The latest uplifting report from our chosen charity, Wings, with news of help given to vulnerable girls and women in Guatemala.
Pop Offsets: WINGS Interim Update
In October 2015, Pop Offsets generously provided WINGS with a £ 5,000 ($7,576.50) grant to fund 9 mobile clinics, and provide highly effective long-acting reversible contraceptives (LARCs) to 150 adolescent girls and women in Guatemala. We are writing now to provide Pop Offsets with an update on how these funds are enabling WINGS to increase access to essential family planning and reproductive health services among vulnerable women and girls throughout Guatemala.
Mid 2015, WINGS began the important process of strengthening its service provision by acquiring a second mobile unit and hiring the supporting medical team including a Gynecologist to serve as Medical Director and nurse practitioners to offer services in rural communities. With the second mobile unit equipped and staff trained, our team expanded service provision from 4 to 12 provinces in a 6 month period. Although we originally anticipated providing services in 8 additional provinces, the ongoing instability in the Ministry of Health and corresponding demand from a variety of local and international organizations has driven our team to respond to the needs at the national level.
Organizing at least 9 mobile clinics a month with community organizations and local charities, our team has travelled to remote communities on a daily basis to provide copper intrauterine devices (IUDs) and subdermal hormonal implants (Jadelles), in addition to cervical cancer screening and immediate treatment for precancerous cells with cryotherapy. During each clinic, two nurses provide LARCs to approximately 20 women, but in some instances, the team sees 50 women in a day for a combination of family planning and reproductive health services.
In addition to acquiring the second mobile unit, WINGS also implemented a no cost policy for adolescents under age 20. In Guatemala, 58.1% of young women become pregnant for the first time before age 18, contributing to one of the highest adolescent fertility rates regionally: 92.4 pregnancies per 1,000 women aged 15 to 19 (ECLAC 2014). According to the 2008-2009 National Maternal and Infant Health Survey, only 6.5% of adolescents between ages 15 and 19 currently use a modern contraceptive method (MSPAS et al. 2010). Although the level of use rises to 24.2% in young adults between 20 and 24 years, 25.6% of young women between 15 and 24 expressed an unmet need for family planning, the highest of any age group, implying that various barriers exist to access (MSPAS et al. 2010).
The immense unmet need among young Guatemalan women underscores the lack of accessible and affordable youth-friendly services.
Thus WINGS has moved to an increasingly youth-friendly approach which includes removing economic barriers to services as well as increasing service delivery points throughout the country and implementing a new counselling methodology which takes into account the desires of young women regarding initiation or continuation of childbearing.
19-year-old Ana Antonieta and her two children, pictured, visited our mobile clinic in Morelia, a village in the Western Highlands. Accessible only by a muddy dirt road, our mobile team passed through an overflowing river to reach the mountain roads leading to our clinic location. Because of how hard it is to enter and leave the village, Ana had struggled to access information or contraception in the past which is why she gave birth twice at such a young age. However, when our promoter informed women in Morelia about our upcoming mobile clinic, Ana Antonieta was one of the first to arrive. She like many other women in her community opted for the highly effective Jadelle to delay pregnancy for five years and plans to share her experience with friends and family so that they are able to benefit from these mobile services.
In a recent mobile clinic in San Pedro Limón, a community straddling the border between Alta Verapaz and Quiché, a 12 year old girl arrived with her husband. Although the Guatemalan Congress raised the legal age of marriage from 14 to 18 for girls in November 2015, child marriage remains widespread in many rural impoverished communities where the lack of educational and economic opportunities have impeded a cultural shift away from this practice.
As it is often quite difficult to reach these young brides and ensure that they have access to information and services to make well-informed decisions and delay high-risk pregnancies, our team was impressed that the young couple came on their own to learn about their options. Mobile Unit Coordinator Blanca spoke with them privately about the reproductive risks the young girl might face in pregnancy and provided complete contraceptive counselling in Q’eqchi’, the couple’s native language. Although the couple was not ready at the time, they recently contacted us to inquire about the availability of the smaller copper IUD models which we will provide to the girl in a follow-up clinic.
Nurse Claudia unloading supplies for the San Limón mobile clinic
The interest of the young couple in the copper IUD is not unique. Rather uptake for this highly effective LARC has been growing in communities we serve. Historically myths and misconceptions about how the contraceptive method worked have deterred women from utilizing the copper IUD. However, our efforts to dispel myths and promote the benefits through community talks and home visits are helping: in a small mobile clinic in Sololá in October 2015, 7 out of 9 women attending opted for a copper IUD. As pictured at right, two of the women in the clinic examine the copper IUD during our pre-clinic talk. Since that October clinic, WINGS has provided a total of 233 IUDs in addition to 849 Jadelle throughout the country. Moreover, our mobile teams continue to build on their initial successes increasing access to LARCs by coordinating additional clinic dates each month and visiting clinic locations up to two weeks in advance to offer informational talks and individual counselling.
We look forward to sharing our advances on this grant in October.