About the PCPCD
 The Prevention and Control of Priority Communicable Diseases (PCPCD) Program, funded by the Canadian International Development Agency (CIDA), aims to improve the health of vulnerable and hard to reach populations in four target countries in South America by integrating recognized global and regional strategies. Projects have been implemented in selected geographic areas in Colombia, Ecuador, Paraguay and Peru, interfacing Stop tuberculosis (TB), Integrated Management of Childhood Illness (IMCI), Chagas disease, sexually transmitted infections and dengue prevention and control strategies with a gender equality cross cutting component and a continual focus on the sustainability of its achievements.
The PCPCD was initiated in 2002 for an eight year period in the amount of CAD$12 million. Program activities ended in March 2011.
Description of the PCPCD
PAHO worked in close collaboration with national counterparts in each of the participating countries to achieve the following objectives:
To design and implement a surveillance system for Chagas disease with active community participation including schools in endemic areas of Paraguay; to strengthen vector control and community based surveillance in the Southern Region of Peru (Arequipa, Moquegua and Tacna); and, to strengthen epidemiological and entomological surveillance of Chagas disease with community participation in the provinces of El Oro, Guayas, Loja and Manabi in Ecuador.
To promote the adoption of the Integrated Management Strategy for dengue prevention and control (PAHO Directing Council Resolution CD44.R9 2003) and the development of national integrated dengue plans in all participating countries. Support is also provided for the implementation of the clinical attention, surveillance (entomological and epidemiological) and social communication components of the Strategy (EGI-Dengue, in Spanish).
To promote gender awareness in communicable diseases among health professionals that includes gender sensitivity training, the collection and analysis of health data by sex and the integration of a gender approach in program planning and implementation in Ecuador and Paraguay.
To address the health priorities of the indigenous and creole populations with an intercultural focus and make more effective use of limited human resources using a primary health care approach in the participating communities.
To introduce changes in the academic curricula of health professions (nursing, medicine, public health) in target areas in order to include the principles of the IMCI strategy and improve primary health care services to reduce mortality from diseases and health problems in children under 5 years of age in Colombia, Ecuador, Paraguay and Peru. Based on identified country priorities, activities in community IMCI were added in 2006 to increase the coverage of community based interventions through a combination of outreach services, family and social actor participation.
To strengthen the capacity to expand the prevention and control of sexually transmitted infections in Paraguay, with special attention to gender issues and socioeconomic status. The PCPCD actions are focused on syphilis and congenital syphilis and contribute to the national effort to eliminate congenital syphilis.
To implement the Stop TB strategy for tuberculosis control among indigenous populations in Colombia using a community participation model. Based on the health priorities of the populations, IMCI actions were incorporated in 2006 to develop an integrated TB/IMCI program for this population group.
Key Program Results
Ecuador
- Over 4,211 health professionals, heath promoters, professors, students and community members received education and training to prevent and control Chagas disease in 4 provinces (El Oro, Guayas, Loja and Manabí).
Paraguay
- In June 2008, the interruption of the vector transmission of Trypanosoma cruzi by Triatoma infestans was certified in the Eastern Region of Paraguay.
- Information on Chagas disease and dengue incorporated as a basic competency in science curriculum in primary schools.
- Five community surveillance centres were established in the Central Chaco Region.
Peru
- In December 2009, the interruption of the vector transmission of Trypanosoma cruzi by Triatoma infestans was certified in the Region of Tacna and in September 2010 in the Region of Moquegua.
- Over 600 community surveillance posts were established in Arequipa, Moquegua and Tacna for the surveillance and implementation of Chagas disease interventions and other programs (dengue, IMCI).
- Agreement was signed by the Ministry of Health, PAHO and mayors of 25 districts in Arequipa, Moquegua and Tacna to include Chagas disease in their municipal development plans for health promotion and disease prevention and control activities.
- All four countries adopted the integrated management strategy for the prevention and control of dengue (EGI-dengue) and developed national plans.
- In Paraguay, over 911 health professionals (681 women and 230 men) participated in training to help them integrate gender equality in health activities.
- In Ecuador, 60 health professionals received training in gender and health, and gender and social communications methods.
- Local participatory diagnostic studies incorporating a gender focus were carried out in five cantons to develop capacity building requirements, materials and social communication messages for community IMCI.
- In total, 39 health sciences schools (medicine, nursing and technical) incorporated the IMCI strategy as part of their academic curriculum and human resources development in Ecuador, Paraguay and Peru.
- Support to develop new tools for capacity building in IMCI, including ICATT: IMCI computerized adaptation and training tool, community health workers guide, local operational planning guide and short program review assessment.
Colombia
- Over 109 health professionals were trained in clinical IMCI in 5 departments (Amazonas, Cesar, Guaviare, Guajira and Nariño).
- Over 1,100 health professionals, health promoters and indigenous leaders received training in community IMCI in the 5 departments.
- Intercultural adaptation of the IMCI strategy for the Arhuaco population in the department of Cesar and the Tikuna population in the department of Amazonas.
Ecuador
- IMCI program was expanded as a model at the national level with over 8,300 health professionals trained in clinical, community and neonatal IMCI nationally and the IMCI strategy implemented in 2,000 health establishments.
- Fourteen universities established an agreement between the Ministry of Public Health, Ecuadorian Association of Schools of Medicine and Health Sciences (AFEME), Ecuadorian Association of Nursing Schools (ASEDEFE) and PAHO, to incorporate IMCI into the university curriculum.
- Integration of gender equality and ethnicity focus in the IMCI strategy in 10 cantons to reinforce the equity and efficiency of the Strategy.
Paraguay
- Over 1,200 health professionals trained in clinical IMCI and 200 health professionals and health promoters trained in community IMCI in 6 departments (Boquerón, Caazapá, Central, Itapua, Presidente Hayes and San Pedro) and Asunción.
- Program supported the national Primary Health Care Initiative to train over 800 health professionals in cross disciplines (IMCI strategy, communicable diseases, emerging diseases, non-communicable diseases, sexual and reproductive health) in over 500 local health services (family health units) in 14 departments.
Peru
- Over 9,000 health professionals trained in clinical IMCI and 990 community health workers trained in community IMCI in 3 regions (Apurimac, Cusco and Huancavelica).
- Coordination of IMCI actions and support to the national CRECER strategy to reduce poverty and scale up actions.
- Integrated Health Program in the Paraguayan Chaco
- The Program supported the development of an integrated primary health program for indigenous communities with 67 health providers trained to provide comprehensive care with an intercultural focus for 37 indigenous communities.
- Supported the development of the curriculum for the “Alma Chaquenian” Institute of Health of Boquerón for the formation of technical nursing staff.
- Over 800 health professionals trained and providing prevention and care for sexually transmitted infections using the syndromic management approach in 7 departments (Alto Paraná, Amambay, Boquerón, Central, Cordillera, Itapúa and Paraguarí) and Asunción.
- Program contributed to passing a national Ministerial resolution to ensure that all pregnant women and their partners receive free testing and treatment for syphilis.
- Coverage of syphilis diagnosis and treatment of pregnant women increased in the Program’s beneficiary services; more than 50,000 pregnant women received testing for syphilis and over 2,800 with positive serology received treatment.
- Contributed to placing TB control in the indigenous population as a public health problem in Colombia.
- Program was used as a model to expand actions at a national level and increase coverage to 36 departments with national resources.
- In total, over 2,100 health professionals, health promoters and indigenous leaders received training in directly observed treatment short-course (DOTS) in 7 departments (Amazonas, Cesar, Guajira, Guaviare, Magdalena and District of Santa Marta, Nariño and Vichada).
- TB data disaggregated by sex, age and ethnicity are available to support activity programming in conjunction with the IMCI Program.
- Social communication and education materials were produced in Indigenous languages (Awapit, Ahuaca, Ticuna)
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