Throughout rural indigenous Guatemala, there is a severe lack of access to physicians and hospital-based services. As a result lay indigenous midwives remain the most important primary care providers in many rural communities; they are widely respected by their patients, and they are trusted because they share cultural values and speak Mayan languages. However, indigenous midwives are typically minimally supported by the medical community in Guatemala, and they are simultaneously charged with “covering the gap” in service provision and at the same time blamed for any shortfalls that occur. Furthermore, educational opportunities provided to midwives are typically of low quality and are not sensitive to their adult learning styles, low literacy rates, and limited fluency in Spanish (most speak Mayan languages instead).
Since 2008, Wuqu’ Kawoq and ACOTCHI have pioneered a midwife training program that overcomes these barriers. The program utilizes a “continuing education” model and is delivered in Kaqchikel, the native language of participants. Since 2009, the program has also included a track for novice midwifery students. In 2011, a women’s health education track for the general public was added. In 2012, our second group of novice midwives was enrolled, and the program expanded to include midwives from 5 municipalities, covering 183,000 people.
In 2013 the training program is planned to have four tracks. Track 1 will deliver monthly sessions on advanced themes in midwifery to experienced member midwives. Track 2 will be a “midwifery school” for midwives in training, where didactic sessions are coupled with supervised clinical rotations. Track 3 will be a women’s sexual health education track, open to the general public. Track 4 will be an intensive skills training curriculum for ACOTCHI’s core staff on the use of obstetrical ultrasound.
We are proud to report that, through 5 cycles of this program, our midwifery training program has emerged as a model for the region. It has encouraged tremendous professional growth in the membership, and has sparked several important achievements, such as growth in clinical coverage for women and their health needs (the training cooperative now covers a population of ~183,000 persons), the opening of a school for midwives in training, and the opening of a midwife-run birthing center. Another exciting expansion in the last two years has been the development of a sexual health training track for women in the general public; this track provides direct education to women other than midwives, thereby broadening the scope and reach of the initiative.
With the midwife members leading the way, Wuqu’ Kawoq | Maya Health Alliance will continue to support and develop this important healthcare resource for the Kaqchikel Maya of Guatemala.
This program is a partnership with the Conservation, Food & Health Foundation.