Never underestimate the resourcefulness, the innovation, and creativity of pediatricians in resource-limited areas! Their commitment and dedication, coupled with a little help, can achieve amazing results.
Members of the American Academy of Pediatrics’ Section on International Child Health (SOICH) recognized this potential in their colleagues, and in 2006 initiated I-CATCH.
Dr. Anna Mandalakas
I-CATCH is based on the successful AAP’s Community Access to Child Health (CATCH), a domestic program that supports U.S. pediatricians who wish to plan a community-oriented project. I-CATCH (International-CATCH) went global to help our international colleagues make their ideas a reality and improve access to health care for children in their communities.
The grants provide mentoring and $2,000 annually for 3 years, allocating 6 months for planning and 2½ years for implementation. The grants are awarded to competing applicants who have an idea and a community agency to partner with, but who have had little experience in writing grant proposals and implementing a funded project.
There are three important criteria for I-CATCH grants: First, the idea must originate from a children’s health care provider who is well integrated in the targeted, resource-poor community and who will personally oversee the project’s implementation. Second, the project must include collaboration with a community agency or clinic. Third, it must be designed to improve children’s health and their access to health services. Preference is given to projects from the nonindustrialized world that have a high potential for both sustainability beyond the grant period and replication in other communities.
Dr. Burris Duncan
Now in its fifth year, I-CATCH has awarded 29 projects in 20 different countries. Projects have focused on the identification and treatment of malnutrition, infectious diseases, developmental disabilities, and neonatal problems; health education for parents, teachers, health care workers, or entire communities; and the training of outreach workers to augment and expand care in grossly underserved areas.
Neonatologist Margaret Nakakeeto had an idea that would decrease the high rates of newborn morbidity and mortality in the Kayunga District of Uganda. She used I-CATCH funds to mobilize collaboration among six agencies that were working toward a common goal: improving newborn care. Referral systems that improved the management of high-risk newborns were strengthened; a neonatal unit was opened at the district hospital and neonatal protocols were developed; the training of nurses was augmented; 43 new health workers were trained in neonatal resuscitation; and treatment was given to HIV-infected mothers to prevent mother-to-child transmission. All of that was stimulated by $6,000.
Developmental pediatrician Mirjana Remetic’s idea was for early identification of children with autism in Bosnia. Her team has conducted multiple workshops on autism to educate and increase awareness of families, educators, governmental officials, and health care providers. Working with the Ministry of Education, they have distributed autism-explaining posters in schools and day care centers in Tuzla Canton, the northeast region of Bosnia. They have screened more than 800 children for autism and found 28 who needed follow-up evaluations. The increased awareness and child identification has initiated a drive to establish an Autism Center.
Pediatrician Ghulam Mustafa’s idea was to educate mothers living in an urban slum area in Multan, Pakistan. He knew what a positive impact maternal education can bring to the health of children. He gave basic health care training to community health workers, who then went door-to-door educating 260 families. The results showed an increase in the rate of women who made at least three antenatal visits (from 13% to 56%), of births in a health facility (from 1% to 68%), of adequate maternal tetanus shots (from 22% to 84%), of a first dose of hepatitis B vaccine (from 11% to 87%), of the use of iodized salt (from 0% to 96%), of exclusive breastfeeding for 6 months (from 0% to 58%), of oral rehydration solution usage for diarrhea (from 55% to 84%); of vaccination rates (from 67% to 89%); and of school enrollment for children aged 5-14 years (from 22% to 38%). With limited resources, he attacked one of the root causes of childhood morbidity and mortality, and made a very significant improvement in child health in this urban slum.
I-CATCH provides unique opportunities in resource-constrained settings to develop and implement innovative projects to enhance child health at the community level. Grant awardees had been largely prevented from pursuing such activities because of a lack of grant proposal–writing experience and technical support. Mentors from the United States assisted applicants with their proposals and offered advice for funded projects regarding their implementation and sustainability.
The success of these projects highlights the following: