Curamericas Global, Raleigh, North Carolina, USA.
Curamericas/Guatemala, Calhuitz, San Sebastián Coatán, Huehuetenango, Guatemala.
Int J Equity Health. 2023 Feb 28;21(Suppl 2):200. doi: 10.1186/s12939-022-01760-y.
Indigenous Maya women in the rural highlands of Guatemala have traditionally faced constraints to decision-making and participation in community affairs. Anecdotal experiences from previous Curamericas Global projects in Guatemala and Liberia have suggested that interventions using the CBIO+ Approach (which consists of implementing together the Census-Based, Impact-Oriented Approach, the Care Group Approach, and Community Birthing Centers), can be empowering and can facilitate improvements in maternal and child health. This paper, the eighth in a series of 10 papers examining the effectiveness of CBIO+ in improving the health and well-being of mothers and children in an isolated mountainous rural area of the Department of Huehuetenango, explores changes in women's empowerment among mothers of young children associated with the Curamericas/Guatemala Maternal and Child Health Project, 2011-2015.
Knowledge, practice, and coverage (KPC) surveys and focus group discussions (FGDs) were used to explore six indicators of women's empowerment focusing on participation in health-related decision-making and participation in community meetings. KPC surveys were conducted at baseline (January 2012) and endline (June 2015) using standard stratified cluster sampling. Seventeen FGDs (9 with women, 3 with men, 2 with mothers-in-law, and 3 with health committees), approximately 120 people in all, were conducted to obtain opinions about changes in empowerment and to identify and assess qualitative factors that facilitate and/or impede women's empowerment.
The KPC surveys revealed statistically significant increases in women's active participation in community meetings. Women also reported statistically significant increases in rates of participation in health-related decision-making. Further, the findings show a dose-response effect for two of the six empowerment indicators. The qualitative findings from FGDs show that the Project accelerated progress in increasing women's empowerment though women still face major barriers in accessing needed health care services for themselves and their children.
The Project achieved some notable improvements in women's decision-making autonomy and participation in community activities. These improvements often translated into making decisions to practice recommended health behaviors. Traditional cultural norms and the barriers to accessing needed health services are not easily overcome, even when empowerment strategies are effective.
危地马拉农村高地的土著玛雅妇女在决策和参与社区事务方面历来受到限制。危地马拉和利比里亚以前的 Curamericas Global 项目的经验表明，使用 CBIO+ 方法（包括共同实施基于普查的面向影响方法、关怀小组方法和社区分娩中心）的干预措施可以赋予权力，并可以促进改善母婴健康。本文是 10 篇论文系列中的第 8 篇，探讨了 CBIO+ 在改善危地马拉韦韦特南戈省一个偏远山区农村地区母婴健康和福祉方面的有效性，探讨了 2011-2015 年期间，与 Curamericas/危地马拉母婴健康项目相关的幼儿母亲赋权的变化。
使用知识、实践和覆盖（KPC）调查和焦点小组讨论（FGD）来探索六个妇女赋权指标，重点是参与与健康相关的决策和参与社区会议。KPC 调查于基线（2012 年 1 月）和终点（2015 年 6 月）进行，使用标准分层聚类抽样。共进行了 17 次 FGD（9 次与妇女、3 次与男子、2 次与婆婆、3 次与卫生委员会），总共约 120 人，以获取关于赋权变化的意见，并确定和评估促进和/或阻碍妇女赋权的定性因素。
KPC 调查显示，妇女积极参与社区会议的比例有统计学意义的增加。妇女在参与与健康相关的决策方面的比例也有统计学意义的增加。此外，研究结果表明，六个赋权指标中的两个存在剂量反应效应。FGD 的定性结果表明，该项目加速了增加妇女赋权的进展，尽管妇女在为自己和子女获得所需的医疗保健服务方面仍然面临重大障碍。
该项目在妇女决策自主权和参与社区活动方面取得了一些显著的改进。这些改进通常转化为做出实践建议的健康行为的决策。即使赋权策略有效，传统的文化规范和获得所需卫生服务的障碍也不容易克服。
