International Health Assessment Colombia By: Michelle Coots, Rachel LaGrand, Ryan Mayer, and Xavier Vaughn
International Health Assessment Colombia
By: Michelle Coots, Rachel LaGrand, Ryan Mayer, and Xavier Vaughn
About Colombia● Location: Northern tip of South America● Capital: Bogota● Type of Government: Republican● Demographics
○ Nationality: Colombian ○ Ethnicity: Mestizo and White, Afro-Colombian, and Amerindian
● Flag:
About Colombia● Language: Spanish
● Religions
○ Roman Catholic = 90%
○ Other = 10%
● Population: 46, 736, 728
● Life Expectancy
○ Males = 76
○ Females = 83
Colombian Culture● Influenced by Africans, Europeans, and Native Indians● Traditions
○ Express and celebrate culture and diversity through fairs, carnivals, and cultural festivals○ Colombian Music: Cumbia ○ National Sport: Tejo
■ Involves putting an iron quoit into a medal circle surrounded by firecrackers■ Objective of game: Make the biggest explosion
Economic Profile● GNI = $577.8 billion PPP (2013)● GDP = 7,831.22 USD (2013)● GNP = $11,969 PPP (2013)● Gini Index = 53.9 (2013)● Health Sector Expenditure = Upper Middle Income
Health System● Two Legal Processes that frame a comprehensive reform
○ First: Statutory Law: establishes fundamental right to health
○ Second: Ordinary Law: attempts to define structure, operations, competencies, and resources
■ Currently pending in Congress
● First 10-year Public Health Plan (2012-2021)○ Addresses: health as right, social determinants of health, and approaches for different population
groups○ Access: 98% ○ Quality of service still lacks due to inequities, especially in remote parts of country
Health Issues● Top 3 causes of death in adults in Colombia
○ Ischemic Heart Disease
○ Interpersonal Violence
○ Stroke
● Burden of cardiovascular health issues
○ YLL (years of life lost due to premature mortality): 1,250 cases/year
○ YLD (years of healthy life lost due to disability): 250 cases/year
Risk Factors for Cardiovascular Disease● Age● Sex● Family History● Smoking● High blood pressure/cholesterols● Diabetes● Obesity● Physical Inactivity● High stress
No Real Program in Place in Colombia● Physicians and Nurses provide education and support
○ Discuss risk factors
○ Provide tips on how to deal with heart disease
Program in Other Latin American Countries● Salud Para Su Corazón (Health for Your Heart)
○ Currently implemented in Mexico
● Targets heart health by:
○ Focus on entire family
○ Modify health behaviors
● Similar culture to Colombia
○ Latin American background
○ Traditions
Research
● One study asked women what they thought their biggest health threat was
○ Results showed that only 10% correctly thought it was heart disease
○ 62% incorrectly assumed cancer was their biggest threat
Research Cont.
● Colombia piloted a program using Sesame Street characters to teach heart
health
○ Children participated in an educational program focused on cardiovascular health
promotion
○ Children were retested 3 years after the intervention
○ Compared to their scores prior to the program, the children's knowledge improved 15
percent, attitudes 51 percent, and heart-healthy habits 27 percent.
Policy● Almost no legal policy in place in Colombia affecting heart disease
● WHO has some programs guidelines which target risk factors for heart disease
● Program goals include reducing physical inactivity and/or promoting physical
activity, reducing unhealthy diets and/or promoting healthy diets, reducing the
burden of tobacco use, and finally reducing the harmful use of alcohol.
● More research needs to be done to support evidence based policy changes in
order to have a real effect.
Program and Lesson Plan ● Lessons
○ Risk factors/ Heart/ Health Assessment
○ Cholesterol, blood pressure, and blood sugar
○ Dietitian
○ Physical Activity for the family/ Health Assessment
● A month later go back to do another assessment
● Festival at the very end
Key Stakeholders and Community Partners ● Alejandro Gaviria Uribe: Minister of Health and Social Protection
● Mariana Garces Cordoba: Minister of Culture
● Maria Fernanda Campo Saaverdra: Minister of National Education
● Lorena Chaparro Diaz, PhD: Director of Nursing Department
● Carlos Caballero Argaez and Sarmiento Andres Rodriguez: PH program
Timeline ● August: Start training the workers
● September-November: Trials runs
● December-May: Out in the field
Resources ● Pre/Post Assessment
● Delicious Heart Healthy Latino Recipe Book
● Your Heart, Your Life Picture Cards for Community Health Workers
● Song to the Beat of Your Heart
● Student Workers
● Traditions ○ Family oriented
● Selecting the right population
● Interpersonal violence ● Working with government
officials ● Workers being students
Ethical and Cultural Considerations Barriers to Consider
Evaluation● Process
○ Record keeping/database○ Attendance and material tracking
● Impact○ Surveys○ Comprehend material from educational lessons
● Outcome○ Physical exams○ Decrease blood pressure by 5%
ResourcesAmerican Heart Association. (2015). Heartorg Home Page. Retrieved December 1, 2015, from http://www.heart.org/HEARTORG
Balcázar, H., Fernández-Gaxiola, A., Pérez-Lizaur, A., Peyron, R., & Ayala, C. (2015, March 2). Improvıng heart healthy lıfestyles among partıcıpants ın a salud para su corazón promotores model: the mexıcan pılot study, 2009-2012. Retrieved October 25, 2015, from http://www.cdc.gov/pcd/issues/2015/14_0292.htm
Central Intelligence Agency: The World Factbook. (n.d.) Colombıa. Retrieved September 5, 2015, from https://www.cia.gov/library/publications/the-world-factbook/geos/co.html
Colombian Embassy. (2012). Colombıan Culture. Retrieved September 5, 2015, from http://www.colombiaemb.org/node/1331
Medical Express. (2013, December 19). Colombıan preschoolers learn heart-healthy lessons wıth sesame street. Retrieved October 8, 2015 from http://medicalxpress.com/news/2013-11-colombian-preschoolers-heart-healthy-lessons-sesame.html
National Institute of Health. (n.d.). Delıcıous heart healthy latıno recıpes/platıllos latınos sabrosos y saludables (bilingual English, Spanish). Retrieved December 1, 2015, from http://www.nhlbi.nih.gov/health/resources/heart/recipes-bilingual
National Institute of Health. (n.d.). Your heart, your lıfe pıcture cards for communıty health workers/dıbujos educatıvos para su corazón, su vıda. Retrieved October 25, 2015, from http://catalog.nhlbi.nih.gov/
Resources ContinuedWorld Heart Federation. (2015). Fact Sheets. Retrieved December 1, 2015, from http://www.world-heart-federation.org/heart-facts/fact-sheets/
World Heart Federation. (2008, October 1). Many women Colombıa awareness survey. Retrieved October 8, 2015, from http://www.world-heart-federation.org/publications/heart-beat-e-newsletter/heart-beat-octobernovember-2008/in-this-issue/colombia-awareness-survey/
World Bank. Colombıa. Retrieved September 5, 2015, from http://data.worldbank.org/country/colombia
World Life Expectancy. (2014, May 1). World Lıfe Expectancy. Retrieved October 8, 2015, from http://www.worldlifeexpectancy.com
World Health Organization. (2015). Colombıa. Retrieved September 27, 2015, from http://www.who.int/countries/col/en/
World Health Organization. (May 2014). Colombıa. Retrieved September 5, 2015 from http://www.who.int/countryfocus/cooperation_strategy/ccsbrief_col_en.pdf
World Health Organization. (2014). Colombıa Non-Communıcable Dısease Country Profıle. Retrieved October 8, 2015, from http://www.who.int/nmh/countries/col_en.pdf