“Since Promotores(as) are farmworkers themselves, they are in a position to learn about health and pass it directly to other farmworkers for everyone’s benefit.”
Extension Specialist, Agricultural Safety and Health, University of Illinois at Urbana-Champaign
MHP Salud’s approach to improving health is to support community members — Promotores and Promotoras — who educate and advocate for change. These Promotores(as) are bridges between their communities and clinics, service providers and policymakers. They stand between two worlds and make the connections that reach people and change community health.
Promotores(as) produce results because they are:
Four basic and overlapping themes or philosophies inform the work of MHP Salud: social justice, community empowerment, systems change and Popular Education.
Social justice is an ideal that envisions a fair and moral distribution of resources, responsibilities, social benefits and opportunities in society. It includes the social, political, educational, legal, economic and basic human rights of people. In a socially just world, people enjoy respect, wealth, access to resources and other benefits regardless of their of religion, sect, belief system, gender, color, caste or social status. While we recognize the interrelatedness of these issues, the focus at MHP Salud is social justice regarding health issues for underserved communities.
“I learned and accomplished things I never thought I would.”-Cristina Ramos, Promotora
Achieving social justice requires strong communities that continue to develop their resources and assert their rights in society. Empowerment of a community occurs when its members attain the tools necessary to increase their personal, interpersonal, socioeconomic and political strength and improve their circumstances. MHP Salud supports underserved community members in their struggle to empower and strengthen their communities. As members of these communities, Community Health Workers inspire, work with and organize others to accomplish collective goals.
Community Health Workers and their programs and advocates are more effective when they address the root causes of poor health and related problems. MHP Salud takes a holistic view of health issues and works with the community to improve the systems and conditions that affect peoples’ lives – whether they are clinic policies, workplace rules, camp and neighborhood environments or public policies. MHP Salud works to change the circumstances, processes and practices that have resulted in poor health for underserved and/or isolated communities and to improve health and human rights for generations to come. Further, such an approach reinforces the importance of multilevel or ecological frameworks in creating significant health improvements among traditionally underserved populations.
To attain the goals of social justice, community empowerment and systems change it is essential to integrate the skills, talents and wisdom of all those affected, regardless of their level of formal education. Popular Education is a philosophy and methodology that helps people learn new skills, become more aware and create more just and equal societies. Paulo Freire, a Brazilian, developed Popular Education to help poor farmers learn to read and write. Popular Education has been successfully used in many fields around the world, including health education.
MHP Salud’s first Promotor(a) program was inspired by David Werner’s Village Health Worker model, which is based on Popular Education and defines good teaching as “the art, not of putting ideas into people’s heads, but of drawing ideas out.”2 With that definition in mind, MHP Salud uses a wide variety of interactive teaching methods including brainstorming, theater, group discussions, song, art, problem posing, dance and games. The Promotores(as) learn from their own and others’ experiences, discover new information, practice their skills and take action to change their communities.
(1) Werner, D. & Bower, B. (2001). Helping health workers learn. Berkeley, CA: Hesperian Foundation.
(2) Wiggins, N. (2002, January). Introduction to Population Education. Paper presented at the 13th Annual West Coast Migrant Stream Forum, Seattle, WA.