Building a Healthy World Through Disease Prevention
“What makes me happy is to meet people and give them information and the services they would not have accessed considering the distances they have to cover before getting to the nearest health facilities.”
– Limpo, Community Peer Educator, Zambia
Health is key to living a happy, productive life. For infectious diseases such as Ebola, polio, malaria, and cholera, and chronic diseases such as obesity, diabetes, and cervical cancer, PCI has a long history of working in disease prevention at the community level to empower people with the knowledge, skills, self-efficacy, services, and resources they need to stay healthy and free from disease.
Infectious diseases can be spread directly and indirectly, and in many ways including by air, animal or insect bites, skin contact or mucus membranes, blood, and other bodily fluids. Methods of disease prevention and control range from educating people on how infectious diseases are spread, behavior change communication around water, sanitation, and hygiene, promoting access to life-saving vaccines, and working closely with individuals, families, and communities to promote access to testing, treatment, and comprehensive care and support.
PCI has a long history managing large scale public health and emergency projects, with particular success in scaling-up enhanced infectious disease services at local, regional, and national levels. PCI mobilizes local programmatic platforms, such as uniformed services, schools, parent-teacher associations, and Care Groups to reach the most vulnerable populations, using innovative communication, social mobilization and behavior change strategies to prevent and mitigate the spread of infectious diseases from Ebola and HIV/AIDS to polio and tuberculosis.
The Ebola virus disease outbreak was unprecedented in scale and geographic reach. By November 12, 2014, there were 6,822 confirmed, suspected, and probable cases in Liberia alone, with 2,836 confirmed/suspected deaths (WHO, November 12, 2014 update). An overwhelmed health system, the difficulty of case mapping, and the stigma and fear of Ebola combined to create a catastrophic “perfect Ebola storm” in Liberia. The outbreak took a significant toll on Liberia’s health systems, economy, and government infrastructure. Many hospitals and clinics closed completely or refused patients suspected of having Ebola. Communities also lost faith in health service providers and/or avoided health facilities for fear of coming into contact with the Ebola virus.
Since the beginning of the Ebola outbreak, PCI reached more than 140,000 people in Liberia with Ebola health promotion and disease prevention related interventions through the USAID/OFDA-funded Rapid Ebola Awareness, Communication and Training Program (REACT), the Ebola Community Care Center Program (EC3), and as part of the USAID/FFP-funded Liberian Agriculture Upgrading, Nutrition and Child Health (LAUNCH) program.
PCI strengthened local health systems by equipping communities and health facilities with knowledge, infrastructure, and supplies necessary to prevent the spread of Ebola, including by expanding community education campaigns and training health care providers. PCI also managed an ETU and built three community care centers – constructing infrastructure for the isolation of suspected cases, and providing supplies such as personal protective equipment (PPE) and sanitation necessities to minimize the spread of the virus.
By adapting program platforms that existed before Ebola, PCI engaged and mobilized communities, raised awareness and strengthened capacity to detect, support and refer Ebola cases. These actions, combined with efforts to restart and maintain regular health services, will help to cushion the impact of the outbreak for families in the hardest hit areas of Liberia. More than 90 percent of PCI’s 700 communities remained Ebola-free throughout the outbreak.
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India was once considered the epicenter of polio and nearly half of the world’s polio cases came from there just a few years ago. The impact on the country was devastating, making polio prevention a priority. There is no cure for the disease, but a polio vaccine can prevent it. PCI recruited and trained local leaders and children to get the word out about polio prevention. We also built the capacity of government frontline healthcare workers to work with the community to ensure universal polio vaccination. The World Health Organization declared India polio-free in 2014, but PCI continues to equip communities with knowledge and tools around general health to keep the disease at bay for good.
The HIV and AIDS epidemic in Africa continues to be a major global health issue. In 2016, an estimated 36.7 million people were living with HIV, and 30% of these same people do not know that they have the virus.
Since the start of the epidemic, an estimated 78 million people have become infected with HIV and 35 million people have died of AIDS-related illnesses. In 2016, 1 million people died of AIDS-related illnesses. The vast majority of people living with HIV – an estimated 25.5 million – are located in sub-Saharan Africa.
For vulnerable communities with a high prevalence of HIV/AIDS, the epidemic has caused severe damage to social and economic structures, exacerbating social and economic inequities. HIV and AIDS have taken a terrible toll particularly on children and their families. During the past 30 years, an estimated 17 million children lost one or both parents due to AIDS, and 90% of these children live in sub-Saharan Africa. In addition, 3.4 million children under age 15 are living with HIV.
Without HIV/AIDS treatment and support for HIV-affected households, parents struggle to support their households and care for their children; children may be too sick to attend school, or forced to stay home and care for sick family members.
PCI has been active in HIV/AIDS disease prevention and response since the early 1990s. PCI’s current portfolio spans the range of prevention, care, treatment, and support interventions, including orphans and vulnerable children (OVC), in several countries around the world, including three in sub-Saharan Africa.
PCI’s overarching approach to our HIV/AIDS programs is to leverage our community-based programming platform across different technical areas as an entry point to promoting effective approaches and improving service uptake. PCI also addresses root causes by facilitating community conversations while embarking on systems strengthening including technical and management capacity building especially for civil society organizations. Gender considerations have remained central to all our programs.
An estimated 93,000 women in sub-Saharan Africa develop cervical cancer annually and, while it is extremely treatable, 57,000 die from cervical cancer each year. PCI works in Zambia with Pink Ribbon Red Ribbon and the Zambia Defense Force Medical Services to provide women with cervical cancer screening, treatment, and referral services by fully integrating these services within PCI’s broader mobile HIV/AIDS package of services. By offering mobile cancer screenings, PCI is able to take testing and treatment directly to women who may otherwise not have knowledge about or easy access to cervical cancer services.
To date, PCI has screened over 23,703 service women and civilians for cervical cancer and treated nearly 853 women.