Population Council Research that makes a difference

Maternal mortality and morbidity rates in rural, indigenous areas of Guatemala are among the highest in Latin America and the Caribbean. Maternity waiting homes are residential institutions, located near a qualified medical facility, where pregnant women identified as "high risk" can await their delivery and be transferred to the medical facility shortly before delivery, or earlier, should complications arise. However, maternity waiting homes are underutilized in Guatemala. Population Council researchers conducted a qualitative study to identify and propose feasible strategies to help make maternity waiting homes of higher quality and more accessible, appropriately used, and culturally acceptable to indigenous Guatemalan women and their communities.

Council researchers conducted interviews with 50 participants in the departments of Huehuetenango and Cuilco, including indigenous women who had been cared for in a maternity waiting home, community leaders, and relevant health personnel. Findings indicate that, although participants find the strategy of maternity waiting homes useful, the costs associated with them (e.g., transport, meals, and voluntary contributions) are important barriers to access. In addition, most staff at the homes did not speak indigenous languages, and women were not allowed to stay with the person who accompanied them (usually a family member). Many women reported not receiving any of the educational activities that were available. Once the women were transported to the hospital, most doctors required them to give birth lying down, which was perceived as uncomfortable (traditionally women give birth in a kneeling position). Council researchers created a comprehensive list of recommendations and presented and discussed them with stakeholders at the local and national levels, including Guatemala's Ministry of Health.

This project has filled a knowledge gap by documenting and disseminating new evidence on the challenges of providing effective maternity waiting home services in Guatemala. The study findings were used to inform the Ministry of Health’s proposal to develop and standardize a culturally appropriate national maternal health care model. Such a model will contribute significantly to improved access for women in rural areas to maternal health care services in Guatemala.