“For years I have dreamed of building a
health clinic in rural southwest Guatemala where I grew Up. The Trifinio region
is the poorest part of the county where more than 60 percent of children test
positive for parasites because of contaminated water and poor sanitation. It is
exciting to think of the possibilities we have here to improve the health of
not just our community but also to create an innovative health model that can
be replicated around the world.”
Edwin Asturias, MD, Director of Latin American Projects, Center for Global Health
Addressing a Critical Need
families living in the surrounding communities of Trininio, a rural and
impoverished region located in the southwest of Guatemala have limited access
to medical care for women, mothers and children. As a result, neonatal
mortality rates related to asphyxia and infection are also extremely high.
strategic planning process focused on developing a community based program
targeting mothers, neonates and children. Using nurses and auxiliary nurses
this program called “Creciendo Sanos: madres y ninos” (Growing up healthy for
mothers and children) is enrolling mothers early in their pregnancy and
providing four group prenatal care visits, making newborn home visits during a
baby’s first two months of life, and then providing monthly group child group
sessions that integrate health, development, nutrition, and hygiene education
and track height and weight measurements through age 3 years.
The Center for
Human Development also has built a birthing center with two delivery rooms and
a nursery. Our Center staff is training the traditional birth attendants so
that births can be shifted from the home to the birthing center and if needed
the local hospital where more skilled staff will be available.
The Trifinio Center for Human Development has
also designed and built with Foundation funding a family medical clinic
facility that has six clinic rooms, a dental clinic, a clinical and a research
laboratory, pharmacy, central nurse station, new computers, and an electronic
medical record system. The clinic is designed to be a place for excellent
patient care that meets the standards of United States medical practices in
The Foundation has hired a Guatemalan
physician medical director and all facility staff. University of Colorado faculty
and clinical trainees from the schools of Medicine, Nursing, Pharmacy and Dentistry
rotate though the facility throughout the year.
In 2011, the Center for Global Health and
Children’s Hospital Colorado entered into an agreement with the Guatemalan
Foundation created by the Bolanos family, the owners of AgroAmerica to create
the Trifinio Center for Human Development.
The goal of the agreement was to create a Center for Human
Development that would improve the lives of the children and families of the
employees working in the banana and palm oil plantations run by AgroAmerica, as
well as people living in the surrounding communities. These are impoverished
communities with high rates of maternal illiteracy, food insecurity, maternal
depression, child malnutrition and child developmental delay. There is a lack
of clean drinking water and inadequate sanitation.
The initial phase of the
project included a rapid needs assessment using a home survey as well as
qualitative assessment with focused interviews. The needs assessment found that
the communities had very limited access to medical care for women, mothers, and
As a result these communities had high rates of maternal mortality
and morbidity with approximately half of deliveries occurring in home with an
unskilled traditional birth attendant. As a result, neonatal mortality rates
related to asphyxia and infection were also extremely high. Under 5 childhood
mortality related to pneumonia, febrile illness and diarrhea were also quite
The findings and recommendations
were then presented back to the communities through a community engagement
process and a strategic plan was developed and implemented with the financial
support of the Foundation.
auxiliary nurses are providing programming called “Creciendo Sanos: madres y
ninos” (Growing up healthy for mothers and children) to enroll mothers early in
their pregnancy and providing four group prenatal care visits, making newborn
home visits during a baby’s first two months of life, and providing monthly
group child group sessions that integrate health, development, nutrition, and
hygiene education and track height and weight measurements through age 3 years.
Within a short two-year time frame the Center
for Global Health and the foundation have designed, built, and fully
operationalized the health care facility and Creciendo Sanos community program.
A sophisticated data collection system using smart phone technology allows for
rapid cycle evaluation and quality improvement interventions.
Our specific aims
safe delivery practices by providing prenatal screening and education,
increasing referrals for high-risk pregnancies, decreasing birth complications
and lengthen birth spacing though reproductive health programs through the
maternal-neonatal segment of a program called Creciendo Sanos.
neonatal morbidity and mortality by identifying neonatal danger signs and
increasing clinic/hospital referrals for sick babies.
childhood mortality and improve early childhood growth and development outcomes
through Creciendo Sanos.
The Center for Human Development decreased the cost barrier to families,which is important to families that may make only enough to put food on the table and have little left over for anything else. A visit at the clinic is less than $5 versus at least $25 at the closest hospital plus the cost of transportation and the loss of a day's wages.