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The rates of anemia have increased, for mothers and children alike, thus possibly new channels for information will need to be used.  These channels should try and build the capacity of the communities, not just lend information.  

Even though only approximately 50% of children were considered completely vaccinated, the coverage and access rates are quite high.  In addition, 70% of all mothers had a vaccination card for their child and 92% of all mothers have had their children weighed in the past four months.


A. Background

Project HOPE started this child survival project in Peru in 1996 as a collaborative effort between Project HOPE, The Center for Public Health of the Peruvian University Cayetano Heredia (UPCH), The San Martín Regional Ministry of Health (DIRES-SM), and in cooperation with two NGO’s known as Eastern Center of Studies and Community promotion (CEPCO) and PRISMA.  (The two formal partners are UPCH and DIRES-SM).

*The project is located in Region San Martín (RSM) of central Perú on the Eastern slope of the Andes along one of the main tributaries of the Amazon, the Huallaga River.  For administrative purposes MINSA divides Region San Martín into networks for health services, called Redes de Services de Salud (REDES).  The project includes three sites: REDES El Dorado, REDES Lamas, and REDES San Martin (which was previously called REDES Banda of Shilcayo).  Being part of the Amazon Basin, most of the project area is a tropical rainforest, with poor roads and communication.  (See Appendix for maps of project area).   Out of the total twelve health units in RSM, these three REDES are among the four with the poorest health indicators.  There are approximately 200 communities in the combined target area, only three of which have a population of over 500.  Most communities have less than 100 residents.

In the 1980’s, this region was the world’s largest source of the coca leaves which are used to make cocaine.  Coca became a monoculture, almost totally replacing the basic food crops of the previous subsistence agriculture.  Due to the U.S. government’s successful efforts in coca eradication, USAID is actively involved in social and alternative economic development in this region.

The main economic activity is subsistence agriculture on small plots of land, and up until recently this area was geographically isolated from the centers on the west side of  Peru.  Region San Martin has traditionally suffered from high infant and maternal mortality rates, with lack of services in health education.  The amount of guerilla movement in this area though seems to be decreasing, which will hopefully aid in the reduction of these mortality rates in the coming future.  

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