Mothers Caring For Mothers: Delivering Maternal Care In Chiapas, Mexico

Community health workers provide support, accompaniment for mothers in rural Mexico

Posted on Jan 5, 2021

Vilga Vázquez is a community health worker for PIH in Chiapas, Mexico, who focuses on maternal health.
Vilga Vázquez is a community health worker for Compañeros En Salud, as PIH is known in Chiapas, Mexico, who focuses on maternal health. Photo by Paola Rodriguez / PIH.

On any given day, Vilga Vázquez cooks, cleans the house and runs her family’s grocery store. But her to-do list doesn’t end there. The 36-year-old has another job: caring for new and expectant mothers in her community.

Vázquez is a community health worker for Compañeros En Salud, as Partners In Health is known locally, in Chiapas, Mexico. Compañeros En Salud has worked in Mexico since 2011, partnering with the Ministry of Health to provide medical care and social support in the rural, southwestern state of Chiapas, where more than half of residents live in poverty.

Compañeros En Salud’s community health workers are hired from within the local community and trained to provide basic health services, such as detecting early signs of disease or reminding patients to take their medications.

In Chiapas, Compañeros En Salud employs 99 community health workers who serve patients at local clinics and in the home. Some specialize in areas such as chronic disease or mental health, while others work across clinical areas. All bring deep cultural understanding and lived experience from their communities to their work.

Prenatal and Postnatal Care, at Home 

When Vázquez first heard about the program from Compañeros En Salud staff, she was eager to learn more. She ended up throwing her hat in the ring.

“I wanted to apply because it interested me,” she says. “I thought that even if I was not selected, at least I would learn things about diabetes or hypertension to take care of my family and myself.”

Now, she has been a community health worker for four years, based in the community of Captain Luis Ángel Vidal. She specializes in maternal health—an area that she can relate to on a personal level.

Each week, Vázquez visits new and expectant mothers in their homes, providing prenatal and postnatal care. These home visits are important, she says, because sometimes it is difficult for patients to travel to the clinic, which can be far from their homes. And even those who make the trip may have to stand in line for several hours before being admitted.

Although Mexico provides universal health coverage, reliable, quality health care is hard to come by, especially in the rural communities of Chiapas.

Community health workers such as Vázquez offer critical support and accompaniment as patients identify their health conditions, navigate the local health system, and follow their treatment plans.

Building Trust

Vázquez visits her patients weekly from the second trimester (3-4 months) until the baby is born, and then again during the 42 days following birth, known as the puerperium period.

During these house calls, she asks patients about symptoms they’ve experienced, such as bleeding or severe pain, and checks their glucose and blood pressure. She also shares information about pregnancy and childbirth, such as the stages of fetal development.

These home visits aren’t just about knocking on doors and relaying information. It is important, she says, to earn trust.

“On the first visit, I explain everything,” says Vázquez. “I talk to them about maternal health, the importance of breast milk, weight changes, family planning.”

With some patients, the connection becomes deeply personal.

Vázquez recalls one expectant mother who was initially quiet and shy, making her worry that they wouldn’t be able to relate. During their conversations, Vázquez offered a listening ear and encouraged the woman to share not only about her pregnancy, but also about her personal and family life, reassuring her that everything would remain confidential. And, slowly, things started to change.

“Sometimes we see people and we don’t really know what they are like,” Vázquez says. “When she had her baby, she asked me not to stop visiting her, and I feel like I gained a friend.”

Care Continues Amid COVID-19

During COVID-19, Compañeros En Salud’s medical care and social support continue, and community health workers are critical to that work—especially in Chiapas.

“Accompaniment is an essential part of our job,” says Dr. Ariwame Jiménez, CHW program coordinator. “It widens the support network of our patients, as well as their trust in our services and our CHWs.”

To stop the spread, Vázquez and her colleagues take rigorous safety precautions, such as wearing face masks, handwashing frequently, and reducing the number of house calls with patients. They also distribute face masks and share COVID-19 updates.

But even with these adaptations, Vázquez is keeping busy. She currently has five patients. And she’s not stopping anytime soon.

“What I like most about my job is learning and helping,” she says. “What I learn, I can apply and communicate with others. I’m learning that we have to take care of our bodies, help people, and build a support network among ourselves.”

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