Maternal and child health and HIV/AIDS

UNICEF’s main role lies in advocating key issues with counterparts and providing technical assistance to enable effective planning, budgeting and implementation of selected interventions. In addition, we support the monitoring and evaluating of their services to identify health barriers and bottlenecks. Innovative approaches were promoted to tackle challenges such as the high maternal mortality ratio, and partnerships are strengthened at all levels.

Main Achievements in 2015


Tackling maternal mortality through capacity building of students, women, mothers and communities

sample-image UNICEF continued to further develop technical assistance and promote cost-effective interventions in order to promote maternal health. These initiatives helped to achieve the following outcomes:

• 24 female community leaders in Potosi and Cochabamba were trained as facilitators in health self-care, including family, newborn, and pregnant women care. They reached out to 60 communities and provided information to more than 40 indigenous women of reproductive age; and

• 18,000 students from 25 schools in Potosi received information regarding safe pregnancy, violence, and HIV prevention.

Improving service delivery at municipal level

UNICEF Bolivia supported the “Backpack for Life” initiative that allows municipalities to provide obstetric and neonatal emergency care. In addition, the Continuous Quality Improvement Cycles (CQICs) (see case study box), which monitors 13 quality standards, was expanded from 4 to 96 health facilities, and the Ministry of Health (MoH) elevated the CQICs as a National Standard for all health structures. The kangaroo care method was also introduced as a cost-effective, high-impact intervention to improve care for premature babies.

Strengthening technical assistance at the national level

UNICEF also supported the development of the National Maternal Mortality Study, with technical assistance at the national level and operational support in the Departments of Cochabamba and Potosí. It generates updated baseline information on key variables linked to maternal mortality enabling the national maternal and neonatal health policy to be reoriented.


Key partners

The Ministry of Health; Ministry of Environment and Water; the Ministry of Education; UN agencies such as UNAIDS, PAHO/WHO, UNFPA; Non-governmental Organisations (NGOs) and Civil Society Organizations (CSOs) as well as universities in Bolivia and abroad such as the Emory University. Strategic collaboration has also been developed within the framework of South-South and Triangular Cooperation with Brazil, Cape Verde, Guinea Bissau, Nicaragua, Paraguay, São Tomé and Príncipe, Timor Leste. Important partnerships have been established with Sweden, the European Union, Korean Foundation for International Health and UNICEF National Committees.


Geographic and Population Focus

The Departments of Potosi (the health networks of: Rural Potosí and the municipalities of: Belén de Urmiri, Porco, Tacobamba, Tinguipaya, Tomave, Yocalla); Cochabamba (the health networks of Sacaba, Ivirgarzama, Villa Tunari); and, Department of Santa Cruz in HIV actions (16 networks Health).


Preserving life and health along the Chapare River
In the hands of birth attendants
By Delina Garsón

The health centre in La Misión serves a population of about 800 Yuracaré indigenous people.  The community is located on the banks of the Chapare River on the edge of the Isiboro Secure national park in the Amazon region, which is home to the Yuracaré, Yuqui and Moxeño Trinitario indigenous peoples.

Dr.  Yver Jaylla has been working in the health centre for three years, alongside two other doctors, a nurse and a dentist. “The people we serve live in small communities scattered along the river. As part of our work, we visit families at home and that means organising trips lasting several days. During these home visits we vaccinate babies and children, give pregnant women prenatal check-ups, provide dental and general medical care, and take action to prevent malnutrition. But our work is only possible thanks to the leaders of the local health committees and the community birth attendants. They are like our right arm in preventive healthcare, and the work they do allows us to look after people’s health and lives.”

 

UNICEF Bolivia/2015/Garsón
Facundo Chávez has been helping to deliver babies for 40 years.

One of them is 60-year-old birth attendant Facundo Chávez Roca, who has been helping to deliver babies for 40 years.  “I learned how to do it with my wife. My mother taught me so I could look after her when she had our children. I attended my wife’s eight births. It was hard to start with – the first babies are always the most difficult.”

“When you’re helping women give birth, the most important thing is to be patient. You also have to know about the medicinal herbs you can give them. I use three herbs, and especially very strong coffee because it’s good for preventing haemorrhages. It’s very important to prevent bleeding. So far I’ve never had any serious complications.”

UNICEF is implementing the ‘Right to intercultural health for safe motherhood and childbirth’ project in the Tropics of Cochabamba region, together with the Autonomous Departmental Government of Cochabamba’s Departmental Health Service (SEDES), the Tropics of Cochabamba Indigenous Peoples’ Umbrella Organisation (CPITCO) and Family Care International (FCI). The project has six key components: use of mobile phones and SMS messaging, strengthening health staff capacities, setting up of a Skills Development Centre in Villa Tunari, care and follow-up for women who have just given birth and newborn babies in their first week of life, decentralised systems for the monitoring and evaluation of maternal and neonatal healthcare, and strengthening community organisations.

 

UNICEF Bolivia/2015/Garsón

Dr. Yver Jaylla attends Elena at La Misión health centre after received a back pain reliever treatment from Facundo.

The work to strengthen community organisations includes training for local health committees on preventive healthcare and identifying birth attendants. The training has focused particularly on the birth attendants, who have learned to identify danger signs during pregnancy, how to diagnose pre-eclampsia, what to do if a haemorrhage occurs, and how to care for newborn babies.

During the training workshops, Facundo learned how to notice the danger signs during pregnancy. “Yesterday, for example, Elena was suffering a lot and it looked like she was about to give birth. She was lying in bed unable to move, let alone walk. What I did was stabilise her, because the baby was in the wrong position. I helped her to move it round so she was able to go to sleep comfortably.  Then I told her to come to the health centre here in La Misión. Now she’s walking around fine and Dr. Jaylla is looking after her.”

The birth attendants were given a kit for newborn care, comprising a plastic bathing tub, hygiene supplies and baby clothes. They were also informed about which health centre to contact if an emergency arises.

UNICEF Bolivia/2015/Garsón
The bags that the project delivers to new mothers includes baby clothes and bathing and cleaning.

“We learned a lot in the training sessions,” says Facundo. “I was always careful to disinfect the instruments I use during the birth, but now I know a lot more about how to do it in the safest possible way. I’d never used a tub for washing a newborn baby before, and all these things encourage us in our work. The things we were given are not for ourselves – the clothes and all that are for the babies.” 

The training process also includes accreditation for the birth attendants. As Alexia Escobar from FCI Bolivia explains, “The aim is to ensure that their work is recognised socially and economically and their knowledge and experience is valued. Municipal governments should give them a payment, as other municipalities in the Andean region of the country are doing. The idea is to transfer those experiences to this region.”  

Facundo affirms that “We are respected in the community. If people place their trust in my hands, they call me and I go to them. Looking after a patient is a great responsibility.”


UNICEF works within the framework of five-year cooperation programs which have been agreed to and signed with the Bolivian Government. In order to implement them, UNICEF joins Bolivian government institutions, non-governmental organizations, social organizations, and the private sector.

Office

Calle 20, 7720
Calacoto
La Paz - Bolivia