Maternal mortality in Guatemala is 210 per 100,000 live births, but this belies huge regional variations – believed to be over 400 in some areas of the highlands. Approximately 65% of the maternal mortality takes place during the postpartum period; however, this is the most neglected period, by both institutional and community health providers. In the highlands, among indigenous populations, coverage is estimated at less than 10% for postpartum care. In view of this challenge, CARE Guatemala designed a postpartum pilot project, in partnership with the Ministry of Health. The project goal is to increase utilization of postpartum care services at the community and institutional levels. The two specific objectives are: to strengthen the postpartum care component of the MOH/SIAS model; and, to improve knowledge and practices of traditional birth attendants (TBAs) and women regarding postpartum care. After over a year of project implementation, MOH auxiliary nurses clearly improved their technical capabilities in diagnosis/ treatment of complications including postpartum sepsis, neonatal sepsis and low birth weight/premature babies. Utilization of MOH postpartum care improved beyond expectations from 7.5% initially to 39%. Impressive results were also noted at the community level. Previous to project implementation only 1% of all women who received postpartum care by a MOH health provider were referred by TBAs; however, one year later this was increased to 20%. Thus, demonstrating that involving the community, especially community health workers, in improving practices and quality of health care services, utilization of even the most underutilized services can be dramatically increased.
Learning Objectives: At the conclusion of the session, the participants will be able to: 1) Identify at least 2 key community interventions that influenced an increase in postpartum care coverage in the Verapaz regions of Guatemala 2) Describe how and why the use of an integrated MCH/RH algorithm by the Ministry of Health personnel improved postpartum care coverage at health centers and health posts 3) Articulate the importance of the role of traditional birth attendants (TBAs) in increasing women´s use of timely and quality postpartum care in rural indigenous areas of Guatemala.
Keywords: Maternal Care, International MCH
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: This presentation is based on the findings of a pilot project carried out by CARE in Guatemala. THe funding for the project comes from USAID and the European Union.
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: Employment and grants