0 - PDF, 101 mb - usaid

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Guatemala
0 nol? 520-0000.5-3 -80234 IN0o,;6_
0 raw PROGRAM DEVELOPMENT AND SUPPORT (POPULATION'
520-000.5
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Quoting from the Project Paper Supplement:
"Reducing reproductive risk is a priority for this component.
Worldwide, mortality risks for mother and child are highest
after four births, when births are spaced less than two years
apart, or when the mother is under age 18 or over 35. High
parity and inadequate spacing interact synergistically to
increase risk. All of these factors are common in Guatemala.
The MO recognizes that the .TBA's provide the majority of
pre-natal arid delivery care in Guatemala, but that training and
minimal equipment are required to improve delivery techniques
and for the detection and referral of high risk pregnancies.
The nature and extent of MOH activity financed by the. Project
in the area of training of TBA's will be determined by acareful,
"state-of-the-art" study of existing knowledge and
,aperience in this area in Guatemala. The study to be financed
from non-Project funds, will take place in the Fall of 1988 and
will lay the basis for preparing and scheduling MOH training
activities, as well as further studies to be undertaken by AGES
(another agency receiving financial assistance under the family
planning project). Tentatively, the overall plan includes:
900 auxiliary nurses trained in reproductive risk management,
and equipped with appropriate training materials and TBA kits.
These auxiliary nurses, in turn, will identify and train an
average of four TBA's each in basic principles of asepsis, the
use of the kits, and detection and referral of high risk
pregnancies and improved pre-and post-natal maternal health
care. In order to effectively reduce maternal risk while
establishing an on-going relationship between the auxiliary
nurse ard the TBA, the Project will coordinate with UNEIPA in
the provision of iron supplements for distribution by the
auxiliary nurses through the TBA's to their patients. These
incentives, combined with progressive improvements in the MO0H
reproductive health referral system, significantly enhance the
probability of success.in this outreach effort.
Although contraceptive distribution is not expected to form an