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Community health representative: The first tribally contracted program, since 1968 - American indian paraprofessional healthcare providers


Accomplishments and awards

Navajo Public Health Workers Receive Certificates

By Staff Reports
Story Published: Jun 18, 2009
Story Updated: Jun 18, 2009

The UA Mel and Enid Zuckerman College of Public Health at The University of Arizona in Tucson and Diné College, a Navajo tribal college in Tsaile, Ariz., awarded the first Certificates in Public Health to nine Native American students during a May 7 commencement ceremony at Diné College.

These certificates mark an academic achievement that has been more than seven years in the making for both colleges. The nine students are community health representatives for the Navajo Nation.

Navajo CHRs are important health care workers who live and work in the Navajo community and provide the tribe’s citizens with hands-on care and information on current medical topics and staying healthy. As full-time, paid employees of the Navajo Nation government, CHRs help meet the need for increased basic health care and instruction in Native American homes and communities, greater involvement in their own tribes’ health programs and more participation by Native Americans in identifying and solving their health problems.

CHRs are a “widely recognized and widely appreciated personnel whose function is to get the health care knowledge and education out into the community,” said Dr. Ed Garrison, a faculty member at Diné College since 1983. Garrison’s academic background includes degrees in biology, anthropology and public health – a combination he considers ideal for his work among the Navajo people. He also worked to establish the public health program at Diné College in 1998.

Navajo health workers
Pictured from left, are Ed Garrison, MD, Diné College; Ferlin Clark, EdM, president, Diné College;
Doug Taren, PhD, associate dean for academic affairs,College of Public Health;
Jacqueline Jim-Shorty, Diné College student and Community Health Representative receiving her Certificate in Public Health

CHRs serve as professional health personnel who stay up-to-date on public health issues that affect the Navajo. For example, with the current swine flu cases spreading, Garrison said CHRs are out in the Navajo community explaining the situation and teaching people how to protect themselves.

“CHRs are the first-line responders, whether it’s swine flu, a weather emergency or a forest fire. They are the ones out there in the community, knowing what is going on and what people are thinking and feeling.” CHRs function as the “eyes and ears of the federal government, tribal health system and Navajo Nation,” educating the tribe about health care issues and communicating health care information from the tribal members to their government.

This new certification is a “stepping stone” for CHRs and shows that each has taken the 12 college credits which cover the basics of public health. These college hours may be used later as the foundation for a two-year associate’s in public health degree or a four-year bachelor’s of science in public health degree from Diné College.

Navajo health workers
Pictured in the front row, from left, are Ed Garrison, MD, Diné College;
Jolanta Billey, Anita David, and Meria Miller-Castillo, Diné College students and Community Health Representatives who received Certificates in Public Health;
and Doug Taren, PhD, associate dean for academic affairs, College of Public Health.
Pictured in the back row, from left, are Mark C. Bauer, PhD, Diné College; Jacqueline Jim-Shorty, Diné College student and CHR who received a certificate;
Mae-Gilene Begay, program director, CHR/Outreach Program, Navajo Nation Division of Health; and Madan Poudel, PhD, Navajo Nation Division of Health

For CHRs already employed by the Navajo, the federal government contract for their scope of work now specifies that they must complete the certification within a reasonable amount of time.

Credit hours ensure that CHRs have the same knowledge base and that they have successfully completed an overview of public health. These community members and background first responders now have the opportunity to integrate all their health care experience into a public health perspective. This particular joint certification program is tailored to the Navajo Nation’s public health needs and concerns. Presenting this information in a culturally appropriate way is part of the work of CHRs in the community.

For more information about the Certificate in Public Health, visit the UA Zuckerman College of Public Health Web site or contact Lorraine Varela at (520) 626-5664, or

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