Southern NM Promotoras
Every day a Promotor or Promotora is responding to the needs of someone in their community. In Southern New Mexico these individuals, both male and female, are trusted members of the communities they serve. They are also known as Community Health Workers (CHWs) or Community Health Representative (CHRs) in tribal communities. Many live in the same communities as they serve and have a unique understanding of the issues they face. They share the same language and cultural values. They are the bridge that connects individuals, families and communities to services that, for various reasons, they do not have access to.
Some promotoras are working for agencies that provide clinical services, while others work for social service agencies. Some promotoras are independent and volunteer their time. What they have in common is their desire to help and improve the lives of their neighbors. They serve as advocates for their communities and empower individuals to become involved in indentifying solutions for improved living conditions and health outcomes. They teach and support families to understand the importance of prevention and managing chronic diseases. Historically their focus has been maternal and child health, diabetes, hypertension and disease prevention.
However, most promotoras now have a much broader scope of work. They may also provide care coordination, provide transportation to access health care services, health screenings, translation services, assist with immigration issues, food insecurity, substandard housing, community infrastructure needs, make referrals or provide information about depression, domestic violence and/or drug abuse counseling. Many health agencies employ promotoras to reach the population that do not seek care on their own or are unfamiliar with navigating the health care system. It is important to recognize that untreated health conditions of an individual or community affect all of us either by direct contact or by economic impact.
Many promotoras conduct home visits and are able to make assessments and recommendations that would not happen without being in the home to see firsthand the needs of the individual or family. The relationship that develops is different and more personal than what may occur in an office setting.
Many of us can remember an individual in our own neighborhoods that everyone went to for advice on which doctor to see or how to get help with paying for utility bills or for a child that was having difficulty in school. Perhaps that person was simply a good listener. That person in essence was a promotora. He or she was a trusted neighbor, who having had similar experiences did not pass judgment but tried to find a way to help.
Promotoras receive trainings to increase their skill level in assisting individuals, families and communities. These trainings are offered through various venues by health clinics, Area Health Education Centers, Community service agencies, and academic institutions or professional community organizations. There are also several promotora networking groups across the state that bring in trainers to provide specialty trainings on topics such as heart health, Asthma, Cancer and other topics that may be requested by the promotoras themselves.
This past legislative session Senate Bill 58, “The Community Health Workers Act” sponsored by Senator Mary Kay Papen and Representative Doreen Gallegos was passed by the legislature. It gives the New Mexico Department of Health the authority to implement statewide voluntary certification for community health workers. As part of this initiative a standardized core competency curriculum is being developed to provide additional training for promotoras to better serve their community. The passage of this bill acknowledges the value and contributions of the promotoras to reducing health disparities and overall improved health outcomes for communities.
A typical day for a promotora may include a home visit to an individual that neighbors have told her is not feeling well. As this individual knows the promotora, either because she lives in her community or the promotora has helped her before, she is comfortable with her and welcomes her into her home. The promotora inquires how she is feeling and finds out the women has diabetes. They discuss healthy eating for diabetics and the importance of taking the medication as prescribed. She finds out that there is limited food in the house and that the woman does not understand the directions on how to take her medication. The promotora reads her the label and explains how to take her medication. She lets her know what programs are available for food assistance and asks if she wants her to set up appointments for her.
She finds out that she does not have transportation and she has missed her follow-up appointment with her medical provider. The promotora offers to take her to the appointments and also that she can accompany her to her appointments.
The promotoras not only help others, they also serve as a support system for each other. The Southern New Mexico Promotora committee is a grass roots organization that provides a venue for promotoras to network and share ideas on how to better serve their communities. They also arrange for training on various topics and services available to the community. Promotoras from all areas of the southern part of state are invited to attend.