Bolivia: Making Motherhood Safer in Cochabamba

The Manoff Group was a partner on the MotherCare Project. The project in Bolivia addressed maternal health through increasing acceptability, demand and appropriate utilization of reproductive health services contributing to a decline in the high maternal mortality rate. The project had four components: research, health communications, training and service enhancement.

Formative research

A qualitative study of women's reproductive health knowledge, attitudes and practices was undertaken. The objectives of the study were to describe and better understand women's perceptions and behaviors in relation to the formal health care system. More than 230 women participated in focus group discussions, in-depth interviews and clinic exit interviews. Traditional birth attendants were also interviewed and clinic-based observations of client-provider interactions were made.

The findings were analyzed by reproductive stage and topic and as a whole to generate an explanation of the way in which the women interviewed understood the physiology of the human body and reproduction. The analysis enabled the investigators to compare the women's (Quechua-Aymara) view of physiology with the bio-medical model maintained by the health workers in the formal health system. Findings were used to develop intervention strategies to improve home practices, increase the appropriate use of formal health services and to train health care providers to offer better quality services more in keeping with women's needs and desires.