HEALTH PEOJECT– COMMUNITY BASED PROGRAMS FOR THE HEALTH AND ACTIVE LIVING OF OLDER PERSONS IN FOUR OLDER PERSONS IN ENTEBBE.
Issues faced by older persons in Uganda, like in many other developing countries, are largely invisible. Often older persons are not included in development or health systems strengthening efforts. This project aims at building on the strengths of older persons by engaging, encouraging and empowering them, and key stakeholders to co-design actions that can influence intergenerational cooperation and community action to improve the health of older persons and their families through responsive programs, effective policies and strengthened health systems.
Health project is part of an international collaboration with HelpAge International including implementation in Tanzania, India and Uganda. The project has four phases designing a design challenge, inspiration, ideation and implementation.
In this project HENU has worked hand in hand with the communities of older persons to build a strategy for sustainable health outcomes and healthy living for older persons in the Entebbe sub-district. In this project we see a real manifestation of the principles of community life competence at work. Using a practice called design thinking we worked closely with communities over a period of time in what is called the Inspiration stage. During this stage we facilitated and supported them to identify their needs and desires and dreams for their community. They identified ideas of what they wanted their communities to look like and came out with a series of ideas to be discussed in the next stages.
After the inspiration stage we moved on to the ideation stage where the community began to make sense of the ideas they had developed and come up with a comprehensive strategy for their community. Here the ideas began to take shape and out of all the areas identified they came up with four areas that are pivotal to their health and well being. These four areas are Sanitation and hygiene, Nutrition, Active living and Exercise and Regular health check-ups. These have become the central focus of the health project and it is through these that community will achieve a clean and sanitary environment, healthy nutrition, active living and regular checks on the health of the community. During this stage communities developed strategies to achieve these goals and this was an impressive process to watch and learn from.
These four areas were identified as an initiative from the older persons groups and in the same spirit they did not wait for prompting to initiate the changes, but began all on their own. The Bugonga community started social visits where they checked on each other’s health and advising each other to build and keep pit latrines clean, dig rubbish pits and sensitized the community on the importance of washing hands when using the toilet. The Kitubulu group ventured quite seriously into meeting to socialize and make crafts for sell and earn an income to better their lives, as well as exercise and active living. This community is highly intergenerational and it is interesting that young people are getting involved in older persons activities which makes them feel more appreciated and acknowledged as important people in the community.
SANITATION AND HYGIENE
Communities pointed out that the hygiene and sanitation of a community directly affects the health of not just older persons, but also the health of other members of the community. Good sanitation and hygiene in communities is the responsibility of those who live on those communities first as opposed to the government. Community leaders supported by HENU staff discussed the values required to develop strategies, strengths within the community to enable those strategies to work, what needs the community had to get the project started, and suggestions for potential prototypes.
- Unity between community members
- Desire to volunteer by community members
- Knowledge of the community
- Assignment of duties and responsibilities to community members
- Leading by example to motivate others
- Engagement of Municipal health inspectors to carry out supervision and inspections.
Nutrition ranks highly when it comes to the healthy living of older persons. A proper balanced and healthy diet for older persons contributes greatly to their wellbeing and quality of life. During the course of the interaction with older persons it has been noted that many consider the intake of vegetables and fat free or low fat meals is ideal in maintaining their good health. It was however also further noted that many of these older persons do not have a source of income to buy the foods they need, and neither do they have gardens at their residences.
- Building model farms to share with other communities
- Educating communities on the importance of nutrition
- Every family should have a small garden
- Everyone should plant bitter greens like Nakati, Gobbe, Katunkuma
- A tree in every garden
- Come back to the traditional way of cooking
- Do not over cook food it kills the value in it
- Do not use plastic bags when cooking
- Do not fry foods
- Encourage steaming instead of frying
- Cook foods without pealing like matooke, irish potatoes, sweet potatoes to lock in the food values
- Do not let food over stay in the fridge
- Every home should at least have one or two chickens because they can provide at least an egg a day and do not require large spaces to rare them as opposed to larger animals like goats and cows
EXERCISE AND ACTIVE LIVING
Exercise is vital to the health and wellbeing of both older persons and the youth. In our work with older persons we have found that many older persons are willing to improve their fitness however their bodies no longer respond as they did in the past. There is therefore a need to start slowly introducing age appropriate exercises and the proper support to build fitness in older persons. Older persons developed strategies to start the active living process, identified their values and unique qualities that enable them to start the process of building exercise into their lifestyle and these will be discussed below
- Commitment to creating time to work out – before every group meeting
- Commitment to frequent morning walks
- Use of household chores as a form of work out
- Support from local leaders to guide groups through this process
- willingness to support each other through visits and support
- Support from youth who are involved with older persons to provide support in exercises, massages, and taking invalids out for sunlight
REGULAR HEALTH CHECKS
In the development of strategies and potential prototypes for healthy and active living older persons in the communities’ ideas revolved around being physically healthy. To achieve this there was an overwhelming call for age appropriate treatment at hospitals, age friendly constructions and facilities, personnel who were conversant with issues concerning older persons like geriatric doctors and nurses, community based health providers for immediate first aid and monitoring like the village health teams. Health care for older persons is paramount in ensuring good living and the following values, strengths, priorities were set
- It is important to set personal and group priorities and targets regarding healthy living and ensure they are met
- Groups should continue to have regular meetings and health checks should be on the agenda
- Increase advocacy on the plight of older persons until their voice is heard and action taken. This can be done with medical personnel, doctors, VHTs, Ministry of health officials.
- Identification of vulnerable older persons in need of immediate support and health
- Health needs to support and advocate for health issues among older persons