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00" 1Eh-UATIW 04"1cA-- wr=a-r=^wm ^AC 0XIT E6- VMEr- -I-. OF 6 AA43c r0._ _ _ __ _ _ _ Guatemala 0 nol? 520-0000.5-3 -80234 IN0o,;6_ 0 raw PROGRAM DEVELOPMENT AND SUPPORT (POPULATION' 520-000.5 0 P',. 2 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, co<strong>mb</strong>ined 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
UPTCI TrAT C awl ', IWA nNAT1I;AI. r 6 Cussjtra'n1"CuIrlr r0CVLLOrLt4T COOPCATIO.4 AGCNCY 0 W.-alv," E I...,€ nct PAGF I or" tACEJ INTECRIATIONAL DCVELOPMCHT 1. G.uperna f un y , Guatemala . S-n.U1AT10; fJ FIo/C 2,. 0 NumVa. ., 2tF. - 8 0 SHLE£T 520-0000.5-3 234 No. . __. 3. hoject Nurnhcr &n. Tidr EJ PlOfr PROGRAM DEVELOPMENT AND SUPPORT (POPULATION) 520-0000.5 I- PA JPR r,: Itcscc L,this form to co.plctc thc informa.ion scuircd ir a.:'.! b k of a P1OP. P7tOT or P.A FL For P!OIC, f'irniah tAm tc= lnuntr, quantit). dc 3c r.ptnninccitac
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LA CAPACITACION Y PRACTICA DE LAS C
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-2 manipulando as! la posici6n de
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-4 proporciona evidencia que la c
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- 6 definici6n de lo que deberia
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CAPACITACION -8- 1. Las comadronas,
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- 10 - Una evaluaci6n 'e los protoc
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- 12 a. PrActicas Daftinas b. Pr
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- 14 consultores. Las entrevista
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- 16 areas m~s del 90 de todos l
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- 18 - No. 74 de fecha 9 de mayo de
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II. SITUACION ACTUAL - 20 - a. La p
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- 22 - Evaluaci6n del Trabajo de Pa
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- 24 trabajo. Hay una variedad d
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- 26 3. Diferencias entre las pr
Page 29 and 30: - 28 responsabilidades de su hog
Page 31 and 32: 7. Efectividad - 30 A pesar de l
Page 33 and 34: - 32 y las comadronas Mayas feme
Page 35 and 36: - 34 que las reuniones mensuales
Page 37 and 38: - 36 - CLINICA MAXENA, Santo Tomas
Page 39 and 40: - 38 paquetes de sales de rehidr
Page 41 and 42: 3. Donor Agencies - 40 FOADO DE
Page 43 and 44: - 42 tambien se sienten libres d
Page 45 and 46: - 44 componentes - un estudio de
Page 47 and 48: - 46 "Hace diez afios habia tan
Page 49 and 50: - 48 - A menos que las actitudes de
Page 51 and 52: - 50 5. Contenido de la Capacita
Page 53 and 54: - 52 - Aunque ingerir alcohol duran
Page 55 and 56: - 54 dependiendo de la naturalez
Page 57 and 58: - 56 c. PRACTICAS TRADICIONALES
Page 59 and 60: - 58 entrevistadas afirmaron que
Page 61 and 62: - 60 d. PRACTICAS TRADICIONALES
Page 63 and 64: - 62 contraido. Los peligros con
Page 65 and 66: - 64 5. La evidencia empirica mu
Page 67 and 68: - 66 - El potencial para un papel a
Page 69 and 70: - 68 disponibles los fondos. El
Page 71 and 72: - 70 - La Universidad Francisco Mar
Page 73 and 74: - 72 - La importancia del alcance d
Page 75 and 76: - 74 - No es necesariamente factibl
Page 77 and 78: - 76 2. La factibilidad de utili
Page 79: XTNA APPENDIX A 1 "(Y Y-V/,4 /, .gJ
Page 83 and 84: ,,r Ct-,C,,AT10,, ^QcreCy [] WIr'd
Page 85 and 86: APPENDIX B SCHEDULE AND LIST OF CON
Page 87 and 88: Thursday, February 2 9:30am Met wit
Page 89 and 90: Sunday, February 19 Report preparat
Page 91 and 92: APPENDIX D BIBLIOGRAPHY 1. Cosminsk
Page 93 and 94: 34. "The Extension of Health Servic
Page 95 and 96: - 79 - APENDICE F MATERIALES DE ENS
Page 97 and 98: PREPARACION DEL AMBIENTE PARA LA AT
Page 99 and 100: _n z IL 'RiMeT '?eTI'0odo: Lo ciue
Page 101: Cuiciados a lai Mache Despues Cle\
Page 104 and 105: Indice e-eu6un N-o? . . . . . .. .
Page 106 and 107: 2%A es un Niho2. Les encanion \Qc3
Page 108 and 109: LaMule cM2cia poy 6\ \-ombie el0 pa
Page 110 and 111: -Quiere deciy SOue, quieye decir Mc
Page 112 and 113: 8lin die &oinr:.e que 1'10rrno~mean
Page 114 and 115: 10 La rnujer debe aprender ax -econ
Page 116 and 117: A2juntarse 1a5 celulos Tepi-oduclof
Page 118 and 119: 14 Desciryoilo Em orona~io___ _____
Page 120 and 121: 16 3. Aoayece una Ihnea Morena mas
Page 122 and 123: 4 ~~~E.n lo bocci teviscar los dfen
Page 124 and 125: 20_ _ _ _ _ _ _ _ 9-C 9-d Cp9-e No
Page 126 and 127: 22 PILENTACID N de acueydo a I a dc
Page 128 and 129: 24 J~i~d IQ 0 r del __ mbcazo Seq i
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26 Cuido~dos de la Mcidye Durante e
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28CuIdcados de la Mcidye Duranli- e
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30 NMotestiaEs Normales DUrarite P-
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32 Peliqyos Uu~ciote el Embcxyatzo
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34 ?eli gros que Neces.ifan Aiencio
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36 RaTf o Norrral PrImey Per'loo- C
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38PrimerT Petfodlo, Lo que Viacen l
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40 Th~MeT ?eTI'odo:- Lo que ace~la
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42 Ve r eviso~ 9 ue It COiSa es~e p
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44 'BegundIO "PeT'o0do Lao oue hace
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L 6 5e undo eFiodo (Tyae al Nitio)
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418Culdados al Rekcien Nacido. Scuc
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50 Cuidadlos al Recien Nacido. Pone
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52 Cuidcos al Pe,-'Ie n N ac6i6d El
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54-- Teycey FeTI'00do del Pa~d 0 o
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56 Cuid-jcc, Medicdo-- po Poire d~e
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Cuidlados a la Mache Desp,-*S %APe
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60 Enfer-medades COngelv-od o De eo
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62 'Be puecien daT Pmobemcis durant
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64 Crecimiento y De-siv~ollo cl Nii
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£1Niio Descde el Nacimienlo. kasia
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C~eimen.-oEI Nivzi de (o ct q Meses
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70 El Nifio cle- 12. ot it Meses. F
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72 Cyecimienlac 1~ Desorfollo Ul Ni
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- Cyecimienlo I ( Desamiolo. Acfivi
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Nu'rriyse es comner alirnenios 9 ue
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40! Nujeves~c Ebrads cn con anemi~a
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0 I Culdaco con 106 malos h6Abi+o)S
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APoqyamai de Romo~oy es cie SFoud "
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- 82 - Se debe desarrollar un plan
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