International Day for Maternal Health and Rights: The Right to Skilled and Dignified Care

An Indigenous traditional midwife checks up on her pregnant patient in a rural community of Totonicapán, Guatemala. Midwives are currently the most accessible and acceptable maternal health service for most Indigenous families in Guatemala.

On International Day for Maternal Health and Rights, Horizons of Friendship recognizes the great need for improved maternal health care and awareness of rights for women. Skilled and dignified care continues to be beyond the reach of many women around the world, especially in regions with high levels of poverty and gender discrimination. These barriers preventing better health care and recognition of rights present harmful and even deadly consequences for pregnant women and mothers. That’s why on April 11, we demand improved provision and access to skilled and dignified care for women.

Horizons and our partners are working to bring awareness to the challenges for maternal health and rights in Central America and Mexico. Currently, our largest project, “Maternal, Newborn and Child Health: Transforming Indigenous Lives” (MNCH), strives to address gaps in health care and rights for pregnant women and mothers in the majority Indigenous Department (province) of Totonicapán, Guatemala.

The MNCH project aims to not only improve the health and wellbeing of pregnant women and new mothers but also their children. In the first 18-months of the project, Horizons and PIES have already reached 70,000 women, men and children in Totonicapán.

According to the World Bank, Guatemala possesses one of the highest maternal mortality rates in Latin America, especially in rural and Indigenous areas. These high rates of maternal mortality stem from the immense levels of poverty facing the majority of Indigenous peoples throughout the country. This had lead to many communities struggling to access basic needs and services, including health care. A lack of access to these essential services put many Indigenous women in danger if they experience health emergencies during or after pregnancy. Currently Indigenous women are twice as likely to die during childbirth than non-Indigenous women in Guatemala.

These issues are particularly evident in Totonicapán, where the Ministry of Health estimates that 147 out of 100,000 pregnant women die during childbirth – 18x the rate of pregnant women in Canada.

To address this high level of maternal mortality in Totonicapán, Horizons and our local partner, PIES (Association for Health Promotion, Research and Education) are working increasing access to and utilization of health care by this population at various points in the public health system. These efforts have already demonstrated incredible feats in this journey to improve the health and wellbeing of pregnant women, new mothers and their children.

Using a train-the-trainer approach, the project has recruited already 35 traditional midwives to lead and train other midwives in updated MNCH best practices.

A central force in this project is upgrading the skills of more than 1,000 Indigenous traditional midwives as their service delivery is currently the most accessible and acceptable to most Indigenous women in Totonicapán, who often face discrimination when accessing public health services.

The project also focuses on building relationships of mutual-respect and understanding between midwives and conventional health providers to ensure concerted actions between all points of maternal and child health delivery. This includes training primary health care personnel, particularly nurse auxiliaries, on the Mayan worldview to ensure frontline health care in Totonicapán is more culturally pertinent and effective for Indigenous peoples.

Nurses and Doctors working with the public health system have begun receiving courses in the Mayan Worldview on Health so they can better serve their Indigenous patients.