An article in the November 30, 2003, New York Times tells the story of training and using Haitian residents living in remote villages to provide HIV/AIDS health care for those unable to receive the services. The program, identified as Spartan, began because program funding had been drastically cut. Yet the health needs of both newly diagnosed HIV/AIDS patients, as well as those already diagnosed, continued to increase. Therefore program officials from Boston, MA decided to train area residents to undertake a number of patient health care needs which included administration of medication, lab work and follow-up visits. All patient contacts were made in homes because neither clinics nor clinic staff were available in the areas. Tracking the work of resident home visitors revealed that the patients’ health status improved and those recently diagnosed were living better and remaining healthier.
Similar health promoting activities undertaken by area residents to their communities are currently being developed and promoted by the Texas Department of Health (TDH) - Office of Public Health Practices. Based on health promotion models such as the one used in Haiti, or in India and countries in Africa, the Promotor(a) or Community Health Worker (CHW) Training and Certification Advisory Committee has been involved in recommending qualifying applications to TDH as promotoras or Community Health Workers. The committee has led focus groups statewide to test the ease of completion of the application for certification as promotoras or Community Health Workers, instructors and sponsoring institutions/training programs. As of December 2003, 224 promotoras or Community Health Workers have been certified by TDH.
There is a special grandfather provision of experience that allows Community Health Workers to be considered for certification based on at least 1000 hours of service as a promtor(a) or Community Health Worker between July 1997 and January 2004. Experience is considered based on the utilization of the eight core competencies or skills adopted by the program: advocacy, capacity building, communication, interpersonal relations, knowledge, organization, service coordination, and teaching.
Groups who have shown an interest in becoming certified Community Health Worker include individuals working within faith based organizations and parish nurses. Additional information concerning promotoras (Community Health Worker) and the work of the committee can be found at www.tdh.state.tx.us/ophp/chw. The committee is now involved in reviewing applications for certification of Community Health Worker instructors and sponsoring institutions/training programs. Committee members serve as the voice of stakeholders in their communities.
Liz Kelly, a member of Christ the King Church, is one of nine members of the TDH Promotoras (Community Health Worker) Certification committee. She became aware of the importance of Community Health Worker through her work as a community health nurse. These experiences provided her with opportunities to learn from area residents how strongly they desire to know how to become involved in improving the health and life of their community and of their neighbors.