Guaymate, Dominican Republic

Source: OCHA/ReliefWeb

A partnership between Peace Corps-Dominican Republic, the community of Guaymate, the University of Illinois-Chicago and Northwestern University

The Peace Care Dominican Republic partnership began in 2012. After successes in Senegal and Ethiopia, the Global Community Health Collaborative (GCHC) model is again serving as the foundation for the Peace Care Dominican Republic project. This collaborative model brought together faculty and trainees from University of Illinois-Chicago (UIC) and Northwestern University (NU), Peace Corps volunteers in the Dominican Republic, and the Guaymate community to initiate a community-driven assessment of the its health systems andhealth services needs. Based on this assessment, an intervention was developed to address health services quality at Guaymate Municipal Hospital and improve health education of the Guaymate community. The intervention phase began in February 2014, and will continue to evolve as PeaceCare evaluates interventions that will build local capacity.

Partnership Formation

Peace Corps-Dominican Republic recommended the municipality of Guaymate in the eastern Dominican Republic as an ideal partnership site based on their barriers to health and their energetic youth sector volunteers.

Community Assessment

The community assessment phase began in September 2013, when members of the Community Advisory Board (CAB) conducted focus groups discussions. The Peace Care team arrived in Guaymate in mid-September 2013 to complete the assessment phase by revisiting focus groups and conducting key informant interviews.

Site Visit – March 2013

This initial site visit was designed to build the partnership, and was conducted by a team of three physicians from UIC and a team from NU Access to Health program. The team met Peace Corps volunteer Rosa and to present the GCHC model to the CAB members that Rosa had invited to participate. The team was very well received as the community embraced the GCHC model. The team visited surrounding bateyes – communities of sugarcane plantation workers and their families, with significant health needs and barriers to care.

Site Visit – September 2013

Four physicians from UIC and NU participated in this site visit – the goal of which was to conclude the community assessment phase and to start discussing potential interventions with the CAB and community. Various forms of community assessment consistently reported a lack of health promoters in Guaymate and inconsistent services provided at the Guaymate Hospital as the major concerns. The team also met with various stakeholders in the Guaymate community and its surrounding bateyes to identify resources and potential collaborations. At the end of their stay in Guaymate, the team met with CAB members to establish a timeline to develop an intervention and training curriculum to be ready before the next site visit. The team concluded the trip with a meeting with Peace Corps Dominican Republic..

Site Visit – February 2014

Eight members from UIC and NU participated in this site visit, which began the implementation phase of the partnership. The team introduced EngenderHealth’s Client-Oriented Provider-Efficient (COPE) quality improvement tool to the staff at Guaymate Hospital, which has been used in over 50 low- to mid-income countries since the 1980s. With external facilitation by a local health educator experienced in using COPE, hospital staff completed self assessments and client interviews to help arrive at an action plan to improve health services. A COPE Committee was established, and concrete steps were discussed to implement in the near future. The PeaceCare team also participated in knowledge sharing with health care providers from Guaymate Hospital and Clinica de Familia La Romana. The site visit concluded with a community-based health promotion fair, with leadership provided by the Community Advisory Board and youth group volunteers.

Site Visit – September 2014

Five physicians from UIC participated in this site visit, which continued the implementation phase of the partnership. The team trouble-shot COPE implementation with Guaymate Hospital, and discussed plans to reintroduce COPE in the coming months. The team helped re-organize a large shipment of hospital supplies for Guaymate Hospital. The team continued knowledge sharing with Clinica de Familia La Romana. The team discussed health promoter programs with Hospital Buen Samaritano in La Romana. The team worked with Peace Corps youth group in improving their educational outreach programs.

Future Directions

Peace Care will continue to work with Guaymate Hospital in ongoing COPE implementation, Guaymate youth group in community education, and Clinica de Familia in provider continuing education. Peace Care is also partnering with other US universities and NGOs who work in La Romana province to coordinate programs.