Provision of Reproductive Health Services by Traditional Birth Attendants and Health Workers in Rural Guatemala

This project started in 2009 with an intensive hospital-based training of 9 traditional bith attendants and 1 auxiliary nurse in standardized anthropometry and two methods of newborn gestational age assessment (Capurro and New Ballard), in an effort to assist in the identification of premature or small for gestational age newborns needing referral to health centers and hospitals. During this 5-week study, 65 babies were assessed by 10 trained health workers. In 2010, a qualitative study was conducted to identify knowledge, attitude, and behaviors in relation to obstetric care and exposures to household air pollution during the post-partum period. Five focus groups were conducted composed of a convenience sample of 39 TBAs and nurses in active practice in 19 rural Guatemalan communities. In 2011, a qualitative study on provider perceptions of family planning services was conducted using key informant interviews. Five traditional birth attendants, five nurses, two physicians, and one official from the Ministry of Health were interviewed using open-ended questionnaires about family planning services in the San Marcos Department of Guatemala. These three studies provide pilot data for a future, prospective cohort study to examine the impact of household air pollution from solid fuel use on birth weight and other infant outcomes. Results of these three studies have been presented at national conferences and have been written up and submitted for publication.


UCSF School of Nursing Intramural Funding (2009-10) and UCSF Global Health Sciences Burke Family Faculty Award (2009-present)