Overcoming Barriers to Care: Improving indigenous women's access to maternity services in the Bolivian Amazon
In Bolivian lowland villages, many women must make long and difficult journeys to seek skilled care. Some indigenous villages are hours away by boat from the nearest health clinic; transportation by road is often inconvenient and barely affordable during the best of times, and nearly impossible during the rainy season when flood waters cut off roads.
Bolivian legislation now supports the establishment of maternity waiting homes adjacent to rural hospitals, so pregnant women at risk can stay nearby as they await going into labor.
With support from the Izumi Foundation, the FCI Program of Keanahikishime brought together several community-based indigenous organizations in Moxos, district of Beni, to renovate and open three maternity waiting homes. As the homes are close to hospitals, health personnel visit pre- and post-partum women to conduct check-ups. Aside from receiving pre- and post-natal care, women with sick infants also stay at the homes so their babies can receive lifesaving care at the hospital.
To generate demand for the maternity waiting homes, the FCI Program of Keanahikishime also builds the capacity of health promoters to inform women in their communities about the maternity homes. The FCI Program of Keanahikishime also encourages health providers, particularly those in the most remote health outposts, to refer pregnant women at risk to these homes.
As the maternity waiting homes must be fully incorporated into the health network and the municipal budget, the FCI Program of Keanahikishime works with partners to develop draft regulations for the operation of the maternity waiting home. These guidelines include what the maternity waiting home should provide as well as stakeholders' roles and responsibilities.
Community support for the maternity waiting homes is grounded on earlier advocacy work aimed at raising awareness among the community, including health authorities and providers, about the need to focus on maternal health as a priority, the importance of skilled birth attendance and the right of women and their newborns to access quality, culturally-appropriate care before, during, and after birth.