Rollercoaster Rides in Program Development and Implementation in Chiapas, Mexico

Rose Molina, MD

Global Women’s Health Fellow, The Connors Center for Women’s Health and Gender Biology, Brigham and Women’s Hospital

I returned to Chiapas, Mexico in June 2016 to continue my Global Women’s Health Fellowship research project. Working closely alongside the maternal health team at Compañeros En Salud (CES), I have advanced our project around adapting and implementing the WHO Safe Childbirth Checklist (SCC) for a new cadre of obstetric nurses in a basic community hospital. During this most recent trip, our maternal health team focused on curriculum development, grant writing, and adapting and piloting the SCC in our context in Chiapas. Additionally, we have been working with a group of students in creating the checklist into a mobile platform in anticipation of the obstetric nurses’ arrival in August 2016.

This visit has highlighted the ups and downs and turns of embarking on a maternal health project in close collaboration with the Ministry of Health in a new type of health facility (secondary level hospital as opposed to primary care clinics, which is where CES currently works). In order to achieve sustained engagement with the public sector, political setbacks are par for the course. However, it is important to remain optimistic in resolving problems in order to move work forward together. Only when the government is involved can a project be truly adopted and sustained as part of a larger health agenda that can be scaled up to a regional or state level.

Andrea Reyes (CES Maternal Health Coordinator) and Carolina Menchu (Professional Midwife) caring for a pregnant woman in Chiapas, Mexico

I am grateful for the opportunity to have continuous involvement with this project over the course of my two-year Global Women’s Health Fellowship. It has been a wonderful opportunity to see the nuts and bolts of program development and implementation in a new clinical area and with a new collaboration with the Mexican Ministry of Health. Furthermore, I have grown with the maternal health team and have learned valuable lessons in communication and relationship-building, which are the foundation of any meaningful long-term engagement. Lastly, I am excited to bring on a new research volunteer to lead our on-the-ground research efforts in measuring the impact of our project. It has been a roller-coaster ride of all emotions—fear, thrill, uncertainty, and excitement—but a foundational experience in building my career in global health implementation science.