The maternity waiting home is now fully functional, equipped and well utilized by women from Pando District in Bolivia!
The number of women seeking services at the maternity waiting home over the last year, based on health district records
Estimated girls & women affected
Information about the waiting home was disseminated to 57 communities in the waiting home’s area. Communities in this area have an average of 60 people; 50% of which are women and girls
Estimated community members affected
The maternity waiting home is now fully functional, equipped and well utilized by women from the Pando District in Bolivia. On average, it’s visited by six women a month, many of whom suffer from pre-eclampsia and seek urgent care. Not only are the women at lesser risk when they go into labor by being right next to the clinic, they also use the waiting home for postpartum recovery and care. Women attending the maternity waiting home are also now getting vaccinations for their children who accompany them to the center.
At the beginning of the project, Family Care International (FCI) held meetings with community members, health center staff, and municipal authorities to develop a joint work plan. FCI held capacity-building workshops with 57 health promoters who are now conducting outreach to build awareness on the maternity waiting home, signs of risk during pregnancy, and emergency referral plans. The referrals to the maternity waiting home are a result of their effective outreach. Together with partners, FCI identified the culturally appropriate furnishing needs of the maternity waiting home in the town of Puerto Rico. Among the items purchased with the generous contribution of Catapult donors are: tables and chairs, hammocks, beds, kitchen utensils, and an air conditioner. In addition, a chicken coop was built next to the waiting home for the pregnant women bringing hens, since chicken broth is a traditional food given during and after delivery. These culturally appropriate items comfort women.
María lives far away from a health center. Two weeks before her due date, María felt a strong pain. A trusted neighbor assured her that it was not time to give birth. However, María was scared, so a trucker drove her to the health center to see a doctor, who advised her to return later. As getting home and back to the clinic would have been difficult and risky, María stayed at the maternity waiting home for two days. When her water broke, she had easy access to a clinic & gave birth to a healthy baby.
Risks and challenges
The maternity waiting home has broad community support. Local and federal governments have allocated funds for running the home during the first year of operation. However, elections in October might pose a risk to ongoing funding. Without funding, women could lose access to quality care to ensure a safe delivery. FCI and partners will continue to advocate for budgets to include upkeep of the maternity waiting home and presence of skilled birth attendants at the health center in the coming years. Support from individuals has been instrumental in supplying the home with essentials to ensure its use and save lives.
What we’ve learned
Participation of key stakeholders was critical to the success of this project. As local health authorities and indigenous leaders in Pando have been involved in all stages of planning and implementation - from building community awareness of the waiting home, to promoting its use, and capacity building workshops with local health promoter -, these local leaders fully recognize the value added of the maternity waiting home and have expressed commitment to sustain it. It was important that this project was based on the expressed needs of women in the community. Furthermore, the solid commitment of the Ministry of Health of Bolivia to maternity waiting homes is key to ensuring sustainability in the future.
The maternity waiting home is now well utilized by women and their families. Since the waiting home has been running, there appears to be a trend in increased skilled birth attendance at the health center. However, only four out of every six pregnant women visiting the waiting home deliver in the health center. A third of those staying at the maternity waiting home choose to deliver at home. FCI will focus on addressing these barriers to care and promote skilled attendance at birth.
Amount spent so far
Equipment for the maternity waiting home
Family Care International (FCI) held meetings with indigenous women leaders from our partner organization, CIMAP – Central de Mujeres Indígenas de la Amazonía, to discuss needs. The women identified the immense need to have a maternity waiting home near the main hospital of the Department of Pando that could accommodate both pregnant women and their families. In response, FCI provided technical assistance to indigenous women leaders from CIMAP to develop a proposal to improve the maternity waiting home. The women leaders presented the proposal to the Minister of Health of the Department of Pando. As a result, the Minister committed to refurbish the maternity waiting home. Work is to start immediately. Once this is complete, FCI will purchase the equipment for the home with the funds generously donated by Catapult contributors. This will give pregnant women and their families a safe, culturally appropriate place to stay during the days and weeks before going into labor to ensure that they will be near the hospital before giving birth.
Risks and challenges
FCI has a close partnership with indigenous leaders from CIMAP, and this project is based on needs identified by the women themselves, and has the full support of local health authorities. The Department of Pando has secured federal funding to ensure the presence of qualified doctors and adequate access to skilled obstetric care. One of the risks is that the rainy season, which runs from October to March, has started and it’s possible that it could cause some delays in refurbishing the maternity waiting home.
Many women in the region are directly touched by the need to have access to skilled obstetric care and personally know a neighbor or family member who has died during childbirth. Recently, a woman from a small indigenous community two hours away from the hospital, had signs of pre-eclampsia during her seventh month of pregnancy. She made the difficult journey in a rented vehicle to the hospital, where she spent three days and her condition was treated and temporarily stabilized. The doctors recommended that she stay in the hospital longer, but the woman did not feel comfortable there – physically or culturally - and decided to return to her community. A week later, she died as a result of convulsions caused by uncontrolled high blood pressure. This tragedy has really shaken the community and was one of the main reasons CIMAP leaders identified the need for a comfortable, culturally appropriate, waiting home for women with high-risk pregnancies, and their families.
Once the maternity waiting home is ready, FCI will purchase culturally appropriate supplies with the funds generously donated by Catapult contributors. In the meantime, we will continue working with CIMAC leaders to follow up on government commitments for the maternity waiting home.
FCI will also continue to work with providers and local authorities to ensure that quality and respectful care, adapted to the cultural needs and expectation of indigenous women, are offered at the hospital.
In the poor, remote villages of the Amazon, women die from treatable childbirth complications because they can’t make it to a health clinic in time.
Why we care: Bolivia has the highest maternal mortality in South America, and indigenous communities have the highest maternal mortality in the country.
How we're solving this: Equipping a maternity waiting home, so indigenous women have a safe place to stay near the hospital as their due date approaches.
Along the rivers of the Bolivian lowlands, many pregnant women have little or no access to basic reproductive health services. In Bolivia, the country with the highest maternal mortality rate in South America, even the most common childbirth complications can turn fatal. In these remote communities, nearly two-thirds of all maternal deaths occur at home, or as the woman makes the long and difficult journey to a health facility. When the rivers flood in the wet season, traveling quickly to the clinics becomes almost impossible and women die from complications as they try to get to emergency care.
To address this barrier, Family Care International (FCI) is working with local health authorities and women’s groups to equip a maternity waiting home, near the regional hospital in the town of Puerto Rico, in the Pando Region of Bolivia. Pregnant women and their families will be able to stay at the home in the days and weeks before going into labor to ensure that they will be near the hospital before giving birth. Once it is equipped, the home will be available to 1,000 women of reproductive age and their families in the area. The maternity waiting home will be especially crucial for women giving birth in the wet season, when traveling to the hospital is the most difficult.
When you donate to this project, the money will go directly to buying the equipment for the maternity waiting home, including beds, fully equipped kitchens and other culturally appropriate supplies needed to make the women and families feel comfortable. For many pregnant Bolivian women, getting to a healthcare facility often means the difference between life and death. Ensuring access to the hospital is a huge step in the fight to reduce maternal mortality in the region.