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MNCH: Transforming Indigenous lives in Guatemala over the first six months

Raul Scorza blog

Raúl Scorza
Community Outreach and Communications Coordinator

In the Spring of 2016, Horizons embarked on the largest initiative it has undertaken to date: a four year, multimillion dollar project alongside its long-time Guatemalan partner, the Association for Health Promotion, Research, and Education (PIES), aimed at reducing the gaps in maternal, newborn and child health (MNCH) for Indigenous Maya K’iche’ peoples in Totonicapán, Guatemala. With the year’s end offering an opportunity to reflect on how this project has started to transform the lives of Indigenous women, children and families during its first six months, we invite you to read our latest blog post and learn how this transformation is taking place.

An essential component of the project rests on increasing MNCH service coverage to remote, predominantly Indigenous areas of Totonicapán. Given that approximately 70% of births in Totonicapán are attended by traditional Indigenous Maya K’iche’ midwives at the home, training and equipping these community-based care providers is an important step towards improving MNCH. PIES reports it has successfully recruited 40 traditional Indigenous midwives, all Maya K’iche’ women from six of the eight municipalities in Totonicapán, and has begun training them in updated, culturally-relevant MNCH best practices that include a focus on gender equality. This training will result in fewer maternal deaths as well as the early referral of high-risk pregnancies to formal health care services. After one year of training, these 40 traditional Indigenous midwives will then train another 1,000 traditional Indigenous midwives, upgrading the skills of virtually all traditional Indigenous midwives in Totonicapán.

Doña Esperanza

Doña Esperanza, one of the midwives recruited and being trained by PIES

137 community health promoters, all of whom are Maya K’iche, were also recruited by PIES. These promoters, key to family planning counselling and the early detection of high-risk pregnancy warning signs and prevalent diseases among children under five years old in Totonicapán’s rural Indigenous communities, were all exclusively recruited from municipalities with few to no health promoters. They, too, have begun to receive training in updated MNCH best practices with a gender equality focus during the first semester.

This initiative will not only train community-based care providers. It will also ensure current and future formal health sector staff possess knowledge of culturally-pertinent MNCH care, helping erode the discrimination Indigenous peoples often face at conventional health institutions. 220 medical and nursing students have started an educational module on traditional Mayan medicine and the Mayan view of health and illness, a module based on a training program developed by PIES and being delivered in collaboration with Guatemala’s University of San Carlos in Quetzaltenango. The module will be adapted for health care providers employed by the Ministry of Health and Social Assistance (MSPAS), which will culminate in an accredited Diploma on Culturally Pertinent MNCH care.

Further, more than 5,000 Indigenous women have participated during the first six months in over 70 women’s discussion groups revolving around MNCH best practices, including family planning, high-risk pregnancy warnings, exclusive breastfeeding, immunization and improved nutrition. Pregnant women, new mothers, mothers of children under five years old, and even in-laws (of important notice, as relatives like female in-laws may act as decision-makers in health-related choices such as seeking care in an obstetric emergency) have been part of these discussion groups. The fact that these figures have already surpassed the project’s first year target clearly shows the desire shared by Totonicapán’s Indigenous women for safe spaces to talk about the health and wellness of their children, their families and their own selves.

PIES health educator and Maya K'iche' woman with her family

The PIES health educator shows a Maya K'iche' family the "wheel of MNCH best practices"

The MNCH best practices described above are also being promoted by means beyond the discussion groups. A mass-media health communications campaign led by PIES has kicked off, with seven radio spots being released on Totonicapán’s airwaves to share information about topics including family planning, high-risk pregnancy warning signs and exclusive breastfeeding – both in the Spanish and K’iche’ languages.

Additionally, more than 1,000 household visits were carried out by PIES health educators in remote rural communities with some of the worst MNCH indicators in Totonicapán. Health educators continue to promote behaviours linked to better MNCH outcomes. When Horizons visited Guatemala to monitor and evaluate the progress of the project, Horizons staff accompanied one of these health educators on her household visits. An Indigenous Maya K’iche’ mother of four children, who was six months pregnant with her fifth child, narrated how she had gone for her first ever prenatal visit to a health centre after having been visited by a health educator. The woman, who was consulted exclusively in K’iche’ and said she had experienced complications in her previous pregnancy, would remain “on alert” for the high-risk pregnancy warning signs she learned about. This example, one of thousands, shows how responding to the MNCH realities in rural, Indigenous Totonicapán will directly lead to lives saved. 

First Canada-to-Guatemala Knowledge Exchange Team

Horizons staff and the first Canadian participants of the project's MNCH knowledge-exchanges

Work to share stories like that of the PIES health educator among Canadians, engaging with them in ways in which the importance of MNCH is made clear and cooperation between Canada and Guatemala to strengthen MNCH is facilitated, has been carried out during the project’s first six months. More than 40 Canadian MNCH-concerned professionals were reached through awareness-raising activities at community venues and MNCH institutions, where over 250 Canadians from the general public were also informed about the project. Horizons, seeking to provide an opportunity for Ontario’s youth to learn about global issues like MNCH, partnered with the Kawartha Pine Ridge Elementary Teacher’s Federation of Ontario (KPR-ETFO) to carry out a youth engagement program that will start up in the Clarington region in the coming months. Finally, dates for reciprocal knowledge-sharing exchanges between Canadian MNCH providers and leaders and their Guatemalan counterparts, including traditional Indigenous midwives, were chosen for February and March 2017. After conducting its selection process during the first semester, Horizons confirmed the participation of the Canadian and Guatemalan individuals in the first exchanges.
We hope this post has given you chance to look back at what has been accomplished in the MNCH project’s first six months. Know that the Horizons and PIES teams are prepared to look ahead, and continue to transform the lives of Indigenous women, children and families in Guatemala. This project, which is enabled in part with the support of Global Affairs Canada, would not be possible without the solidarity of our individual and institutional supporters. To discuss ways in which you can be part of this transformation, please contact Raúl Scorza at rscorza@horizons.ca.


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