Posts Tagged ‘Future Generations’

Empowering rural women leaders to promote maternal health in Cusco, Peru: test of a new teaching method

Wednesday, March 14th, 2012 by Christopher Lindahl

The following is the final installment of a series of project updates from Future Generations. MHTF is supporting their project, Using Pregnancy Histories to Help Mothers, based in Peru. More information on MHTF supported projects can be found here.

 

Written by: Future Generations

 

Rural women need to be empowered to make better decisions about home health behaviors. Frequently, in poor communities where women’s health needs are greatest, they are the least empowered: so the question is — how to support the critical transition from disempowered to empowered? The hypothesis of Future Generations was tested with women leaders from rural Andean communities of Peru through an operations research project entitled “Between Us (Women): Sharing Pregnancy Histories as Part of Community Education for Maternal and Neonatal Health,” in which processes used to train women leaders were designed to empower them as change agents. Women selected as community health promoter volunteers (Women Leaders) by other women in their own community, are asked to share their experiences from each of their own pregnancies, births, postpartum periods, breastfeeding experiences, and other issues related to maternal and child health, in terms of what they did, what they felt, if they sought help, what was the outcome, and other aspects. These experiences are used as the basis of subsequent training, through identifying and analyzing local customs and practices, identifying positive and negative beliefs and behaviors, and learning from each other. A pilot project using this method implemented in Afghanistan by Future Generations found a significant decline in child mortality in communities where this method was implemented.

 

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Between Us (Women)

Monday, June 6th, 2011 by Christopher Lindahl

The following is part of a series of project updates from Future Generations. MHTF is supporting their project, Using Pregnancy Histories to Help Mothers, based in Peru. More information on MHTF supported projects can be found here.

 

Written by: Future Generations

 

Our Women Leader is teaching community mothers using our flipchart on breastfeeding. Photo by Carmen Pfuyo

Our Women Leader is teaching community mothers using our flipchart on breastfeeding. Photo by Carmen Pfuyo

 

As the first project year reaches completion, the “Between Us (Women)” Project has trained 72 Women Leaders (WL) from 28 communities of the Andean highlands of Cusco in Peru. Of these, 93% are still “active”, even though not all are consistently able to attend all the workshops. We are far enough along in the project to graph results on training workshop attendance trends which have leveled off around the 70% mark with a late further decline associated with the pre-winter harvest season. We have also graphed results of pretests and posttests for all six priority topics for the project, showing more improved posttest scores in the intervention group as compared to the control group, the topics including pregnancy, birth and postpartum, newborn, breastfeeding, infant diarrhea and pneumonia. Monitoring data on community education activities carried out by WL show how many community women have been exposed to educational activities of the WL through home visits and in women´s group meetings. WL in the intervention groups have completed on average twice the number of home visits to pregnant women and mothers of children under age two, as compared to the control group.

 

In two out of the four project districts where women gather in meetings on a monthly basis as a requirement for a cash transfer program (called the JUNTOS program), WL have been able to reach more than triple the number of women for group education activities (and quadruple the number by WL in the intervention group), as compared to districts where JUNTOS does not operate. In other words, given that JUNTOS does not provide educational content to its beneficiaries, our training program for WL has greatly potentiated the health education of JUNTOS beneficiaries who otherwise would not receive health information in this important national program that is targeted to women in extreme poverty.

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Pregnancy Histories and Community Education in Peru

Thursday, December 2nd, 2010 by Christopher Lindahl

The following is part of a series of project updates from Future Generations. MHTF is supporting their project, Using Pregnancy Histories to Help Mothers, based in Peru. More information on MHTF supported projects can be found here. All photos courtesy of Laura Altobelli.

Written by: Future Generations

Group B Urcos Oct. 22-23 2010

Sixty-three Women Leaders from highland Andean communities (“comunidades alto-andinos”) have been selected by the women in their own communities, and have started their training in maternal-neonatal-child health using an experimental training design. Each of the four training groups has 13 to 19 Women Leaders that meet monthly. The first round of workshops in October was an introduction to the program and the topic of pregnancy with a focus on danger signs, nutrition and preventive home care and hygiene during pregnancy, birth planning, and community organization for evacuation of obstetrical emergencies. Two of the four training groups had an additional focus using the Pregnancy History methodology. One of our challenges: Women Leaders bring their small children with them at our invitation so they don’t worry so much about having to get home quickly. It helps to hire a child-care person to distract the toddlers while their mom is in the workshop. Another challenge: all of our training is conducted in the Quechua language. It helps to have the workshops tape-recorded and transcribed so that non-Quechua speakers (such as the P.I.) can have access to the proceedings of the workshops for later review and analysis.

Group D Quiquijana Broken hearts matching game Oct.15-16 2010

Two remarkable events occurred this quarter, one good and one bad. The good one was the spontaneous formation of an Association of Women Leaders by one of the intervention groups. The idea was launched by two Women Leaders, and a long discussion resulted in their decision to form the association and elect a President, Vice-President, and Secretary. This is similar to the type of male-dominated community councils found in every Andean community. Women’s empowerment at work! The second event was a death by hemorrhage of a 23-year-old woman during her first birthing. She lived in one of the easy-access “low communities” next to the main road in the valley, a 10-minute ride to the Urcos Health Center, and therefore not one of our project communities. Investigation of the maternal death suggests that certain older women in the community refused to allow help-seeking during the home birth. As a result of this tragedy, the Urcos Health Center asked the community to select two Women Leaders and requested that Future Generations include them in our training workshops on maternal, neonatal, child health. This death has provided for much relevant discussion and learning during our training workshops.

Group B Urcos Emergency evacuation socio-drama - Oct. 22-23, 2010

Group D Quiquijana Baby lamb participant - Oct 15-16, 2010

Group D Quiquijana

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Weekend Reading

Friday, October 15th, 2010 by Christopher Lindahl

Recently on the MHTF blog, we’ve heard updates from:

Plus, some links for the weekend:

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Women Leaders in Peru

Friday, October 8th, 2010 by admin

The following is part of a series of project updates from Future Generations.  MHTF is supporting their project, Using Pregnancy Histories to Help Mothers, based in Peru. More information on MHTF supported projects can be found here. All photos courtesy of Laura Altobelli.

Written by: Future Generations

 

View from the road part of the way to Callatiac.  Looking back down the hill to the Vilcanota River valley below and the main road from Cusco to Puno that follows alongside the river through the valley.   The city of Cusco is far off to the upper right of the photo behind the mountains.

View from the road part of the way to Callatiac. Looking back down the hill to the Vilcanota River valley below and the main road from Cusco to Puno that follows alongside the river through the valley. The city of Cusco is far off to the upper right of the photo behind the mountains.

We have our office and staff quarters up and running in the rural town of Urcos, about one hour south of the city of Cusco. Being home to one of the seven wonders of the world, Macchu Pichu, the city of Cusco has a multi-million dollar tourist industry but, paradoxically, in its rural areas among the highest rates of maternal and perinatal mortality in the country. One understands this when visiting our 28 project communities, divided into 62 sectors and annexes, which require a one, two or more-hour drive (or two to six-hour walk on foot) on rutty dirt roads through the Andes, there and back from the major towns of Urcos or Quiquijana on the main paved road through the river valley. Public transportation runs only on Sundays from communities. Not surprising that mothers are tempted to give birth at home or to delay seeking care for a sick newborn or infant when faced with that long walk.

Two young girls herding sheep and newborn lambs down the road from Callatiac to Urin Qosqo.

Two young girls herding sheep and newborn lambs down the road from Callatiac to Urin Qosqo.

We selected the “highland communities” for our intervention since that is where the need is, where women and families tend to live in scattered homesteads with limited and pyramidal social organization. We have been pleased at the very positive response from community leaders and husbands to the idea that Women Leaders will be trained to teach women in their community. 

 

Quechua-speaking women are present at a community meeting in the community called Urin Qosqo which is located at high altitude about 2 hours by car off the main road in the valley, a total of 3.5 hours from the capital city of Cusco.

Quechua-speaking women are present at a community meeting in the community called Urin Qosqo which is located at high altitude about 2 hours by car off the main road in the valley, a total of 3.5 hours from the capital city of Cusco.

Community health promoters who have received training in the past have mostly been men. One told us, “How good that women will be trained: they are shy and need to be more active.”  One woman, not so shy, who was chosen by other women in her community to receive training from the project as a Women Leader told everyone, “Now it will be a rule that every time we meet to pick up food [from a government food distribution program for children] I will make you stay to get a talk on health.”  In another community, the men joked that they will be fine while the selected Women Leaders are away at training since they cook better than the women.  At that, everyone laughed heartily.

 

Women on road from Callatiac, Cusco-Peru

Women on road from Callatiac, Cusco-Peru

 

Community Assembly-UrinQosqo

Community Assembly

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The Maternal Health Task Announces New Grants, Innovative Maternal Health Projects to Inform National Policies

Thursday, July 22nd, 2010 by KateMitch

8 new grants

NEW YORK, July 22—The Maternal Health Task Force at EngenderHealth announced today that it has awarded eight new grants supporting innovative maternal health projects across Asia, Africa, and Latin America. The projects, which will be carried out by local organizations in developing countries, will lead to national policy recommendations for improving maternal health.

Each project will evaluate an ongoing effort to advance maternal health in places where too many women still die from preventable complications of pregnancy and childbirth. Examples of such projects include integrating maternal health care with HIV prevention and treatment, organizing support groups for pregnant mothers, and outfitting health workers in rural communities with cellular phones to facilitate emergency care for pregnant women. Following are summaries of the new grants:

In Bangladesh, scientists and nonscientists will collaborate at the International Centre for Diarrhoeal Disease Research in Bangladesh (ICDDR,B) in translating new and existing knowledge about maternal health into proposals to improve government policies and practices. They will seek consensus on identifying key questions raised by three recent research programs, ensure access to the findings, reach out to national policymakers, and build ICDDR,B capacity and visibility for future work in knowledge translation.

In India, the Centre for Development and Population Activities (CEDPA) will combat India’s high maternal mortality and morbidity rates by demonstrating the value of integrating maternal health programs into HIV and AIDS programs. Using forums, workshops, and consultations, CEDPA will evaluate existing programs of the government’s National Rural Health Mission, the National AIDS Control Programme, and the National Health Policy Administration in the Rajasthan area, to compile best practices and build consensus on a set of recommendations for policymakers.

In Malawi, the MaiMwana project will be a pilot effort to strengthen the current inadequate Maternal Death Review (MDR) system with a village-level program of maternal death audits. Kamuzu Central Hospital and the Mchinji District Hospital will support the formation of three-member MDR teams in each village to conduct a verbal autopsy (a structured interview) among relatives and neighbors within two days of every maternal death. Improved data will allow better analysis and service improvements and will contribute to recommendations to the Ministry of Health for a national audit procedure.

In Mexico, the Centro de Investigaciones y Estudios Superiores en Antropologia Social (CIESAS) is conducting an assessment of the Ministry of Health’s Advanced Life Support for Obstetrics Program (ALSO), which manages delivery emergencies in Oaxaca. CIESAS will determine whether ALSO courses improve the technical skills and professional morale of health care providers enough to justify expanding the program nationwide.

In Peru, Future Generations, in partnership with the Peruvian Ministry of Health, will field test promising methods of reducing maternal and newborn mortality by organizing groups of pregnant women to share their pregnancy histories and experiences. In a controlled trial involving 500 pregnant women, health workers will guide the discussions, document benefits, develop a training manual and materials for possible nationwide use, hold workshops on the materials, and advocate for policy change.

In South Africa and Kenya, the mothers2mothers program, which offers education and emotional support to pregnant women and new mothers living with HIV, will field test “active client follow-up” to increase the number of HIV-positive pregnant women who return to a health care facility for care after an initial visit. In much of Africa, the return rate is low, posing a major obstacle to preventing mother-to-child transmission of HIV. Mothers2mothers will use peer “mentor mothers” to send text messages or cell phone calls to previously contacted pregnant women to urge them to make return visits. Best practices will be collected for integration into the mothers2mothers standard model used continent-wide.

In Sri Lanka, the Department of Community Medicine at Rajarata University will work to improve the collection of data on the impact of maternal death and postpartum illness, a process that is now limited to hospital reports. University researchers will develop a survey questionnaire for field testing among a sample of expectant mothers in the resource-poor Anuradhapura District, where maternal mortality rates are high. Researchers will analyze the frequency and prevalence of health events and their direct and indirect economic impacts on families, to contribute to national service delivery planning.

In Tanzania, the Ifakara Health Institute (IHI) will seek to improve emergency care for pregnant women and newborns by providing free cellular phones and business-related services for mid-level health care providers, to allow better communication with distant emergency obstetric specialists. Cooperating with district councils and a local telecommunications company IHI will evaluate the cost, feasibility, and implementation issues that arise if health workers at the district level have better access to long-distance counseling, faster referrals and resupply services, and emergency clinical support.

EngenderHealth is a leading international reproductive health organization working to improve the quality of health care in the world’s poorest communities. EngenderHealth empowers people to make informed choices about contraception, trains health care providers to make motherhood safer, promotes gender equity, enhances the quality of HIV and AIDS services, and advocates for positive policy change. The nonprofit organization works in partnership with governments, institutions, communities, and health care professionals in more than 20 countries around the world. For more information, visit www.engenderhealth.org.

The Maternal Health Task Force at EngenderHealth brings together existing maternal health initiatives and engages new organizations to facilitate global coordination of maternal health evidence, programs, and policies. Supported by the Bill & Melinda Gates Foundation, the Maternal Health Task Force convenes stakeholders and creates an inclusive setting to engage in dialogue, build consensus, foster innovation, and share information. For more information, visit www.maternalhealthtaskforce.org.


Contact:
Tim Thomas, Maternal Health Task Force/EngenderHealth
646-436-6555, tthomas@engenderhealth.org

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