Barriers to contraceptive use among adolescents in Nicaragua

: 2.045_NEP Needs assessment in a rural haitian community: Assessing the socioeconomic and cultural determinants of health N. Othman, E. Ulrich, S. Keene, M. Smith, C. Chuang; Wayne State University School of Medicine Background: International healthcare initiatives must evolve from individual programs that target single diseases to systems of care that address the needs of the whole person. Since 2001, the World Health Student Organization (WHSO) at Wayne State University School of Medicine has sent medical students and physicians to Central and South America on medical relief trips. WHSO annually sends three teams to Morne, L’Hopital, Haiti to provide sustainable healthcare and facilitate continuity of care. A needs assessment was developed to evaluate the community’s healthcare needs. Methods: Needs assessments may be structured as focus groups, traditional surveys, or both. Questions generally diverge into three categories: demographics, healthcare access, and healthcare delivery. Considering the short-term nature of our relief trips, a 15 minute assessment was developed that focused on the above three themes. Participants were chosen randomly from a triage waiting area, consented, and then completed the survey via Creole interpreters. 34 surveys were completed by men and women age 18 and older. This study was approved by the Haitian Ethics Committee and the Wayne State University Institutional Review Board. Findings: Results include age, marital status, years of education, household size, number of children, availability of running water and electricity, occupation, income, perceived health problems, methods of accessing their healthcare systems, and barriers to obtaining needed care. The most common perceived problems were gastrointestinal disease, headache, fever, abdominal pain, and anemia. Respondents thought a nearby clinic, clean water, more medications, more money, and electricity would be most beneficial for their health. Barriers to healthcare access included lack of monetary funds and long travel times. Interpretation: International relief work struggles to provide efficacious care to lower-and-middle income countries, which may be due to a lack of understanding of cultural and socioeconomic factors that affect healthcare delivery. The needs assessment is the first step to identifying these key factors, in an effort to ultimately deliver community requested healthcare in a culturally competent manner. WHSO aims to avoid “creating a problem then prescribing a solution”, and instead partner with the community and Haitian organizations to provide healthcare the community values.