Reducing inequities in maternal and child health in rural Guatemala through the CBIO+ approach of Curamericas: 2. Study site, design, and methods

Henry B Perry; Mario Valdez; Stanley Blanco; Ramiro Llanque; Shayanne Martin; Jason Lambden; Corey Gregg; Kaitlin Leach; Elijah Olivas; Barbara Muffoletto; Jacqueline Wallace; Nina Modanlo; Erin Pfeiffer; Carey C Westgate; Breanne Lesnar; Ira Stollak

doi:10.1186/s12939-022-01754-w

Reducing inequities in maternal and child health in rural Guatemala through the CBIO+ approach of Curamericas: 2. Study site, design, and methods

Int J Equity Health. 2023 Feb 28;21(Suppl 2):195. doi: 10.1186/s12939-022-01754-w.

Authors

Affiliations

¹ Health Systems Program, Department of International Health, Johns Hopkins School of Public Health, Baltimore, Maryland, USA. hperry2@jhu.edu.
² Curamericas/Guatemala, Calhuitz, San Sebastián Coatán, Huehuetenango, Guatemala.
³ Consejo de Salud Rural Andino/Curamericas, La Paz, Bolivia.
⁴ Institute for Global Health Sciences, University of California San Francisco, San Francisco, California, USA.
⁵ McGaw Medical Center, Northwestern University, Chicago, Illinois, USA.
⁶ Department of Internal Medicine, Louisiana State University Health Sciences Center at New Orleans (LSUHSC-NO), New Orleans, Louisiana, USA.
⁷ Optum, SeaTac, Washington, USA.
⁸ Student, PhD Program, Department of International Health, Johns Hopkins School of Public Health, Baltimore, Maryland, USA.
⁹ Curamericas Global, Raleigh, North Carolina, USA.
¹⁰ Independent Consultant, Baltimore, Maryland, USA.
¹¹ David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA.
¹² Independent Consultant, Winston-Salem, North Carolina, USA.
¹³ Community Health Impact Coalition, New York, New York, USA.
¹⁴ Program Coordinator for Research Engagement, AVAC (Global Advocacy for HIV Prevention), New York City, New York, USA.

Abstract

Background: The Curamericas/Guatemala Maternal and Child Health Project, 2011-2015, included implementation research designed to assess the effectiveness of an approach referred to as CBIO+ , composed of: (1) the Census-Based, Impact-Oriented (CBIO) Approach, (2) the Care Group Approach, and (3) the Community Birthing Center Approach. This is the second paper in a supplement of 10 articles describing the implementation research and its findings. Paper 1 describes CBIO+ , the Project Area, and how the Project was implemented.

Objective: This paper describes the implementation research design and details of how it was carried out.

Methods: We reviewed the original implementation research protocol and the methods used for all data collection related to this Project. The protocol and methods used for the implementation research related to this Project were all standard approaches to the monitoring and evaluation of child survival projects as developed by the United States Agency for International Development Child Survival and Health Grants Program (CSHGP) and the CORE Group. They underwent independent peer review supervised by the CSHGP before the implementation research began.

Results: The study area was divided into two sets of communities with a total population of 98,000 people. Project interventions were implemented in Area A from 2011 until the end of the project in 2015 (44 months) and in Area B from late 2013 until 2015 (20 months). Thus, Area B served as a quasi-comparison area during the first two years of Project implementation. The overarching study question was whether the CBIO+ Approach improved the health and well-being of children and mothers. The outcome indicators included (1) changes in population coverage of evidence-based interventions, (2) changes in childhood nutritional status, (3) changes in the mortality of children and mothers, (4) quality of care provided at Community Birthing Centers, (5) the impact of the Project on women's empowerment and social capital, (6) stakeholder assessment of the effectiveness of the CBIO+ Approach, and (7) the potential of wider adoption of the CBIO+ Approach.

Conclusion: The implementation research protocol guided the assessment of the effectiveness of the CBIO+ Approach in improving the health and well-being of children, mothers, and their communities.

Keywords: Care Groups; Census-based; Child health; Community Birthing Centers; Community health; Community-based primary health care; Curamericas Global; Curamericas/Guatemala; Equity; Guatemala; Impact-oriented approach; Implementation research; Maternal health; Primary health care.

Publication types

Review
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

Censuses*
Child
Child Health*
Data Collection
Female
Guatemala
Humans
Mothers