A report of a midwifery model for training traditional midwives in Guatemala.

OBJECTIVE: to describe the specific characteristics of one model of training traditional birth attendants (TBAs) in Guatemala.
DESIGN: participant observation, unstructured and semi-structured interviews undertaken between 1997 and 2003 to gather the data to report on the characteristics of this training programme as it is evolving in the field.
SETTING: the birth centre site of Ixmucane in Antigua, Guatemala, as well as community sites in the Departments of Saquetepequez, Chimaltenango, and Quetzaltenango in the western highlands of Guatemala. PARTICIPANTS: traditional midwives, certified nurse-midwives and certified professional midwives, as well as many allied health professionals and volunteers. INTERVENTION: training philosophy, participant selection, curriculum content, intensity, and planned follow-up are the key components of the training programme described. MEASUREMENT AND
FINDINGS: 93 TBAs have received training through the development of a 150 hrs contact course for self-selected TBAs in the Midwives for Midwives Program. Formal evaluation of this training is underway but results are not yet available. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: the value of incorporating midwifery philosophy and praxis in TBA training has received scant attention in the TBA literature. This report suggests that TBA training programme characteristics are important considerations in any evaluation of training efficacy of TBAs to improve maternal-child health.