MANAGUA, Nicaragua — Although Nicaragua is still known as the second poorest nation in the Western Hemisphere, since subscribing to the Millennium Development Goals (MDGs) in 2000, Nicaragua has made great strides in advancing the health of its women. This is demonstrated by a reduction in the nation’s maternal mortality rates from 86.47 deaths per 100,000 births in 2005 to 50.6 per 100,000 in 2012. Health in Nicaragua is seeing success in lowering its maternal death rates, partly attributed to the implementation of its Red Nacional de Casas Maternas.
The Casa Materna, or “Maternal Home,” is an establishment that offers a short-term residence free of charge to high-risk expecting and postpartum mothers. The Casa Materna provides these women with basic necessities such as food, shelter, education, transportation and obstetrics care as they prepare for childbirth or recover from a procedure.
While the births take place at a nearby hospital, the services of the Casa Materna provide assistance to expectant mothers from rural areas in order to ensure access to immediate medical needs and prevent complications from potential homebirths. Casa Maternas are particularly vital in a country where, as of 2006, abortions have been completely illegalized.
The Casa Materna was conceived in the late 1980s at the grassroots level in response to Nicaragua’s growing numbers of rural mothers dying in pregnancy, birthing and in the days following childbirth. The initial funding for the program came from the Instituto de la Mujer (the Women’s Institute) of Madrid, Spain. As of January 2013, there were a recorded 100 Casa Maternas throughout the country that still receive a majority of their finances from NGOs and multilateral and bilateral organizations.
The Nicaraguan Ministry of Health (MINSA) provides some medical care and monetary support for meals. However, the mothers are at times expected to personally contribute to cover additional operational costs. This is often a heavy burden for women from rural areas and can be a factor that inhibits them from taking advantage of the Casa Materna’s resources. Furthermore, occasionally when the demand for space in the Casa Materna exceeds the availability of beds, women may be turned away or have to endure inadequate conditions.
Due to lack of support, most of the country’s Casa Maternas spend more money than they have budgeted. In order to combat their deficits, some Casa Maternas have developed small businesses where they sell bread or snacks in order to promote self-sustainability and pay for supplies which MINSA and outside funding fails to provide.
In July 2013, MINSA announced that it would provide support for the construction of 45 additional Casa Maternas throughout the country. While this is a significant step towards furthering the drop in rates of maternal and child deaths in the nation, more collaborated efforts between MINSA and private organizations can be fostered. These types of relationships will be useful in ensuring the Casa Maternas’ sustainability and effectiveness towards reaching MDG 5’s indicators to improve maternal health in Nicaragua.
– Talia Langman