Building community capacity to develop a local strategy to increase coverage of maternal and neonatal care in Totonicapán, Guatemala

The purpose of the formative research conducted and ongoing intervention were to build community capacity and empowerment to carry out local strategies to improve postpartum maternal and neonatal care in Mayan communities in Guatemala. Through formative research using qualitative research techniques such as key informant interviews and focus groups with members of community organizations, community health providers, men, and women of reproductive age knowledge, attitudes and practices regarding postpartum maternal and neonatal care were examined and strengths and weakness of the health system and community organization were identified and documented.

Barriers found for women not attending postpartum care had to do with cultural practices, low social status of women, and difficulties with the public health system. Economic and geographic barriers were not mentioned as frequently as the former. Mostly male local authorities and leaders were found to lack knowledge about maternal and neonatal health and were disinterested in it as a community problem viewing development only in terms of infrastructure projects.

During the intervention phase that is ongoing a strategy to increase access of women with complications to maternal care was developed. The strategy included advocacy with authorities, formation and training of health committees in emergency planning and the promotion of prenatal and postpartum through different channels such as forming support groups of pregnant women who participate in regular educational sessions, talks and home visiting. Positive results include the increase in coverage of prenatal and postpartum care, transport of women with complications to health services, and an increasing number of lives saved. More than local authorities and organizations, women themselves have been empowered through their participation in support groups.