Bronx-based Community Health Worker Initiative Improves Women’s Health Knowledge and Access to Care

Evaluation of Grameen Promotoras Shows Highly Positive Results

New York, NY—An assessment of the Grameen Promotoras initiative in the Bronx found significant improvements in local women’s knowledge of health topics and access to health care. For the 470 women who participated in the second phase of the program, there was a more than 150 percent improvement in overall health perception, dietary intake, and physical activity. Participants in the program had a 41 percent greater knowledge of health-related topics than before. Of those who participated, there was a 45 percent increase in breast cancer screenings and 20 percent increase in cervical cancer screenings. The majority of the women in the program lack health insurance and are isolated from the mainstream health system, so Grameen Promotoras plays a crucial role in providing and connecting them to essential services.

Grameen Promotoras is a joint initiative between Grameen America and Grameen PrimaCare, supported by the Medtronic Foundation. The Promotoras initiative—which leverages Grameen America’s group-lending model and long-term relationships in the community—centers on community health workers (called promotoras), who provide basic health education to their peers at Grameen America’s weekly center meetings. The promotoras lead workshops on a different health or wellness topic each week and engage participants in interactive group discussions. In addition, the promotoras provide the women with basic health screenings, referrals for health services at existing local resources, assistance in scheduling necessary medical appointments, and support in navigating the city’s health system and attaining social services.

“We are thrilled with the results of the Promotoras initiative,” said Greg Mann, Executive Director of Grameen PrimaCare. “Our team has seen the impact the program is having on local women: how it is increasing their understanding of important health and wellness issues and helping them access critical services in their own communities.”

Over the course of the initiative, there were notable rises in access to care among the participants: those gaining a primary care physician rose by 31 percent, those obtaining medical appointments rose by 60 percent, those getting dental care rose by 127 percent, and those getting vision screenings rose by 143 percent.

Phase 2 of the initiative ran from September 2017–May 2018; the first phase took place September 2016–May 2017. Seventy-seven percent of participants reported being very satisfied with the program, and 90 percent said they learned a lot about how to take better care of their health. Grameen Promotoras has been implemented among some of Grameen America’s groups in the Bronx, during the next phase of the program, all Grameen America members in the Bronx will participate in the workshops. The program will then be expanded to all of Grameen America’s New York members and eventually its entire U.S. network.

Andrea Jung, President and CEO of Grameen America and Grameen PrimaCare Board Member, commented, "The innovative Promotoras initiative has allowed us to provide our members with services that address two critical aspects of their overall wellbeing—finances and health. The impressive outcomes we have seen in the first two phases of the program position us well as we look to scale this important health initiative and better serve members across the country."

The evaluation, which was conducted by Grameen PrimaCare, employed a quasi-experimental research design. MDRC provided technical advice throughout the evaluation.