GPA's training program builds on the ancestral knowledge that Indigenous midwives have passed down for generations
In poor regions, where access to state health services is limited, traditional midwives, or birth attendants (TBAs), often provide initial and essential maternal and child health care. In many of the communities where we work, at least 80% of births take place at home with assistance of TBAs. We support these important practitioners by offering workshops in evidence-based pediatric primary care, prenatal care, birth techniques and management, the recognition of risk factors and danger signs, and the integration of traditional medicine. Our training program, developed from an intercultural, gender-based perspective of care, recognizes and values these essential health workers as true specialists in their communities for caring for women, while also enriching their knowledge and practice with elements of Western Medicine.
We design our curriculum and teaching methods through direct collaboration with workshop participants, and incorporate an intercultural, gender and rights-based perspective of care. Our instructors are doctors, nurses and bilingual professional midwives. Our trainings are dynamic and incorporate interactive, participatory, adult-learning techniques, taking into account the various education, language and cultural backgrounds of participants.
Programs Teaching the Skills to Save Lives
Indigenous midwives in El Roblar, Mexico learn to monitor a fetal heart rate as part of a GPA training series
Chiapas and Yucatán
Over the past eight years, we have been collaborating with W.K. Kellogg Foundation to train, organize, and equip upwards of 800 Tzeltal, Tzotzil and Maya-speaking midwives in the regions of Los Altos de Chiapas, Ocosingo, Sitalá, Yajalón, Chilón, Guaquitepec and Altamirano, as well as the health districts of Mérida, Valladolid and Tizimin, in the state of Yucatan. These are rural areas with extremely isolated health care, where 88% of the population is poor and where a majority of people live in extreme poverty. The project addresses comprehensive prenatal care; community and medical response to obstetric emergencies; and family planning, and violence and gender inequality as they impact maternal health. A community action plan will be in place to refer mothers to health institutions when needed, and we are working with local authorities and health centers to systematize referrals and treatment of common causes of maternal death. Our work is projected to impact approximately 210,000 people.
Las Margaritas, Chiapas
85% of the population in the municipality of Las Margaritas speaks Tojolabal, with the remaining population speaking either Tzotzil (6.3%) or Kanjobal (4.%). It is one of the municipalities with the lowest Human Development Index rankings and is classified as "highly marginalized" by the National Population Council (CONAPO). Out of the 111,487 inhabitants, 75.339 live in extreme poverty. Health services are inadequate especially for the many isolated communities in the municipality. Teenage marriage and pregnancy is common. GPA held a series of five trainings for a group of 29 traditional midwives from the Nichim Dios organization, divided into advanced and new TBA groups in order to advance their skill levels in prenatal care, attending deliveries and recognizing obstetric emergencies. Many of the midwives have built links with the Hospital de Salud in Las Margaritas, and represent 14 communities, reaching an estimated 15,000 people.
More than 70 midwives from the Los Altos region of Chiapas received a year-long series of trainings on lifesaving skills
In collaboration with the local organization FOCA, 20 midwives from the Luz de Salvación midwifery organization in Sitalá, which GPA has been working with and who represent 16 communities and approximately 4,900 people, received follow up training on responding to obsteric emergencies. Additionally, with Pace International, 33 traditional midwives representing Sitalá, and San Cristóbal de las Casas, were trained in CLSO (Community Life Support for Obstetrics).
Indigenous midwives in Chiapas, Mexico practice neonatal resuscitation techniques
San Cristóbal de las Casas, Chiapas
GPA partnered with Save the Children to offer a series of four workshops to 28 midwives and Community Health Promoters representing four neighborhoods in San Cristóbal de las Casas to recognize and respond to emergency situations during pregnancy, birth and in the post-partum period. Ten of the participants also participated in a course on breastfeeding.
Midwives and health promoters from areas near San Cristobal de las Casas, Mexico discuss high risk factors during pregnancy