Bellon Margot, Brody Annalie, Parker Mahdia, Mendoza Ana Leticia, Hernandez Sasha, Clarke Rachel D, Shirazian Taraneh, Oliveira Jessica B
Drexel University College of Medicine, Philadelphia, Pennsylvania, USA.
Saving Mothers, New York, New York, USA.
Int J Gynaecol Obstet. 2025 Jul;170(1):439-447. doi: 10.1002/ijgo.16165. Epub 2025 Jan 21.
Guatemala has one of the highest rates of maternal mortality in Central America. A total of 60% of births in Guatemala are attended by traditional Mayan birth attendants, or comadronas. Their prevalence in these communities makes them a valuable resource to bridge home births with safe prenatal care. The objective of this study was to evaluate a low-cost prenatal care training program for Guatemalan comadronas with the goal of improving maternal health outcomes in the region.
In this retrospective longitudinal cohort study, we examined the knowledge retention of comadronas enrolled in a 12-month prenatal care training program known as the School of PowHER (SOP). Recruited from the Lake Atitlán region of Guatemala by Saving Mothers, 501(c)(3) and the Guatemalan Ministry of Health, comadronas participated in a four-month didactic curriculum followed by a nine-month clinical curriculum. Pre- and post-tests were administered to assess learning outcomes over the study's duration (2014-2022), and test results were evaluated to assess the effectiveness of the SOP.
A total of 123 women were recruited and enrolled in all eight graduating classes of the SOP from 2014, 2016-2019, and 2021-2022. An average, statistically significant improvement in didactic and clinical pre- and post-test scores was found across all years analyzed.
The SOP is a low-cost, culturally appropriate, community-based model that empowers comadronas through knowledge and skill acquisition to improve local maternal health outcomes. This program proves effective at not only teaching comadronas prenatal health information and clinical skills, but also at promoting long-term retention of these skills.
危地马拉是中美洲孕产妇死亡率最高的国家之一。危地马拉60%的分娩由传统的玛雅助产士（即“科马德罗纳”）接生。她们在这些社区中的普遍存在使她们成为连接家庭分娩与安全产前护理的宝贵资源。本研究的目的是评估一项针对危地马拉科马德罗纳的低成本产前护理培训项目，目标是改善该地区的孕产妇健康结局。
在这项回顾性纵向队列研究中，我们考察了参加一个为期12个月的名为“力量学校”（SOP）的产前护理培训项目的科马德罗纳的知识保留情况。科马德罗纳由501(c)(3)组织“拯救母亲”和危地马拉卫生部从危地马拉的阿蒂特兰湖地区招募而来，她们参加了为期四个月的理论课程，随后是为期九个月的临床课程。在研究期间（2014年至2022年）进行了前后测试，以评估学习成果，并对测试结果进行评估以评估SOP的有效性。
从2014年、2016年至2019年以及2021年至2022年，共有123名女性被招募并参加了SOP的所有八个毕业班。在所有分析年份中，理论和临床前后测试分数均有统计学意义的平均显著提高。
SOP是一种低成本、适合文化背景、基于社区的模式，通过知识和技能获取增强科马德罗纳的能力，以改善当地孕产妇健康结局。该项目不仅在教授科马德罗纳产前健康信息和临床技能方面有效，而且在促进这些技能的长期保留方面也有效。
