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Reducing inequities in maternal and child health in rural Guatemala through the CBIO+ Approach of Curamericas: 9. Key stakeholder perspectives on strengthening the CBIO+ Approach.
Lambden, Jason; Martin, Shayanne; Valdez, Mario; Stollak, Ira; Westgate, Carey C; Perry, Henry B.
Afiliação
  • Lambden J; McGaw Medical Center, Northwestern University, Chicago, Illinois, USA.
  • Martin S; Institute for Global Health Sciences, University of California San Francisco, San Francisco, California, USA.
  • Valdez M; Curamericas/Guatemala, Calhuitz, San Sebastián Coatán, Huehuetenango, Guatemala.
  • Stollak I; Curamericas Global, Raleigh, North Carolina, USA.
  • Westgate CC; Community Health Impact Coalition, New York, New York, USA.
  • Perry HB; Health Systems Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA. hperry2@jhu.edu.
Int J Equity Health ; 21(Suppl 2): 201, 2023 02 28.
Article em En | MEDLINE | ID: mdl-36855068
BACKGROUND: Community-based health interventions have been an integral part of recent health gains globally. An innovative approach to delivering community health care combines the Census-Based, Impact-Oriented (CBIO) Approach with Care Groups and Community Birthing Centers called Casas Maternas Rurales. CBIO+ was adopted by Curamericas/Guatemala in its Maternal and Child Health Project, 2011-2015. Here, we describe the opinions of Project staff and local government health care workers about the strengths and challenges of CBIO+.  METHODS: Self-administered questionnaires, key informant interviews, and focus group discussions were used to obtain the views of 21 staff members from Curamericas/Guatemala as well as 15 local government health workers. The evaluation focused on four primary areas: (1) advisability of integrating the CBIO+ Approach into the government's rural health system, (2) staff knowledge of the CBIO+ Approach, (3) advantages, disadvantages and challenges of the CBIO+ Approach, and (4) proposed improvements to the CBIO+ Approach. The data were coded into categories and from these categories themes were derived. RESULTS: The most commonly mentioned advantage of CBIO+ was the inclusion of the community in program planning, which improved participation. Many respondents noted that the CBIO+ Approach was challenging to implement in communities with internal conflicts. Among other challenges mentioned were coordinating (both among the Project staff and with others in the communities), maintenance of a high level of community participation, and overcoming opposition of men to women's participation in Care Groups. The staff mentioned a number of possible changes, including increasing male involvement, raising salaries for community-level paid staff, providing volunteers with incentives, and improving coordination both internally and externally. There was a strong demand among the local Ministry of Public Health and Social Welfare staff for the Project to continue. CONCLUSION: The CBIO+ Approach and its implementation by Curamericas/Guatemala was overall embraced by local staff. By eliciting feedback while the project was ongoing, actionable areas for improvement were identified.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Saúde da Criança / Censos Tipo de estudo: Qualitative_research Aspecto: Equity_inequality Limite: Child / Female / Humans / Male País/Região como assunto: America central / Guatemala Idioma: En Revista: Int J Equity Health Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: Reino Unido

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Saúde da Criança / Censos Tipo de estudo: Qualitative_research Aspecto: Equity_inequality Limite: Child / Female / Humans / Male País/Região como assunto: America central / Guatemala Idioma: En Revista: Int J Equity Health Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: Reino Unido