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The city of Pátzcuaro and the pueblos near Lake Pátzcuaro in the state of Michoacán, Mexico, are inhabited by a mixed indigenous and mestizo population. The Pátzcuaro regional health department and state and federal governmental agencies have identified this area, especially the indigenous communities, as being underserved in the area of health care delivery. In particular, these communities are in need of enhanced health care infrastructure development and coordination, especially in maternal and child health, and women's health care generally, as they suffer from a lack of skilled health care providers who can deliver care and facilitate integration of services for women and children. Without proper health care, maternal mortality remains a serious threat for women and children: when women die in childbirth, their children are significantly more likely to die as well. The presence of trained health care personnel and a proper health delivery system can save the lives of women during childbirth, which enhances the general health of the communities in which they live.

Summary

Through a partnership with the Women's Institute of Pátzcuaro, Heartland Alliance is working to enhance the existing maternal and child health care delivery system of the Lake Pátzcuaro area in Michoacán, Mexico, by (1) increasing the number and improving the educational levels of maternal and child health nurses through the development and implementation of a nurse midwifery training program, and (2) expanding and strengthening the health care infrastructure, particularly for the women in the indigenous pueblos, through outreach, education and facilitating coordination of services. The midwifery training program consists of a postgraduate nursing program in midwifery, with internships at the local health care clinic serving the indigenous population and, through the clinic's outreach programs, in local pueblos. Advisors for the project include the women's advisory group in Pátzcuaro, and all activities are coordinated with the local community college and the regional health department.

Activities

To enhance the health care system for women and children in Pátzcuaro, this project is working to:

• Develop a midwifery health care curriculum and implement a postgraduate nursing program in midwifery;
• Support internships at local clinics;
• Provide financial assistance to midwives enrolled in training;
• Implement a women and child health initiative in Pátzcuaro to expand health care infrastructure through outreach, education and facilitating coordination of services.