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
Abstract 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 Mate...
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| Format: | Article |
| Language: | English |
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BMC
2023-02-01
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| Series: | International Journal for Equity in Health |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12939-022-01761-x |
| _version_ | 1827984838163955712 |
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| author | Jason Lambden Shayanne Martin Mario Valdez Ira Stollak Carey C. Westgate Henry B. Perry |
| author_facet | Jason Lambden Shayanne Martin Mario Valdez Ira Stollak Carey C. Westgate Henry B. Perry |
| author_sort | Jason Lambden |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-04-09T23:05:16Z |
| format | Article |
| id | doaj.art-770b04ba50984dc6b359d0440e09c1f6 |
| institution | Directory Open Access Journal |
| issn | 1475-9276 |
| language | English |
| last_indexed | 2024-04-09T23:05:16Z |
| publishDate | 2023-02-01 |
| publisher | BMC |
| record_format | Article |
| series | International Journal for Equity in Health |
| spelling | doaj.art-770b04ba50984dc6b359d0440e09c1f62023-03-22T10:43:36ZengBMCInternational Journal for Equity in Health1475-92762023-02-0121S211310.1186/s12939-022-01761-xReducing inequities in maternal and child health in rural Guatemala through the CBIO+ Approach of Curamericas: 9. Key stakeholder perspectives on strengthening the CBIO+ ApproachJason Lambden0Shayanne Martin1Mario Valdez2Ira Stollak3Carey C. Westgate4Henry B. Perry5McGaw Medical Center, Northwestern UniversityInstitute for Global Health Sciences, University of California San FranciscoCuramericas/Guatemala, Calhuitz, San Sebastián CoatánCuramericas GlobalCommunity Health Impact CoalitionHealth Systems Program, Department of International Health, Johns Hopkins Bloomberg School of Public HealthAbstract 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.https://doi.org/10.1186/s12939-022-01761-xMaternal healthChild healthCommunity healthPrimary health careCommunity-based primary health careImplementation research |
| spellingShingle | Jason Lambden Shayanne Martin Mario Valdez Ira Stollak Carey C. Westgate Henry B. Perry 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 International Journal for Equity in Health Maternal health Child health Community health Primary health care Community-based primary health care Implementation research |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| topic | Maternal health Child health Community health Primary health care Community-based primary health care Implementation research |
| url | https://doi.org/10.1186/s12939-022-01761-x |
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