The Navajo Health Authority is a nonprofit health organization established in June of 1972 by the Tribal Council, as the legal entity of the Navajo Tribe. One of the Navajo Health Authority's primary goals includes support, guidance and assistance in the planning, development, operation, and evaluation of a health service for the Navajo people. The purpose of this study was to suggest ways of improving the health status of the Navajo people through modification and expansion of various services. Six general areas of concerns were identified: 1) identify the services that the selected project sites provided to the Navajo population; 2) identify Navajos who will receive these services and also identify the group characteristics; 3) identify the mechanisms employed by these four project sites in delivering personal health services to the Navajo consumer; 4) identify the cost of delivering personal health services by the type of service; 5) ascertain whether the consumers are satisfied with the services and care they are receiving; and 6) ascertain whether the consumers receiving services are satisfied with the kind of care being rendered in their institutions. The scope of the project was the evaluation of the four sites - Tuba City Hospital (Federal), Chinle USPHS Health Center (Federal), Monument Valley Seventh Day Adventist Hospital (religious), and Sage Memorial Hospital- Project Hope (Ganado-Voluntary). The approach used in this study was comparative analysis. The results were obtained from other projects and compared to the data collected in this project. Bilingual Navajo speaking college students were used to conduct the consumer survey. Random sampling was employed in the selection of respondents, consumers, and providers. A computer program was designed to provide a descriptive data framework, contingency table and graphs, from which chi-square and non-parametric statistical analysis were performed. Individual protocols were spot checked to verify the accuracy of the analyzed data. The findings were generalized and not intended to be definitive to a specific site. The data revealed numerous findings with regard to both mortality and morbidity. The highest mortality rate occurred in an area that did not have a hospital. The practitioners feel that there was a lack of adequate backup resources, manpower skills, and equipment. The motor vehicle accidents caused a high mortality rate because patient movement and transportation time plays a major factor in survival. Upper respiratory infections had the highest incidence in all four areas, with the highest rate at 641.5 per 1,000. The next three most serious diseases were gastroenteritis, acute otitis media and pharyngitis. The recommendations for a quality health program for the Navajo Nation varies in degreeaccording to the particular site that was evaluated; however, there are numerous general and vitalservices that must improve across the Navajo Nation. They are as follows: 1) safe water, air, and adequate waste disposal; 2) adequate housing and clothing; 3) nutritionally adequate food; 4) available health delivery systems that protect against contagious disease by immunization; 5) early detection and treatment of disease; 6) health education to prevent disease; 7) servicesrendered in a culturally acceptable way; and (8) reduction in distance to service sites.
Indian Health Service, Staff Office of Planning, Evaluation and Research, Rockville, MD 20857 (E-23).
Callan LC. Muneta A. Comparative study of health care delivery within the Navajo Nation: a summary report. Indian Health Service, Staff Office of Planning, Evaluation and Research, Rockville, MD 20857 (E-23). 1974