A report of a midwifery model for training traditional midwives in Guatemala

Foster, Jennifer; Anderson, Angela; Houston, Jennifer; Doe-Simkins, Maya

doi:10.1016/j.midw.2004.01.004

Cited by 20 publications

(7 citation statements)

References 6 publications

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“…A TBA training program in Guatemala found that respecting TBAs as authoritative sources of knowledge and incorporating traditional practices and beliefs into training sessions improved the acceptability of the training sessions. In addition, a non-hierarchical structure was established between biomedical personnel and TBAs based on mutual trust [18]. A review of intercultural health programs in Guatemala, Suriname, Chile, Colombia and Ecuador also found that collaboration, respect for indigenous practices, and integration of the indigenous community into the health centers are essential for success and acceptance of the program [19].…”

Section: Discussionmentioning

confidence: 99%

The acceptability and feasibility of an intercultural birth center in the highlands of Chiapas, Mexico

Tucker

Ochoa

Garcia

et al. 2013

BMC Pregnancy Childbirth

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BackgroundAn intercultural birthing house was established in the Highlands of Chiapas, Mexico, as an intervention to reduce maternal mortality among indigenous women. This birth center, known locally as the Casa Materna, is a place where women can come to give birth with their traditional birth attendant. However, three months after opening, no woman had used the birthing house.MethodsThis study reports on the knowledge, attitudes and practices related to childbirth and use of the Casa Materna from the perspective of the health workers, traditional birth attendants and the program’s target population. Structured interviews, in-depth interviews and focus group discussions were conducted with participants from each of these groups. Data was searched for emerging themes and coded.Results and conclusionsFindings show that the potential success of this program is jeopardized by lack of transport and a strong cultural preference for home births. The paper highlights the importance of community participation in planning and implementing such an intervention and of establishing trust and mutual respect among key actors. Recommendations are provided for moving forward the maternal health agenda of indigenous women in Chiapas.

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Section: Discussionmentioning

confidence: 99%

The acceptability and feasibility of an intercultural birth center in the highlands of Chiapas, Mexico

Tucker

Ochoa

Garcia

et al. 2013

BMC Pregnancy Childbirth

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“…TBA-related interventions in Guatemala have historically focused on one of three areas: training of TBAs, integrating TBAs into public hospitals and most recently, the provision of culturally-appropriate services by including TBAs as health providers in clinics. Myriad institutions both local and foreign have provided training and support to TBAs; however, the results of these efforts have been mixed [18-20]. Furthermore, there are many gaps in the literature as far as how TBAs have been trained, methods used and actual program results.…”

Section: Introductionmentioning

confidence: 99%

A matched pair cluster randomized implementation trail to measure the effectiveness of an intervention package aiming to decrease perinatal mortality and increase institution-based obstetric care among indigenous women in Guatemala: study protocol

Kestler

Walker

Bonvecchio

et al. 2013

BMC Pregnancy Childbirth

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BackgroundMaternal and perinatal mortality continue to be a high priority problem on the health agendas of less developed countries. Despite the progress made in the last decade to quantify the magnitude of maternal mortality, few interventions have been implemented with the intent to measure impact directly on maternal or perinatal deaths. The success of interventions implemented in less developed countries to reduce mortality has been questioned, in terms of the tendency to maintain a clinical perspective with a focus on purely medical care separate from community-based approaches that take cultural and social aspects of maternal and perinatal deaths into account. Our innovative approach utilizes both the clinical and community perspectives; moreover, our study will report the weight that each of these components may have had on reducing perinatal mortality and increasing institution-based deliveries.Methods/DesignA matched pair cluster-randomized trial will be conducted in clinics in four rural indigenous districts with the highest maternal mortality ratios in Guatemala. The individual clinic will serve as the unit of randomization, with 15 matched pairs of control and intervention clinics composing the final sample. Three interventions will be implemented in indigenous, rural and poor populations: a simulation training program for emergency obstetric and perinatal care, increased participation of the professional midwife in strengthening the link between traditional birth attendants (TBA) and the formal health care system, and a social marketing campaign to promote institution-based deliveries. No external intervention is planned for control clinics, although enhanced monitoring, surveillance and data collection will occur throughout the study in all clinics throughout the four districts. All obstetric events occurring in any of the participating health facilities and districts during the 18 months implementation period will be included in the analysis, controlling for the cluster design. Our main outcome measures will be the change in perinatal mortality and in the proportion of institution-based deliveries.DiscussionA unique feature of this protocol is that we are not proposing an individual intervention, but rather a package of interventions, which is designed to address the complexities and realities of maternal and perinatal mortality in developing countries. To date, many other countries, has focused its efforts to decrease maternal mortality indirectly by improving infrastructure and data collection systems rather than on implementing specific interventions to directly improve outcomes.Trial registrationClinicalTrial.gov,http://NCT01653626.

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“…Limited Spanish literacy skills are a common problem in the rural areas of Guatemala. Foster, Anderson, Houston, and Doe‐Simkins () encountered difficulty during midwifery training in Guatemala with data collection instruments that required documentation. Their study suggested that the documentation tools would hold promise with midwives who had basic literacy in Spanish.…”

Section: Discussionmentioning

confidence: 99%

Implementation of a Training Program for Low‐Literacy Promotoras in Oral Rehydration Therapy

Amerson

Hall-Clifford

Thompson

et al. 2014

Public Health Nursing

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Objective The purpose of this study was to ascertain the effectiveness of a culturally appropriate promotora training program related to oral rehydration therapy and diarrheal management. Factors that influenced the development, implementation, and evaluation of the program provided to low-literacy women in Guatemala are explored. Design and Sample Promotora training was conducted with 15 Mayan women from a rural community in the highlands of Guatemala. Women were selected by leaders of the community to participate in the program. Measures Quantitative data were collected and analyzed to determine descriptive statistics and reliability coefficients for the pretests and posttests. A non-parametric Wilcoxon test for paired-samples was conducted. The qualitative data from the program evaluations were analyzed for themes. Results Mean scores increased from 41.73 (sd = 9.65) to 70.33 (sd = 21.29) on the pretest and posttest. The Cronbach’s alpha was 0.54 on the pretest with 0.65 on the posttest. The Wilcoxon test demonstrated a significant difference between the pretest and posttest scores (Z = 3.040, p < .05). Conclusions Extremely low literacy levels played a major role in the ability of the women to successfully complete the requirements of the training program. The curriculum demonstrated effectiveness, but will benefit from replication with a larger sample.

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A report of a midwifery model for training traditional midwives in Guatemala

Cited by 20 publications

References 6 publications

The acceptability and feasibility of an intercultural birth center in the highlands of Chiapas, Mexico

The acceptability and feasibility of an intercultural birth center in the highlands of Chiapas, Mexico

A matched pair cluster randomized implementation trail to measure the effectiveness of an intervention package aiming to decrease perinatal mortality and increase institution-based obstetric care among indigenous women in Guatemala: study protocol

Implementation of a Training Program for Low‐Literacy Promotoras in Oral Rehydration Therapy

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