“… That part is the one that enriches, the contribution of the community towards us is a strength: participation, community mobilization. That is powerful and priceless ... That the community itself seeks service is our ultimate goal ... "

Carlos Alberto Gallego (CG)

Carlos Gallego is the Coordinator of health promotion and education, in the Ixil Health Area Headquarters, of the Ministry of Health (MSPAS). For a year now, it has been coordinating the implementation of the PDQ methodology, promoted by the MCSP (Maternal and Child Survival Project) program of Save the Children, which seeks to improve the quality and accessibility of health services and nutrition, through the involvement of communities in the prioritization of needs and the development of action plans.

“The community participates when there is an end in common and we are going to do something for everyone” (CG).

The methodology has 4 phases:

Phase 1

Creation of support

It consists of identifying the different community actors involved in the health area. Among them are the Community Development Council, the mayor's health commission, community leaders and therapists of all specialties (midwives, healers, etc.). Carlos says that in this phase you have to be very careful not to leave out any actors and take advantage of all the community wisdom gathered in those who still use customary and ancestral healing practices. To achieve common objectives, it is necessary that the entire community feels represented by the people in whom they have placed their credibility and trust, on this depends the relevance and acceptability of the services.

“… I think that this is wealth, so that community participation is a fact and that it contributes a lot to the health system…” (CG).

Phase 2

Exploring the quality

In this phase it is found out how the people of the community understand the quality and who provide the health service. It is at the stage in which it is discovered what needs the different age groups have: women, men, boys, girls, adolescents and older adults.

Phase 3

Develop a community work plan

With the information collected in the previous phase, the main problems are categorized and emphasized and a committee chosen to work on the quality improvement plan is chosen.

Phase 4

Work together

The elected committee, together with the MSPAS staff, analyzes the problems and possible solutions and develops an action plan.

According to Carlos, the close relationship with the communities has helped them discover the origin of some of the health problems. Many have their cause in environmental problems, water and sanitation, waste management, among others. For the MSPAS, it is very useful to know these situations, because, although it does not interfere in everything, it can help the community to connect with the municipality or with the entities responsible for offering solutions to these problems.

In this work methodology, the protagonists are the members of the community, since the offer of services and improvement plans are based on the needs that the community manifests, from their experiences and their cultural motivations.

"... That harmony that is achieved is what gives success to achieve a quality in health ... Because it is no longer something only thought from our point of view as a Ministry, but is something agreed upon ..." (CG ).

Within this methodology of planning and implementation of health services, the MSPAS has begun to play a role closer to communities: it serves as a moderator of the dialogue to reach consensus, promoter and facilitator of health information for families and leaders community and, of course , deals with the expected roles; Healing and rehabilitation.

With the application of the methodology, more mothers have been approached to the posts and health centers to maintain adequate control in the 1000-day window. Which is an important achievement, because this guarantees qualified care in the mother's prenatal care; access to a safe birth; effective follow-up during breastfeeding, first feeding and preventive health care for the baby, up to two years.

Carlos says that for him and his team it was a lot of learning and support to coordinate with Save the Children, because with the accompaniment and training they helped them develop communication tools to establish an open dialogue with the communities. In addition, they provided materials and equipment to develop the methodology.

“They (Save the Children) have been that support that we need, for example, in equipment… support in planning with communities, technical assistance” (CG).