Results from the Community-Based Impact-Oriented (CBIO) Child Survival Survey Report
Knowing where and how Curameri
cas makes an impact is crucial for the success of our programs. Impact Global Health Alliance recently conducted a survey in Guatemala to measure the impact that our Community-Based Impact-Oriented and Care Group (CBIO+CG) methodology has on unifying communities. The goal of the survey was to determine if creating Community Health Plans, community emergency transportation plans, and the formation of Care Groups actually empowered communities to improve their own health. These surveys ensure that the direction of our programming is working to meet the needs of communities and are essential to creating sustainable practices that will continue to improve lives for many years to come.
Our Guatemala program seeks to reduce maternal and child deaths across the remote, mountainous region of Huehuetenango, an area primarily inhabited by a rural, poor Mayan population with very limited health facilities and resources. The CBIO+CG method builds partnerships with communities, and includes door-to-door visits to learn about community needs, designing programs that address these needs, delivering services, and collecting data to measure the impact of the programs. Care Groups (CG) are an essential program part and are made up of women in the community who have been trained in basic health and nutrition. These women teach mothers in their community the importance of breast feeding, eating foods with high nutritional value, and many other skills while offering advice on issues central to a healthy lifestyle.
By conducting the CBIO survey, we learned that our project was successful in building trust and community participation in Huehuetenango, which led to some very positive results. There was a significant increase in the number of communities with emergency response plans (to aid mothers who experience birth complications). This is very important since it helped to lower the maternal mortality ratio from 740 deaths/100,000 live births (between Oct. 2012 and Sept. 2013) to 221 deaths/100,000 live births (between Oct. 2014 and May 2015). In the last 3 years of the project, 82 out of 84 women who had complications with pregnancy, delivery, or post-partum, and were transported to either the Casa Maternas or a hospital, survived. This drop in maternal mortality was accomplished through pregnant mothers delivering their babies at Casas Maternas, community-owned and managed maternal birthing centers, as well as an increase in the use of emergency transport (in case there were complications with pregnancy, delivery, or post-partum).
In our program communities, there has been a dramatic increase in the awareness that pneumonia, diarrhea, and fever are community health priorities, which supports data that shows pneumonia as the number one cause of death for children under 5 years, and diarrhea as the number three cause. However, the project was not successful in increasing awareness that lack of family planning and malnutrition in children were community health priorities. Also, despite education efforts through groups and Casas Maternas, the use of modern contraceptives did not change from 2012-2015 and usage remains low. The birthrate remains high, especially in teens, adding to maternal mortality, poverty, and food insecurity.
The project was successful in greatly increasing the number of babies delivered in health facilities. However, most women are still delivering babies at home, indicating the need to increase awareness of the dangers of delivering a baby at home. Overall, the report showed very positive program feedback! Impact Global Health Alliance Global will use the information generated in this report to improve the quality of our projects and services to better meet the needs of mothers and children in Huehuetenango.
For full survey results, please see the full report here. For those interested in a brief description of the survey methodology used, please see below.
Survey Methodology
91 communities participated in programming during Phase 1 and received project involvement from October 2011-May 2015. 89 communities participated in Phase 2, who received project involvement only from October 2013-May 2015. In January 2012, 599 mothers of children 0-23 months were surveyed to determine a baseline. In September 2013 a mini-survey of 94 mothers of children age 0-23 months was conducted in Phase 1 communities. A final survey of 600 mothers of children age 0-23 months was conducted in June 2015.
Survey Results
In Phase 1 communities, the percentage of mothers who reported that their community had an emergency response system in place increased from 29.4% in the 2012 survey to 44.7% in the 2015 survey. Additionally, the percentage of mothers who reported that their community had worked together to solve a problem or make an improvement in the past 90 days increased from 13% in 2012 to 66% in 2013 and then declined to 11% in 2015.
In Phase 2 communities, the percentage of mothers who reported that their community had an emergency response system in place increased from 37% in 2012 to 52.7% in 2015, yielding a significant 15.7% increase in these 3.5 years. Furthermore, the percentage of mothers of who reported that their community worked together to solve a problem or make an improvement in the past 90 days increased from 16% in 2012 to 22.7% in 2015, for an overall 6.7% increase in 3.5 years.
When Phase 1 and Phase 2 communities were compared in 2015, 44.7% of Phase 1 community mothers reported that their community had an emergency response system, as opposed to 52.7% in Phase 2. 11% of Phase 1 community respondents reported that their community has worked together in the past 90 days, nearly half when compared to the 22.7% of Phase 2 community respondents.
Phase 2 communities showed significantly higher emergency response plans and community problem solving, which are our two indicators for end of project coverage, ) than Phase 1 communities. This shows that superior improvements in the indicators were achieved in Phase 2, despite having a shorter duration of project interventions.
