Mexico: First Stage of Fieldwork Comes to a Close in the Mountains of Guerrero, 2008

As the season for sowing neared and peasants set fire to mountain slopes, in the early Spring of 2008, indigenous researchers, backed by CIET staff, went from door to door in 40 remote villages of Guerrero state, Mexico. They were completing the baseline survey in a 3-year effort to reduce perinatal deaths in rural indigenous communities.

At the same time, these locals were honing key research skills, as they moved from village to village right before the rainy season set in and the rugged mountain roads became all but impassable.

This was another crucial step in a participatory research initiative that looks to bring together indigenous and biomedical knowledge and practices to improve maternal and perinatal outcomes in Xochistlahuaca and Tlacoachistlahuaca, two remote rural municipalities with majority of indigenous population in Guerrero.

Amuzgo community health promoters, led by Abraham de Jesús (right), an Amuzgo medical practitioner from Xochistlahuaca, prepare and discuss key informant interview guides in Guadalupe Victoria, in November 2007.

The first cycle in the 3-year program began in October 2007, in Acapulco, where CIET held a three-day workshop with indigenous health promoters who came from Amuzgo communities in Xochistlahuaca, social scientists, medical practitioners and epidemiologists. This resulted in valuable insights that greatly enriched the design of instruments for the baseline survey. In return for their contributions, the indigenous health promoters received training in techniques for interviewing key informants in their own communities. Through these interviews, they built on their research skills and returned with a second layer of community input to the design of the survey instruments, each layer providing a somewhat different perspective on the issues. These shifts in perspectives are a crucial component of our effort to build up an intercultural research approach. 

Based on these interviews, on direct observation, and on our review of the literature, our team developed the baseline survey, which included questionnaires for women of reproductive age, husbands, older women, directors of health facilities, health staff, and traditional birth attendants. By talking separately with young women, men, and elderly women in the same households, we were able to get, from different family sources, multiple clues for piecing together how families make decisions during pregnancy and delivery, while securing privacy for those who were interviewed.

Patricia Luis and Hermenegildo Epitacio Santiago, two community- based researchers, interview an Amuzgo woman and her husband in their household, in Llano de Carmen, near Xochistlahuaca, during the baseline survey on newborn survival.

The next task is to enter this huge amount of information into computers and analyze it. Once we have preliminary results, we will go back to the communities and discuss them in focus groups with men, women, traditional birth attendants and government health staff. Group discussion allows people to interpret the evidence and to give their own views about potential actions that could improve maternal and perinatal health.

After feeding these views from the community into another round of analysis, we will facilitate collective discussion of the results, laying out possible lines of work and their potential impact. Community meetings are a longstanding tradition in the area, and a good way to bring everyone on board.