[Tagging] Adding values healthcare=dispensary and healthcare=community_care?

[Mario Frasca]

Hello everybody.

thank you Claire for alerting the Telegram group 'OSM Africa Tagging' 
about your message on this list!

I forwarded your invitation to the groups América Central, LatAm, 
Panamá, and Colombia.

yesterday we had a look at the typologies that exist from an official 
point of view here in Panamá, and at the lower end of the range there's 
indeed facilities that don't match the amenity=[clinic|doctors] nor any 
healthcare values.

the three low-range facilities are called: "Puesto de Salud", "Subcentro 
de Salud", and "Centro de Promoción de Salud".  I've never seen one of 
them, personally speaking, I'm just interpreting the information at 
http://www.minsa.gob.pa/cartera-salud/cartera-de-servicio-por-nivel-de-atencion 
and asking local people for help understanding what I'm reading.

The "centro de promoción" does not offer any other support but by 
education and communication.  allegedly: "Organización comunitaria, 
Participación Social, Educación y comunicación para la Salud."  
supposing they do exist and they do provide the service, I would not 
know how to tag these.

Subcentros and Puestos are for remote areas reachable only with 
difficulty in the dry season.  there's quite a few communities here 
which can only be reached by boat via rivers, possibly on foot after 
leaving the boat.  these Puestos and Subcentros have respectively a 
'ayudante o asistente' de salud, and a 'Auxiliar de Enfermería (Técnico) 
o Enfermera permanente'.  I'm not sure, but to me an 'ayudante' sounds 
like someone from the community having received some minimal training, 
while the 'Técnico/Auxiliar' is a graduate professional.  these 
locations are periodically visited from the Centro from which they 
depend.  "many" of these places (la gran mayoría de los casos) only 
exist on paper, and are abandoned, or only used as storage for goods 
unrelated to healthcare.  (when I asked at the local Centro de Salud, 
the doctor made a call to the administration to check his knowledge, and 
confirm which of the dependencies were in function.  I got the idea it's 
quite volatile information.)

summarizing, to represent the lower end of the Panamanian healthcare 
facilities, apart from the mentioned proposed new categories: 
healthcare=nurses (technicians/engineers), and healthcare=community_* 
(stagists/capacitated/?), we als need to tag the periodicity of the 
extra presence, and the prevention/education/information function.

I hope we will have an extended definition: we can use it here,

thanks again.

Mario

On 19/05/2020 10:14, claire.halleux at hotosm.org (Claire Halleux) wrote:
> Hello,
>
> This message follows previous discussions that took place in Africa Tagging
> Telegram group and on talk-cd list related to (missing) tags for mapping
> rural healthcare facilities.
>
> A dispensary ("dispensaire" or "poste de santé" per DRC local names)
> matches the following definition extracted from Wikipedia: "a dispensary is
> a small outpatient health facility, usually managed by a registered nurse.
> It provides the most basic primary healthcare services to rural
> communities, e.g. childhood immunization, family planning, wound dressing
> and management of common ailments like colds, diarrhea and simple malaria.
> The nurses report to the nursing officer at the health center, where they
> refer patients with complicated diseases".
>
> In the DRC, the mapping of dispensaries has been mainly using
> health_facility:type=dispensary tag from abandoned proposal healthcare 2.0
> for the last 2 years. Most of the involved mappers would now like to switch
> towards a more consistent tagging scheme (that would hopefully also be
> rendered on carto at some point).
> What are your thoughts about adding the value "dispensary" in the wiki to
> the healthcare key to map these places?
>
> Additionally, despite dispensaries, a number of rural areas are still out
> of reach of any regular healthcare provider. Therefore the Ministry of
> Public Health in the DRC also recognized and organized community healthcare
> provided by trained volunteers from the communities (these places are
> called "sites de soins communautaires"). These places have a particular
> focus on deadly diseases affecting children, they include prevention,
> health promotion and curative activities. Since these don't even have a
> single nurse as staff, I would like to propose a separate value such as
> healthcare=community_care or community_care_site.
>
> Regards,
> Claire
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