Maternal Waiting Homes in Nicaragua
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I’m getting my first taste of the trials and tribulations that accompany a qualitative interview project in a developing country. I’m working as a volunteer for the Population Council and through a series of interviews with health officials, am hoping to deliver some background information on the extent and quality of the Maternal Waiting Homes (Casas Maternas) program in Nicaragua. Casas Maternas provide shelter and medical care to pregnant women who are either geographically or economically unable to access health services, and need a safe place to deliver their baby.
The majority of my background information on the Program in Nicaragua came from a recent World Bank Report. The study finds that the Ministry of Health supports and is expanding the program, that 50 Maternal Waiting Homes already exist, and that overall the greatest weakness is lack of resources. With this knowledge, I assumed that the health officials I approached for interviews would all have a general understanding of the program – even if there was not a functioning Casa Materna in their region. As it turns out, only one in five of the health workers and women's health advocates I have approached in San Juan del Sur, Rivas, and Managua have been able to give me a limited overview of the Casas Maternas Program.
In addition to the shock that the program is not well known, and that finding strong interview candidates will be more difficult than I anticipated – I’m also facing a “State of Emergency” in the Health Centers due to the flu scare, and an intense chain of command in the health system. I traveled to Rivas to interview the municipal health Director on Monday and spent the day bouncing from official to official awaiting “authorization” for my interview. After four hours of phone calls to and from Managua, I was disappointed to learn that the answers would be sent to me via email from MINSA officials in Managua - and that I could not seek the opinions of individuals in Rivas. Keep in mind I am conducting a qualitative interview and seeking experiences and personal suggestions, not specific statistical or financial data.
Amidst the stumbling blocks I’m now setting my sights on interviews with individuals who are working at functioning Casas Maternas. While I know I’m just beginning, my hunch is that there are not 50 Maternal Waiting Homes in the country. Rather I think that number may reflect the inclusion of shelters that admit pregnant women, and hospitals that house women in need of extended care. Overall it seems that the program is not meeting the demand for maternal housing services for Nicaragua’s rural population, and that there is an opportunity to expand, and strengthen the program in the country. I only hope I can find some strong interview candidates to prove it!
