THE PILOT STUDY
From 2007 to 2012, CIET carried out a pilot study in Xochistlahuaca (Xochis), a rural community with majority indigenous Nancue Ñomndaa (Amuzgo) population in Guerrero, one of the poorest states in Mexico. Their remote villages are located in the foothills of the Sierra Madre and travel between them is often difficult due to poor road conditions. Nancue Ñomndaa midwives, respectfully called with the title Nna’, assist women in the community during pregnancy and homebirth.
In a push to reduce indigenous maternal and newborn mortality rates, the government has tried to turn women away from these traditions and draw them to deliver in clinics and hospitals. This trend has raised concerns in the communities. At the request of indigenous health promoters, and through a baseline survey in 2008, we collected information related to recent birth experiences and birth culture in Xochis. We then implemented a cluster-randomized controlled trial (CRCT). In several randomly selected sites, we discussed this evidence with traditional midwives and, guided by them, we decided to carry out interventions that support traditional birth culture.
In February 2012, indigenous fieldworkers carried out a follow-up survey to evaluate the intervention. The findings showed that women can safely give birth without having to give up their traditions in the process. We intend to further prove this point with a larger trial in Mexico and Colombia.
The Association of Indigenous Amuzgo Health Promoters of Xochistlahuaca; the Guerrero State Health Secretariat; CIET, a research NGO and academic centre at the University of Guerrero; other organizations of the civil society in Mexico; and the Centro de Estudios Médicos Interculturales in Colombia are partners in the Safe Birth in Cultural Safety initiative. The project is financed by an anonymous Swiss foundation.