Community Health Strategy

Assignment 1: Community Health Strategy

Advance practice nurses can be found in every aspect of the health care field including out in the community. Advanced practice nurses not only care for the client but all aspects that surround their clients. In this assignment you will focus on promoting the health of the community. You will choose a topic concerning womens health. In a 5 to 6 page APA formatted paper you will create and discuss a community health promotion that pertains to your topic. Make sure to:

1. Identify your chosen topic and the demographic area and population that you are targeting.

2. Discuss why this topic is important to this group (include background information) with references.

3. Use one community based health promotion model.

4. Discuss how this model was used in the creation of this community health promotion strategy.

5. Include your community health promotion strategy.

Assignment Requirements

The finished Assignment should be 5-6 page Analytical essay, encompassing all required items listed. The viewpoint and purpose of this Assignment should be clearly established and sustained.

Community Health Strategy of Caring for Women with Obstetric Fistula in Southern Tanzania


Obstetric Fistulae (OF) comprises of recto-vaginal and vesicovaginal fistula. It is always associated with the development of a fistula (hole) between the vagina and the rectum or the vagina and the bladder. This morbidity often arises from prolonged labor without proper medical attention such as caesarean at the time of childbirth. According to the world Health Organization (WHO), between 50,000 and 100,000 women are noted to develop obstetric fistulae annually and above 2 million women live with it currently (Capes, 2011). The greatest proportions of women who suffer from this condition live in the South Asia and sub-Saharan African countries. In the developing countries such as Tanzania, the reported OF’s aetiology include malignancy, surgery, coital injury and radiotherapy alongside neglected foreign bodies. In developing nations, prolonged labor pains have been noted to be the central cause of obstetric fistulae. The underlying agents of obstetric fistulae, in sub- Saharan Africa region such as Southern Tanzania (Mtwara region), include poverty, childhood, malnutrition and young maternal age during delivery. In addition, health-seeking behavior and genetic illnesses have also been linked to OF (Schwartz, 2013). One of the models that nurses can use to solve this problem is the organizational development model through the formation of community women groups in Mtwara region.
Southern Tanzanian (Mtwara region) Population and Demographic

Mtwara region is situated in the southeast part of Tanzania and borders Mozambique. This region comprises six districts, which are Newala, Namtumbo, Masasi and Tandahimba. Mtwara urban and rural also constitute parts of this region. Each of these districts has a hospital with the exception of Namtumbo and Mtwara rural districts. Besides, there is a mission hospital, in Masasi, that acts as a referral hospital alongside a regional hospital, which is located in Mtwara regional headquarter. In relation to the information issued by the nation’s ministry of health, there are 163 dispensaries and 16 health centers that serve the community at the primary health care level. The districts have been noted to have a 175, 468 women who are at their reproductive age (15-49 years). This figure represents 25.7 % of the population that is found in Mtwara region (Capes, 2011).

Mtwara region is associated with low fertility maternal indicators. For instance, the area registers an overall fertility rate of 4.8 against that of the rural national statistic that is 6.5. In Mtwara region, 37.6 % of women who are expectant obtain professional health aid in comparison to 46.3%, which is the national figure of women in the same condition (Capes, 2011). This low percentage is linked to high poverty level that the Mtwara community faces. In most situations, women are forced to seek help from traditional midwives when they want to deliver. Thus, this contributes to prolonged labor pains since the midwives often lack adequate skills and knowledge to handle expectant women efficiently.

Poverty has been noted to be the leading cause of obstetric fistula in this region. This is because it affects many aspects of the human’s life such as education, nutrition alongside maternal health care (Schwartz, 2013). Furthermore, poverty has also been linked with the issue of early marriages in this region. The mentioned effects of poverty have a direct contribution to the problem of obstetric fistula.

It has been noted that high poverty levels lead to low educational levels among women who are impoverished in relation to maternal health. The lack of information alongside other factors, which hinder women from travelling to hospitals, lead to women arriving at processes of birth without perinatal care (Schwartz, 2013). Therefore, this leads to the development of complications during childbirth, which causes obstetric fistula.

The high level of malnutrition, in this region, makes poverty a leading cause of obstetric fistula. Many families lack adequate finance to obtain proper nutrition in the Mtwara region. This makes most women vulnerable to diseases since they lack mechanisms of preventing them (Schwartz, 2013). Furthermore, malnutrition subjects women to stunted growth that leads to complication during delivery.

Lack of quality maternal health has also been linked to high poverty levels in this region. Poverty prevents women from obtaining usual and emergency obstetric treatment car because of expensive procedures and long distances (Swartz, 2013). Thus, many women seek help from the traditional attendants, which leads to delay in obtaining obstetric care.

Many girls have also been noted to engage in early marriages that lead to early childbirths. The main cause of early marriages is economic challenges that most families face in the Mtwara region. This makes marriage the remaining options to girls that come from disabled families. Such girls often develop complications during childbirth due to their high risk of obstructed labor. Research has noted that young women who are malnourished due to poverty have under-developed pelvises (Schwartz, 2013). This acts as the significant cause of obstructed labor that is associated with them.

Significance of the Strategy in Solving the of Problem in Southern Tanzania (Mtwara region)

Obstetric fistulae often subjects women to immense pain and suffering and they always find it unbearable. Some of its symptoms include pain during the sexual act, vaginal irritation, repeated urinary tract or vaginal infections and a vaginal discharge that has a foul smell among others. In the developing nations, women who experience obstetric fistula always lack full agency over their households and bodies. This makes their husbands or other family members determine the healthcare that they need to obtain. For instance, they may decline the help from a male medical expert while a female medical expert may be unavailable (Schwartz, 2013). This subjects the patient to lack of perinatal care that leads to obstetric fistula.

Formation of community groups for women ensures that women obtain adequate knowledge on maternal health issues and how handle obstetric fistula. It also enables women to obtain financial aid from the groups, which can be used to cover for transportation and perinatal care expenses. This strategy, therefore, will the Mtwara women from far-reaching effects of obstetric fistula, which extend to social, physical, psychological and economic dimensions.
Organizational Development Model and its Role in the Creation of Community Group Strategy

Health promotion refers to the process that grants people the ability to have full control over their health. It aims at helping a group or an individual attain a state of full mental, physical and social well-being. This is achieved when individuals or groups a have the ability to recognize and realize aspirations, meet their needs and change in relation to the environment (Parrill, 2011). Organizational development model ensures that the social set-up of a community is transformed through financial and academic empowerment. This helps in eliminating barriers such as poverty and lack of information that contribute to obstetric fistula.

Organizational development acts as suitable mechanism of creating community group strategy, which is targeted towards empowering the southern Tanzanian women financially and academically. The model helps in transforming the region’s social set-up so that both the expectant women and OF infected women can have full control over their lives. This is achieved through the information and financial aid that these women can obtain from their groups.

My Community Health Promotion Strategy of Caring for OF Women in S. Tanzania

The strategy of forming women groups targets varying scales. This strategy may be directed to local communities, individuals and states. It aims at providing health information to the public through the nurses and mass media. The strategy focuses on improving the lifestyle and behavior of individuals in the Mtwara region. One of the method that is used to facilitate this strategy is dealing with a small population that is vulnerable obstetric fistula (Deguzman, 2012). Southern Tanzania is a significant region, therefore, focusing on Mtwara area will help in empowering the whole of Southern Tanzania in relation to fistula prevention. This is because a behavioral change, in a small group, often leads to the behavioral change in a large group.

According to this strategy, women are encouraged to form small groups that are assigned with nurses or agents. These agents ensure that they educate women concerning maternal health issues, and the significance of seeking prenatal care from hospitals prior to childbirth (Parrill, 2011). They also educate the women infected with OF on how they can live. The nurses can also be granted the responsibility of attending to expectant women who live in areas that are located far from the hospital and dispensaries. This ensures that all expectant women are granted equal maternal care. Moreover, the groups can also be encouraged to form income generating activities such through contributions of little income that can be used to fund these projects. Some of the projects include poultry rearing and farming that helps in the alleviation of high poverty levels. Mass media such as local radio stations can also be used as means of conveying information on maternal health to those in rural regions. This strategy is significant to the southern Tanzanian women because it ensures that they gain both academic and financial empowerment, which is crucial for handling obstetric fistula.

In conclusion, the organization development model can be used an efficient means of handling the problem of obstetric fistula in Southern Tanzania. This can be facilitated through the formation of women groups, which act as sources of academic and financial empowerment to them.


Capes, T; Brodman, M. (2011). Obstetric Fistula in Low and Middle Income Countries. Mount Sinai Journal of Medicine, 78(3) 352-361

Deguzman, B; Kulbok, A. (2012). Changing Health Outcomes of Vulnerable Populations through Nursing’s Influence on Neighborhood Built Environment: A Frame Work for Nursing Research. Journal of Nursing Scholarship, 44(4) 341-348

Parrill, R; Kennedy, R. (2011). Partnerships for Health in the African-American Community Moving Toward Community Based Participatory Research. Journal of Cultural Diversity, 18(4) 150-154    

Schwartz, A. (2013). Challenges in Improvement of Perinatal Health in Developing Nations. Archives of pathology & Laboratory Medicines, 137(6) 742-746