Centro de Salud Monimbo

The Centro de Salud Monimbo is deeply embedded into the communities of Monimbo, the southern district of the city Masaya, and respected by its citizens. The health center responsible for its 76,000 inhabitants of Monimbo and serves its patients through an effective community-outreach delivery model that allows doctors and nurses to become integrated into neighborhoods and facilitates their ability to develop long-term relationships with patients. This model is called Equipos de Salud Familiar y Comunitario (ESAFC), or Family and Community Health Teams. Through this program, teams of a doctor, nurse, and selected community health leader are assigned a health post at one of thirteen geographical districts that they attend to several times a week. This allows these health workers to have strong relationships with patients and be well known and accepted amongst community networks. This aspect of community involvement proved an asset when organizing the pregnant adolescent club for the patients at the Roberto Clemente health post. Though the majority of these patients did not have functioning phone numbers, a nurse at the post was successfully able to find them and notify them to come out to the first meeting, which they ended up attending. The patients’ demonstrated respect for this nurse, amongst other health care workers, is a strong asset of the Centro de Salud Monimbo.

The Centro de Salud Monimbo has strong relationships with schools in the area, including the Modelo Monimbo secondary school. A doctor or nurse from the center will go visit a school around once a month to deliver a workshop on a health topic of choice. The health center has an electronic library of saved PowerPoint presentation and teaching guides compiled by MINSA and by previous interns. Unfortunately though there is one doctor at the Centro de Salud Monimbo who was selected to go out to a local school once a month to present on a health topic, for the past year he has been in charge of this role, he has not once taught a class on sexual education. There are also school education outreach programs led by other local women’s health organizations such Ixchen and Centro de Mujeres, but their efforts are irregular and inconsistent. Persisting high adolescent pregnancy rates in the community underscores the need for a more unique and continued approach.

Though it was evident that the health center was making concerted efforts to improve delivery of care to people located in most isolated and rural boundaries of the region, issues such as overburdened health professionals, lack of functioning technological resources such as simple otoscopes and reliable running water, and failure to collaborate with other existing organizations in the area hindered their efforts. I believe that relatively simple changes such as more communication with local organizations like Ixchen and Centro de Mujeres or more financial incentives for health staff employees to work overtime could greatly improve the ability of the center to better help patients.