Part V: The Impact
Posted: September 22, 2017

Curamericas Global, an international nonprofit, established Casas Maternas in three municipalities located in the isolated northwestern highlands of Guatemala—an area with high maternal mortality ratio (636 maternal deaths per 100,000 live births). Casas Maternas are maternal health facilities that provide vital health services, encourage local accountability through staffing local people and provide a safe environment where cultural norms and traditions are respected. Traditional birth attendants are encouraged to bring patients for delivery at the Casas Maternas, where trained staff are present and access to referral care is facilitated.

The established Casa Materna program in Guatemala has brought positive change to maternal and infant health in the partner communities. Since May 2014, we have eliminated maternal mortality in 26 communities with a combined population of 8700 where at least 1-2 maternal deaths had occurred annually. In this period staff successfully resolved or referred 231 complications of pregnancy, delivery, or postpartum. Nearly half of these complications were resolved by Casa staff and the remaining successfully referred to tertiary facilities. Hemorrhage – responsible for 41% of Guatemala’s maternal deaths – represented only 11% of Casa complications, due to skillful prevention with uterotonic drugs and delivery protocols.

A recently published case study showed that 70% of women from Casa Materna partner communities reported delivering in a health facility compared with only 30% of women from non-partner communities. The case study also showed that the Casas increased health service utilization among partner communities regardless of maternal education or household wealth quintile. Indigenous populations received the same rights to healthcare as non-indigenous groups, resolving a challenging that the indigenous community was previously facing.

Health promotion at the household level by mother peer educators has increased the percent of women seeking antenatal care to 71%, recognition of danger signs in pregnancy to 74%, and immediate breastfeeding to 80%.

Sustainability is built into the model through community-ownership and cost-sharing partnership with the Guatemala Ministry of Health (MOH), local government, non-profits, and the communities themselves. As a result of the positive changes that have been brought by this model, there has been more integration of Casa Materna components into the national health care, vital statistics, and financing systems. The Guatemala MOH is now partnering with Curamericas Global to pilot the scale-up the Casa Materna Rural model to the entire rural indigenous population of San Marcos Department, population 500,000. Indigenous populations around the world face inequitable childbirth outcomes, especially those living in isolated rural locations. Globally, in the least developed countries, 44% of women and newborns still face the high risk of home deliveries without skilled attendance. The model provides a promising approach to increasing facility-based deliveries at low cost throughout rural Guatemala and around the globe.

Article written by Purva Trivedi, Events and Outreach Intern

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