An integrated approach to improving maternal health care in the ixil triangle quiche guatemala
Download
1 / 59

An Integrated Approach to Improving Maternal Health Care in the Ixil Triangle - PowerPoint PPT Presentation


  • 298 Views
  • Uploaded on

An Integrated Approach to Improving Maternal Health Care in the Ixil Triangle, Quiche, Guatemala. Christina Biller Fiona Clement Gia-Thanh Le Jennifer Kasper Sebalda Leshabari Kimberly A. Thiede. Enchantment of the World: Guatemala. http://tamasi.com/history/guatemala.html.

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'An Integrated Approach to Improving Maternal Health Care in the Ixil Triangle' - ryanadan


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
An integrated approach to improving maternal health care in the ixil triangle quiche guatemala l.jpg

An Integrated Approach to Improving Maternal Health Care in the Ixil Triangle, Quiche, Guatemala

Christina Biller

Fiona Clement

Gia-Thanh Le

Jennifer Kasper

Sebalda Leshabari

Kimberly A. Thiede


Slide2 l.jpg

Enchantment of the World: Guatemala the Ixil Triangle, Quiche, Guatemala


Slide3 l.jpg

http://tamasi.com/history/guatemala.html the Ixil Triangle, Quiche, Guatemala


Slide4 l.jpg

Enchantment of the World: Guatemala the Ixil Triangle, Quiche, Guatemala


Slide5 l.jpg

Enchantment of the World: Guatemala the Ixil Triangle, Quiche, Guatemala


Slide6 l.jpg

http://www.public.usit.net/rfinch/santia7m.jpg the Ixil Triangle, Quiche, Guatemala


Slide8 l.jpg

http://www.public.usit.net/rfinch/solola1h.jpg the Ixil Triangle, Quiche, Guatemala


Slide9 l.jpg

Http://stripe.colorado.edu/~weavert/wfpfield1.html the Ixil Triangle, Quiche, Guatemala


History of the armed conflict l.jpg
History of the Armed Conflict the Ixil Triangle, Quiche, Guatemala

  • 36 Years: longest, bloodiest insurgency in Latin America

  • Human Toll

    • 140,000 killed (including 40,000 “disappeared”)

    • 200,000 children orphaned

    • 80,000 widowed

    • 1.5 million displaced (internally and in refugee camps in Mexico)

      *EVERY SINGLE VILLAGE IN THE IXIL TRIANGLE WAS DESTROYED!


History of the armed conflict12 l.jpg
History of the Armed Conflict the Ixil Triangle, Quiche, Guatemala

  • October 8, 1992: Repatriation of Refugees in Mexico

  • Peace Accords signed December 29, 1996

    • Two Critical elements:

      • Government committed to increase spending for health and education by 50%

      • Accord on Identity and Rights of Indigenous Peoples

        • Indigenous practices respected

        • Guatemala “multiethnic, multilingual, pluricultural”


Health indicators l.jpg

Guatemala the Ixil Triangle, Quiche, Guatemala

Fertility Rate 5.1

Maternal Mortality 200/100,000 births

IMR 51/1000 live births

Quiche

Fertility Rate 6.7

Maternal Mortality 284/100,000 births

IMR 69/1000 live births

56% Women have not received tetanus vaccine

Health Indicators


Project goals l.jpg
Project Goals the Ixil Triangle, Quiche, Guatemala

  • Reduce maternal mortality

  • Reduce neonatal mortality

  • Improve women’s health, including their mental health


Strategy l.jpg
Strategy the Ixil Triangle, Quiche, Guatemala

  • Improve quality of TBA services

  • Strengthen obstetric referral services

  • Improve access to emergency services

  • Women’s Community Health Center as forum for women to meet


Slide18 l.jpg

Http://stripe.colorado.edu/~weavert/wfpfield1.html the Ixil Triangle, Quiche, Guatemala


Why the ixil triangle l.jpg
Why the Ixil Triangle? the Ixil Triangle, Quiche, Guatemala

  • MMR and IMR higher than national average

  • Most maternal deaths could be prevented with better prenatal and delivery care

  • 30-40% IMR attributed to inadequate care during pregnancy and childbirth

  • If mother dies, infant has only 10% chance of survival to 1st birthday

  • Psychiatric morbidity may be >35%


Why selected strategy l.jpg
Why Selected Strategy? the Ixil Triangle, Quiche, Guatemala

  • 80% indigenous women deliver at home with TBA

  • Improved TBA training can decrease MMR

  • Some women will need emergency services

  • No rural services for mental health


Tba training l.jpg
TBA Training the Ixil Triangle, Quiche, Guatemala

  • Culturally sensitive, linguistically appropriate course

  • Two 1-week intensive training courses

  • Apply principles from “Training Manual for Traditional Birth Attendants”, “Where Women Have No Doctor”, and other WHO materials

  • Monthly refresher courses


Training course topics l.jpg
Training Course Topics the Ixil Triangle, Quiche, Guatemala

  • Antenatal care/risk assessment

  • Safe, sanitary labor and delivery

  • Emergency situations and referral

  • Care of the newborn

  • Postnatal care

  • Family planning


Methods of teaching tbas l.jpg
Methods of Teaching TBAs the Ixil Triangle, Quiche, Guatemala

  • Demonstration

  • Role-Playing

  • Group Discussion

  • Case-Presentation

  • Visual Aids: diagrams, posters, models, flip charts

  • Incorporate Mayan health beliefs wherever possible


Map of ixil triangle l.jpg
Map of Ixil Triangle the Ixil Triangle, Quiche, Guatemala

Chajul

7 km

Pulay

(site of WCHC)

S. Juan Cotzal

6 km

7 km

Uspantan

(site of Health Center)

45 km

Nebaj


Women s community health center wchc l.jpg
Women’s Community Health Center (WCHC) the Ixil Triangle, Quiche, Guatemala

Activities

  • Prenatal Care/Risk Assessment

  • Delivery Facility/Emergency Services including transportation

  • Postpartum Family Planning

  • Newborn Exam

  • Mental Health


Site of delivery based on prenatal risk assessment l.jpg
Site of Delivery Based on the Ixil Triangle, Quiche, GuatemalaPrenatal Risk Assessment


Intervention capabilities at wchc l.jpg
Intervention Capabilities at WCHC the Ixil Triangle, Quiche, Guatemala

  • Vacuum Extraction

  • IV Fluids/Oxytocics

  • Manual Removal of Placenta

  • Oral/Parenteral antibiotics

  • Anti-Hypertensives/Sedatives

  • Repair of Obstetrical Lacerations


Emergency services l.jpg
Emergency Services the Ixil Triangle, Quiche, Guatemala

  • Communication and Transport

    • Two-way radios in specified villages, WCHC, and transport vehicle

    • Four-wheel drive vehicle

Uspantan

Village TBA

WCHC


Slide32 l.jpg

http://www.public.usit.net/rfinch/traje.html the Ixil Triangle, Quiche, Guatemala


Slide34 l.jpg

http://www.public.usit.net/rfinch/nebaj3m.jpg the Ixil Triangle, Quiche, Guatemala


Network of women in ixil l.jpg
Network of Women in Ixil the Ixil Triangle, Quiche, Guatemala

  • Holistic approach to address maternal health, home life, after-effects of war

  • Centered at WCHC

  • Mental health seminars (formal and informal) in conjunction with CONAVIGUA

  • Weaving club/market day


Conavigua human rights l.jpg
CONAVIGUA/Human Rights the Ixil Triangle, Quiche, Guatemala

  • Women empowered to organize for human rights

  • CONAVIGUA (National Coordinator of Guatemalan Widows) established in 1988

  • More than 11,000 women, primarily poor indigenous women


Weaving club market day l.jpg
Weaving Club/Market Day the Ixil Triangle, Quiche, Guatemala

  • Weaving plays integral role in Mayan women’s culture

  • Women taught skill at early age

  • Guatemala one of the only countries in world where women wear decorative woven dress on daily basis

  • Primero coordinating market day at WCHC once a month


Evaluation of tba training l.jpg
Evaluation of TBA Training the Ixil Triangle, Quiche, Guatemala

Test of Knowledge

  • Content driven oral exam measured against supervisory guides

  • Demonstration of proficiency

    • Simulated deliveries

    • Observation of TBAs on home visits and deliveries


Evaluation of referral system l.jpg
Evaluation of Referral System the Ixil Triangle, Quiche, Guatemala

  • Number of appropriate referrals to WCHC

  • Number of appropriate referrals to Type A

    Facility in Uspantan.

    • Measured by chart reviews

    • Case review and discussion of referrals in monthly TBA refresher course


Evaluation of monthly gatherings and weaving club l.jpg
Evaluation of Monthly Gatherings and Weaving Club the Ixil Triangle, Quiche, Guatemala

  • Personal satisfaction survey

  • Number of women per village at monthly meetings

  • Number of referrals to CONAVIGUA


Slide41 l.jpg

Enchantment of the World: Guatemala the Ixil Triangle, Quiche, Guatemala


Slide47 l.jpg

Enchantment of the World: Guatemala the Ixil Triangle, Quiche, Guatemala


Slide48 l.jpg

Enchantment of the World: Guatemala the Ixil Triangle, Quiche, Guatemala


Project sustainability l.jpg
Project Sustainability the Ixil Triangle, Quiche, Guatemala

  • Partnership with MSPAS for TBA training and obstetric/prenatal care aspects

  • Collaboration with CONAVIGUA to empower women to actively participate in health and human rights

  • Weaving club/Market Day as incentive for women to gather and share/sell woven goods


Project budget contributions l.jpg
Project Budget Contributions the Ixil Triangle, Quiche, Guatemala


Budget summary l.jpg
Budget Summary the Ixil Triangle, Quiche, Guatemala


Cost analysis l.jpg
Cost Analysis the Ixil Triangle, Quiche, Guatemala

  • 31,000 females & 15,000 Women of Reproductive Age (15-49) in Ixil Triangle

  • Primero CBR per Year = $6.86/WRA $3.32/female

  • MSPAS CBR per Year = $1.56/WRA

    $0.76/female

  • Yearly on-going CBR = $2.02/WRA

    $0.97/female

    *CBR=Cost-Benefit Ratio


Slide55 l.jpg

http://www.public.usit.net/rfinch/santia4m.jpg the Ixil Triangle, Quiche, Guatemala


Slide56 l.jpg

http://www.public.usit.net/rfinch/chichi6m.jpg the Ixil Triangle, Quiche, Guatemala


ad