Dear John,

Last week, we launched our Guatemala in Focus appeal, highlighting our work with Indigenous Maya communities in the western highlands of the country.

Today, we’ll look at a central pillar of this activity: working with Traditional Birth Attendants (TBAs) to ensure Indigenous Maya women can access safe and culturally appropriate treatment throughout pregnancy. 

Indigenous Maya women usually prefer home births attended by TBAs. Often selected through divine revelations, these women are more than healthcare providers; they are trusted community leaders. These relationships present a significant opportunity to promote positive maternal health practices. 

We have brought together many Indigenous Maya TBAs and Ministry of Health (MoH) staff, so they can share knowledge about antenatal care, home delivery support, newborn care, and identifying danger signs. Crucially, they are finding ways to improve their practices to make them both safe and culturally appropriate. For TBAs, this has meant adopting equipment such as reusable impermeable aprons to improve hygiene practices (pictured above). 

"Now I look out for high blood pressure with my patients; you can tell if she speaks in an agitated way. Now I look out for swelling, or fatigue in my patients", Angela, TBA, Momostenango 

Health Poverty Action is working with TBAs and MoH staff towards an integrated healthcare system that respects cultural preferences while ensuring access to essential services. 

Exchange events between TBAs and Ministry of Health staff have led to the development of a system for emergency referrals to public health facilities. So far, 202 TBAs and 95 MoH workers have participated in these exchanges, improving their working relationships and practices. 

"I activate an emergency plan when I see any danger signs. If the pregnant woman is in trouble, I get her to the hospital quickly. For instance, when the placenta doesn’t come, I just try 5 or 10 minutes, no more", María, TBA, San Carlos Sija 

Further to this, 532 MoH staff have been trained in culturally appropriate practices through community dialogue with TBAs, facilitated by Health Poverty Action, so they can better support Indigenous communities. 

You and supporters like you enable us to commit to long-term initiatives, like our work with TBAs to improve maternal and child health. By donating to our Guatemala in Focus appeal, you'll help provide the training and resources needed to ensure women have access to safe and culturally appropriate healthcare globally. 

Warm regards,

Ella Ronan,

Communications Assistant