Update for spring 2013.
- In 2011 the United States Agency for International Development (USAID) announced a five-year, $32 million project to improve the nutrition and health status of women and children in the highlands Guatemala–essentially the same geographical area covered by TulaSalud. Over the last year or so we have discussed with USAID how we might coordinate funding and implementation. In June 2012 the administration of the contract was awarded to University Research Co, so work could begin. There are a number of potential collaboration: extending CAEC to train nurses for the USAID program, using TulaSalud ‘s capability for in-service training, etc. We will announce progress in this area on our blog.
- Based on the success of the community health initiatives in Alta Verapaz, there is impetus from the Ministry of Health to replicate the program in other departments. We are very keen to see this happen, provided we can find a way to manage the funding and logistical challenges this would entail.
- Our technology component (Kawok) based on Dimagi’s CommCare product is proving to be a very effective tool in our community health program in Alta Verapaz. We (the Tula Foundation, TulaSalud, Dimagi and the Ministry of Health) are in discussions about adopting it as the national standard. We are of course interested in seeing this happen, provided this can be done in an orderly fashion, the reflects the challenges involved in scaling such a system, and the importance of coupling the technology with effective training and collaboration at a local level–the kind of groundwork we have done with DASAV for many years in Alta Verapaz. In parallel we would continue to use Alta Verapaz as our application development center because of the quality and experience of the local health officials in DASAV and their team of community health workers.
- The Ministry of Health (MOH) serves rural communities via the Health Extension Coverage program (or PEC for its Spanish acronym), which has been the model since the Peace Accords were signed in 1996. Recently the MOH has been considering changes to the PEC, potentially affecting the roles of auxiliary nurses and community health workers. TulaSalud and colleagues at DASAV have been contributing to deliberations, offering suggestions based on experience in Alta Verapaz.
- The Tula Foundation has helped fund a traditional birthing center for the regional hospital (Helen Lossi de Laugerud) in Coban, which serves all of Alta Verapaz. We, and all our partners in Guatemala, fully support the traditional midwives (comadronas) and the work they do in their communities, and favor wherever possible that births take place at home. Under some circumstances, though, the health of the mother and child is better served by having the birth monitored in hospital. The purpose of the traditional birthing center is to ensure that in those cases the experience of birth in hospital respects the cultural traditions of the families as much as possible. We proceeded with this initiative only when we were assured that all parties were on side.
- TulaSalud has become the go-to group for international agencies planning health projects in Alta Verapaz. We are always looking for synergies with our existing programs and ways to provide bridges to DASAV and the other organizations we work with.