By Alejandra Cabrera, Strategic Information Manager, PASMO/PSI
Marilin Gómez stepped out of the examination room wearing a loose-fitting blouse and a shy smile. The slender 19-year old was halfway through the second trimester of her first pregnancy. Marilin is at ease with the idea of motherhood, but is worried about her baby’s health. “My biggest fear is to not have a healthy baby. I don’t care if it’s a girl or a boy, I just want it to be healthy.”
The sun was high and a dry heat sat over the houses and shops in Marilin’s small hometown of Barberena, located 55 kilometers south-east of Guatemala City. Sunlight filled Clínica el Cubano, the three-story private clinic where Marilin comes for her consultations. The local health center is part of the region’s over 300 member-network of independent clinics offering discrete services under the Red Segura brand, managed by the Pan American Social Marketing Organization (PASMO), PSI’s Central American network member. Outside, there were only a few cars and tuk-tuks passing by, but the neighboring barbershop’s ranchera music flooded the first floor of the clinic with the characteristic ‘oopa, oompa’ sound of the tuba.
This was Marilin’s fourth appointment with Dr. Ernesto Mendinueta, and she had just received the Mamá Segura Zika prevention kit for the first time.
“He explained what [Zika] was, how you can get it and how to prevent it. We had heard about Zika in the news and how mosquitos spread it, but I didn’t know much.” For a brief moment, her smile disappeared when thinking about the possibility of contracting Zika during her pregnancy.
In 2016, the Zika outbreak significantly affected the Santa Rosa Department, where Barbarena is located. Santa Rosa had the highest rates of Zika in Guatemala. Moreover, the Guatemalan Ministry of Health reported 1,024 pregnant women with suspected Zika virus, including 319 confirmed cases and 27 confirmed cases of Zika-related microcephaly in infants. In response to the epidemic, PSI/PASMO partnered with SC Johnson, Pfizer and Procter & Gamble to develop and distribute nearly 50,000 Mamá Segura Zika prevention kits in Central America. The kit includes a bright orange fabric bag in which pregnant women can find tailored educational material, OFF® mosquito repellant, and PASMO’s brand of latex condoms, VIVE®. When Dr. Mendinueta gives the kits to his patients, he uses the educational material as a guide for his conversations with them.
These prevention kits are the first step in addressing the Zika epidemic in Latin America. However, barriers continue to persist, especially when it comes to preventing the sexual transmission of Zika. Many women do not feel empowered to negotiate condom use with their partners, particularly during their pregnancies. Sexual transmission is rarely addressed in the news or public awareness campaigns. In more rural areas, mosquito-borne illnesses such as dengue and chikungunya are common, but communities receive little information and resources to understand how Zika is different and riskier for pregnant women. Women in rural areas also face barriers such as centralized and inaccessible health services, poverty, and violence.
To address some of these gaps, PASMO will launch a wide-scale, mass media campaign in four countries in Central America and the Caribbean in 2017, with funding from USAID’s Support for International Family Planning Organizations (SIFPO) mechanism. This campaign will communicate with pregnant women and their partners on both the vector-borne and sexual transmission and prevention of Zika, in addition to the work people like Dr. Mendinueta are doing with the Zika prevention kits. In Guatemala, PASMO will also seek to scale-up the distribution of the more than 11,100 Mamá Segura kits to reach more at-risk women like Marilin in Zika-prone communities.
Dr. Mendinueta is optimistic about PASMO’s upcoming campaign and explains that he is already seeing the benefits of the Zika prevention kits. “The women seem pleased with the kit. I tell them to speak to their husbands or partners about how important this is. My goal is for there to be zero cases of Zika reported in Santa Rosa,” he says with optimism.
Marilin loops the Mamá Segura bag over her shoulder and waits for her boyfriend to pick her up outside the clinic. Armed with information and tools to protect herself in hand, along with a more positive outlook after her visit with Dr. Mendinueta, she is hopeful.
Banner photo: © Population Services International / Banner Photo by: Diana Fuentes