Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #106871

Telma Suchi, B'elejeb B'atz, 4301 Connecticut Ave., Suite 310, Washington, DC 20008, 202-867-7969, lundgrer@georgetown.edu, Margarita Monroy, RN, Georgetown University Medical Center, institute for Reproductive Health El Salvador, 4301 Connecticut Ave., Suite 310, Washington, DC 20008, and Rebecka Inga Lundgren, MPH, Georgetown University Medical Center, Institute for Reproductive Health, 4301 Connecticut Ave., Suite 310, Washington, DC 20008.

Despite efforts to improve health indicators, Mayan women shoulder a disproportionate share of the morbidity and mortality burden in Guatemala. Many Mayan couples wish to space their births, yet contraceptive prevalence is low. B'elejeb B'atz, a Mayan NGO, developed an effective strategy to address women's needs. Founded as a weaving cooperative, B'elejeb diversified into adult literacy and micro-enterprise programs. When reproductive health emerged as a priority, B'elejeb' trained community health workers (CHWs) to incorporate health into their activities. CHWs offer low-cost services through home visits, clinics, and a network of community pharmacies. CHWs manage revolving funds to purchase supplies, produce IE&C materials and provide themselves honoraria. A case study was conducted to understand why this program was effective, while many have failed. In-depth interviews and focus groups were conducted with B ‘elejeb directors, CHWs and 100 male and female family planning users. Results suggest that the synergy between B'elejeb's underlying principle of empowerment and provision of a range of family planning choices, including the Standard Days Method and DMPA, contributed to its success. The ability of CHWs to provide quality, integrated services through a variety of outlets was also critical. Finally, explicit integration of a gender perspective led to involving men in program activities. This strategy, although initially controversial, was effective. The role of CHWs in reaching isolated, traditional populations will be discussed, along with innovative training and supervision strategies. Critical program components include involving men, subsidized supplies and BCC campaigns.

Learning Objectives: By the end of the session, participants will be able to

• describe a successful reproductive health program for reaching traditional, rural populations; and
• identify best practices for implementing sustainable, reproductive health services through community health workers.

Keywords: Family Planning, Community Health Promoters

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Recorded presentation