Life Abundant Primary Health Care(LAP)
The LAP ministry began in the later months of 1979 in the Mbem field area following approval by the thenCBC Medical Board to begin a six months pilot project enabling underserved communities to have and to share abundant life and health. It was born out of a deep awareness of and concern within the heart and mind of Sister Daphne Dunger for the observed, expressed, and felt needs of many disadvantaged people living far from the few existing Medical facilities. In 1980 the first 8 LAP Promoters (Village Health Workers, VHCs) and their respective Village Health Committees were trained for the 4 Communities that were able to take hold of the opportunity to have health care in their own villages. The concept of having comprehensive Primary Health Care that was affordable, community owned and sustainable while also being appropriate for each community and which addressed the needs of the Whole person, quickly spread to other communities and continues to do so today. More than 50 Primary Health Centres (PHCs) function in 5 of Cameroon’s 10 Regions while a good number have been upgraded to Integrated Health Centres (IHCs).
In 1984 Sister Ruby Eliason joined Sister Dunger in the Administration and educational activities of the LAP Program together with the gradual addition of Nurse/Pastor Field Coordinators. These six people lived and shared everything in common with the people in the LAP villages. By the 1990s a few of the LAP Promoters advanced to Field Assistants and then later on to Field Coordinators. Other Field Coordinators (now known as Field Supervisors) gradually were added. About the same period, in line with the Cameroon government’s latest plan for Primary Health Care the position of LAP Posts changed. The policy now was that each Integrated Health Centre (IHC) would be responsible for the Primary Health Centres (PHCs) (previously known as LAP Posts) in its area. The Field Supervisors were then posted to the Integrated Health Centres. At moment they are based at the PHCs. The training of birth attendants also became an important part of targeting the care of child-bearing age women (15-44) and their children, especially those under 5.Antenatal Clinics, Under-5 Clinics, and Safe delivery for pregnant mothers. These services became a major part of the health Care work in the communities from the late 1980 onward, with the added expertise of Dr. Laura Edwards and Sister Myrna Goodman to develop a practical and sound MCH (Mother-Child Health) program for the villages. The goal was and is to reduce Maternal and Infant Morbidity and Mortality.
The commitment of the LAP Leadership and the Field Supervisors continues to embody the Truths of John 10:10 and Jeremiah 17:7-8 as LAP seeks to keep central the priorities of Christian growth and spirituality, Discipleship, and sharing the Good news of life Eternal in the Lord Jesus Christ throughout the various ministries of LAP. The Prime work of the Promoters, CoMCHAs, and PHC Nurses is to be teaching Health Promotion, Disease Prevention, Maternal Child Health, and Environmental Care. They also provide Medical Care and Treatment that addresses the Whole person. The Village Health Committees in a self reliant way continue to manage their respective PHCs, while being encouraged by their LAP Field Supervisors. The year 2001 saw the development of comprehensive Maternal Child Health care (MCH) services. All Primary Health Care village health workers are trained to recognize “at risk” mothers and refer them to secondary or tertiary health facilities.
Detailed information on the target group:
LAP covers over 50 villages with services for people of all age groups, sexes, religion, tribes, social and economical standing. Within the 11 LAP Health Areas, there are about 19 separate tribal groups with some areas having several dialects. Socio- economically, LAP communities are mainly rural people with fairly low literacy rates. They rely on subsistence farming, animal husbandry and group income generating schemes for their livelihood. Culturally, communities are different from one to the other though due to migration and settlement, and the heritage of certain groups, there are clear traces of cultural similarities. Basically all LAP communities have good potential for growth and development.
The Village Health Committee is usually made up of volunteers who are the more educated and elderly persons in the village and who supervise the organization and financial concerns of the PHCs.
The criteria for the selection of the target group/beneficiaries and made using pre- set ‘Priority Indicators’ and the recommendation of the Field Supervisor for that area.
LAP Management Committee (LMC):
The LAP Management Committee (LMC) is the management Board for LAP. It meets twice per year and comprises: Director of Health Services, CBC Field Director, BBH Administrator, Director of CIMS, President of CBTS Ndu, Principal of the Private Training School of Health Personnel (PTSHP), Representative of Chief of Centre, Nso Field Pastor, Representative of BGC Mission Board, LAP Administrator, LAP Supervisor of Education, LAP Accountant, LAP Bursar, LAP Field Supervisor Representative, and Local Community Representative. Other relevant and interested parties are invited to attend from time to time e.g. LAP Spiritual Development Supervisor.
Development and planning are done by a team made up of the Administrator, Systems Administrator, Supervisor of Education, Programme Analyst, Supervisor of Christian Development, and Financial Assistant
The Resource Pool (RP) meets two times a year and comprises: LAP Management Team that is all Field Supervisors and Field Assistants. Areas needing special expertise are covered by professionals from Health Board or other appropriate organizations both within and without CBC.
Management Team (LMT):
The LAP Management Team includes all of LAP Central staff plus community representation. They are the LAP Administrator ,LAP Supervisor of Education, Spiritual Development Supervisor, LAP Bursar ,LAP Accountant, Outreach Development Supervisor, Clinical Supervisor, MCH Services Supervisor, Family and Children Services Supervisor, Muslim Ministries Supervisor, Francophone Ministries Field Supervisor, PMTCT Field Supervisor, MTCT+ Field Supervisor , LAP Drivers, Field Assistants, Support and Hospitality & Security Workers, Village Health Workers and Family Health Visitors, Trained Birth Attendants (TBAs) Family Health Visitors and Village Health committee.
PMTCT SERVICES IN LAP SINCE 2005:
The Prevention of Mother to Child Transmission of HIV (PMTCT) program is one of the 11 components of the Cameroon Baptist Convention Health Services AIDS Care and Prevention program. It has been on going in 34 LAP villages. This program has continued to experience a rise in its activities. The Field supervisors together with staff in the coordination office carry out regular supervisory visits to the sites. Visits to the sites are usually on ANC days so that they have the opportunity to participate in counselling sessions and make corrections where need be. These Field supervisors take along drugs and test kits to replenish where necessary and withdraw supplies that are near expiry. HIV and AIDS Care and treatment have been added to be piloted in a few sites.
With the increase in the number of sites, we have shortage of staff and vehicles to carry out supervision. Some of the roads are bad and isolated thus hindering regular and effective supervision.
Treatment centres are still few compared to the HIV positive population and many clients do not have access to these sites either due to bad roads or lack of money for transportation.
Follow up of positive mothers and their children remain a challenge. Fear and stigma make some HIV positive mothers to deny follow – up at home.
Despite the motivation given to service providers, a lot of them still expect more than what the Program can afford and sustain.
Infant feeding still stands as a challenge as most mothers find it difficult sustaining their preferred method.
Most men are not willing to come with their wives to do the HIV test during ANC.