IFGH 2010: Promoting Safe Motherhood Amongst the Miskitu and Suma – Mayanga People, Raan, Nicaragua

The North Atlantic Region of Nicaragua (RAAN) has 6% of the country’s population but 18% of its maternal deaths. 40% of its population are Miskitu and 8% are Sumu- Mayangna indigenous people with a distinctive cosmo-vision and understanding of health and do not readily attend ministry of health MCH services.

A culturally appropriate safe motherhood model was developed and implemented in partnership with the local Ministry of Health (MOH). Its aims to enable Traditional Birth Assistants (TBAs), Community Health Commissions, MOH and Health Service Managers to work together to provide MCH services with which communities can engage, to reduce maternal morbidity and mortality.

The design and implementation of appropriate model of attention required community organization and research on cultural practices. A participatory design process helped to build consensus between beneficiaries, authorities and specialists. Focus group data shows that TBAs are open to evolving their traditional role. Working with local authorities (such as MOH) needs long term interventions using a programmatic approach instead of short term projects. Working with local staff at the manager level, instead of expatriate staff, proved essential.

The project demonstrates an effective approach to producing a sustainable culturally appropriate safe motherhood model and invites researchers to assist with further documentation and dissemination.

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