By Anielka Jirón.- Dulce María Palacios is a midwife and member of both the community health network and the breastfeeding support group in the community of Pueblos Unidos in the municipality of Ocotal, department of Nueva Segovia. What she most likes about her community work is helping women to improve their maternal-infant practices. “We have quite a lot of pregnant women in the community and with the support of the health post nurse we received training on the subject of breastfeeding and started giving talks to pregnant women, and now they’re breastfeeding their babies," Dulce María explains.
In addition to actions implemented at the institutional level, in the child- and mother-friendly health care units, this maternal-infant initiative has also been widely implemented at the community level through breastfeeding support groups. The main work of the community health workers who are members of the support groups is to follow up on women who are pregnant or have just given birth to guarantee that all of the babies are exclusively breastfed during their first six months of life.
Support group members promote breastfeeding and care for newborn babies through family chats, house-to-house visits and counselling in the community health posts. “When women who have recently given birth return home, we visit them and guide them on the techniques and positions for breastfeeding,” Dulce María stresses. “We mainly accompany first-time mothers who don’t know how to prepare for that moment.”
They also provide advice to help women who have just given birth improve their hygiene practices and have an appropriate diet that guarantees effective breastfeeding.
All the family’s women are breastfeeding promoters
The three other women who live in Dulce María’s house—her two daughters and a sister-in-law—are all members of the support group, which along with 14 community health workers and 25 midwives is part of the community health network corresponding to the Pueblos Unidos sector of Ocotal that promotes breastfeeding.
"When you go to the health post, you don’t see the women giving their babies bottles,” Dulce María explains. “Now they take out their breasts and breastfeed them. Before, women were even embarrassed about taking out their breasts, so I always tell them, ‘Go on, give the kid your breast.’” She also recalls that there used to be many girls and boys who were underweight and malnourished because the mothers did not breastfeed them, but now that they do, all of those problems have been overcome.
Being a witness to these changes has motivated this young midwife to continue with her community work.
It has been demonstrated that community actions increase the continuation of exclusive breastfeeding for six months by more than 32% compared to communities without community-level interventions.