Partnering with traditional birth attendants to reach indigenous women in Colombia - Colombia - ReliefWeb

BOGOTA, Colombia – “Colombia is a multicolored country, with varied customs, practices and celebrations... Within that level of inclusion, we need to add traditional midwifery,” said Ledy Manuela Mosquera Moreno, a nurse and the executive director of the Association of the Interethnic Network of Midwifery Practitioners of the Department of Chocó.

Traditional birth attendants and midwives can play a critical role in improving the survival of pregnant women and post-partum mothers in remote and marginalized parts of the country, she and other experts say. Such efforts are important in indigeous areas. The maternal death rate in Colombia has been falling for years, yet many of these gains have not been seen by indigenous communities, where maternal death rates are nearly five times higher, according to the National Health Institute.

There are many barriers to quality maternal health care in these communities, including economic marginalization as well as cultural hurdles, such as fear of Caesarean sections, shame at seeking help outside the community and challenges with language. This is where traditional birth attendants and traditional midwives can help.

“Midwifery goes beyond assisting with a delivery,” said Ms. Mosquera, whose organization works with UNFPA in the Partera Vital project, which equips traditional midwives and community health workers with modern skills and tools. “It is advising, accompanying, guiding women, families and the community in all matters of sexual and reproductive health.”

Respect and trust

UNFPA is also working with traditional midwives in the Global Action Plan for Healthy Lives and Well-being for all, also known as the GAP.

The GAP is a collaboration with three other UN agencies, the health ministry and local authorities. Through this partnership, the Pan American Health Organization is working with health systems to improve maternal health and health systems; UNICEF is mobilizing resources to improve training standards for health teams and traditional practitioners; and the World Food Programme is working to strengthen food and nutritional security in remote communities. UNFPA’s contribution is to training community workers and traditional birth attendants in the indigenous Arhuaca and Wayuu communities, and is also helping to ensure that health facilities and practitioners respect and support indigenous practices.

This approach made all the difference to María Cambar, who was reluctant to go to the nearby Dusakawi maternity clinic in northern Colombia – even when she was in active labour. But a community health worker, Leyla Yadira González, reassured her that her indigenous traditions and perspective would be respected if she were to accept medical assistance. Ms. Cambar felt she could trust Ms. González, who was not only a nurse trained in western medicine but also a member of the community honoured by elders of the Wayúu matriarchal society as a traditional practitioner.

Ms. Cambar was taken by ambulance to the clinic, where she had access to an interpreter and even slept in a bed similar to the hand-woven hammocks, 'chinchorros', she used in her home. There, she gave birth to a healthy baby boy.

Working together

Through the GAP programme, which was launched in 2015, these collaborations between health systems and indigenous communities are being scaled up throughout northern Colombia.

And UNFPA’s other partnerships, with indigenous leaders like Ms. Mosquera, are also having an impact.

“Why is it important? Because this allowed and still allows a link between ancestral knowledge and all actions that in one way or another are articulated within the health services,” Ms. Mosquera says.

She gives a lot of credit to community members themselves, who are working hard to bridge gaps, like “the midwife who considers herself trained from the ancestral perspective yet with the necessary skills and techniques to adequately assist a delivery.”

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