standard values (ex: “yes” is always “yes”, and never “YES” “Yes” or “y”)
Summarize the data in a Pivot Table
In Excel 2007, Pivot Tables are accessed via “Insert”
Set up the pivot table so that…
Row labels = the column you wish to summarize
Values = the “count” of each attribute in the column
Note: add 2 columns to Row Values to summarize data that meets more than 1 condition
Add a column to the table, & calculate percentage (optional)
Use the Pivot Table results to Create a Graph (Chart)
In Excel 2007, Graphs are accessed via “Insert”
Dana Thomson, World Bank
Toolkit
GPS unit
Data collection form
Camera
Excel (or spreadsheet program)
Google Earth and/or ArcGIS (or other GIS)
Map of site (ex. street map, Google Earth image)
Dana Thomson, World Bank
How to Map in Google Earth
Enter the data in an Excel spreadsheet
Each row = one site
If multiple waypoints were collected per site, average the latitude & longitude
values
If you only have Google Earth, enter each site individually
Click “Add Placemark” pushpin icon and set preferences
You may estimate waypoint coordinates after the field work by holding the curser
over a location and copying the latitude/longitude/altitude coordinates displayed
at the bottom of the screen
If you have access to a GIS, add the spreadsheet data and export to a
.kml file (to display on Google Earth)
Dana Thomson, World Bank