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It should be noted though, that the percent of mothers who were younger than twenty years has increased from a baseline of 14.3% (44 mothers) to 16.2% (75 mothers) at final.  The area of teenage pregnancy may be something that the project, in collaboration with the MINSA, may want to address or focus on. (MINSA has also confirmed that they are aware of the rise in teenage pregnancies.)

G.  ARI and Malaria

Infections of the respiratory tract remain a leading cause of premature mortality in large areas of the world, and a major cause of morbidity everywhere4.  The only symptom that was clearly recognizable by the mothers was that of rapid and difficult breaths.  For interventions to be successful the project will need to incorporate case management and health education, along with an immunization campaign against pertussis, diptheria, and measles.  Additionally, children with vitamin A deficiency are more susceptible to ARI, thus these new interventions can work in conjunction with the micronutrient interventions already in place.

From this survey it is not clear on the exact prevalence rates of malaria, but for fever in general, 40% of the mothers reported a child in the family having a fever within the last two months.  80% of the mothers recognized a fever and chills as  signs of malaria, but only about 40% recognized headaches or body aches as symptoms.  As with ARI, case management and education interventions will need to be incorporated into the project.

V.  FINAL CONCLUSIONS

Based on observations, discussions with staff, and project research, it seems this project is technically sound and with the time frame that has occurred, it is being successfully implemented within the project communities.  This is partly due to HOPE and MINSA working together more closely.  For example, 7 MINSA staff actively participated in the final survey.  They did everything from acting as surveyors, and drawing blood, to buying groceries for the next days meals.  In addition, both of the Directors, one for Women’s Health Programs and one for Children’s Health Programs, Dr. Raul Arroyo Tirado, and Sophia Velasquez R.N., were particularly interested in the final results, and seemed in touch with why some of the results were less than expected, e.g. diarrheal case management.  By the end of the meeting they were already brainstorming for new intervention ideas.  This collaboration is essential, without it, the workload for the HOPE Staff would be extremely difficult or impossible.  

In order to increase the success of the program it is recommended that HOPE explore other organizations working in this Region, e.g. Ministry of education, other universities, NGO’s (CARE has a CS program in Otuzco, Trujillo), and or other anthropological agencies.  The use of an anthropologist is mentioned because even though all of the communities are located in Region San Martín, they are distinctly different.  For example, in REDES El Dorado the population is mainly of a migrant origin (from the Coast), San Martín population is rooted in the river culture, and REDES Lamas is mainly of native origins.  Thus, general interventions may not

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