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0 - PDF, 101 mb - usaid
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APPENDIX A 1 "(Y Y-V/,4 /, .gJL-<br />
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PROGRAM DEVELOPMENT AND SUPPORT (POPULATION)<br />
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I. Objective<br />
SCOPE OF W)RK<br />
PIO/T No. 520-0000. 5-3-80234<br />
'Tb provide USAID/Guatemala with a "state-of-the-art" assessme-ant<br />
of community-based health workers (CBHI) and in particular, the<br />
traditional birth attendant (TBA), and their potential use in health<br />
care delivery programs.<br />
II. Background<br />
Guatemala has a remarkably rich experience with CBI's<br />
including the program of Rural Health Tec1hnicians (T6cnicos de Salud<br />
Rural) which is unique to Guatemala, rural health promoters,<br />
volunteers of various descriptions, traditional birth attendants,<br />
traditional healers, patent medicine salesmen and the paid auxiliary<br />
nurse who works at the lvest level of the official health system,<br />
the Health Post. There have been several operational research<br />
efforts to test the usefulness of various approaches to health care<br />
delivery using this level of worker, notably SINAPS,<br />
PRI2ZPS and the<br />
"Patulul Project." Some very interesting studies and evaluations<br />
have been carried out of isolated dimensions of the work of some of<br />
the CBIF 's, including a recent look at the effectiveness of patent<br />
medicine salesmen (PKS) in communicating child survival and family<br />
planning messages to the semi-literate, traditional rural population<br />
of Guatemala.<br />
As an AID "Child Survival Emphasis Country", Guatemala will<br />
continue to receive financing for assistance in improving health<br />
status in general, and of children under five years of age in<br />
particular. t'tst recently,<br />
USAID approved a three-year extension to<br />
the family planning program.which included tentative earmarking of<br />
funds for developing activities in the Ministry of Health which<br />
revolve around reducing risks involved in the birth process. A key<br />
figure in this program is expected to be the traditional birth<br />
attendant (TBA).