Standardizing the process of Care to Reach Children in Difficult Places in Honduras

Mother demonstrates stimulation techniques that she learned at hospital due to the support of ASSIST, Honduras

19-year-old Jane didn’t think that there was anything different about her baby right away, but immediately she noticed that he didn’t cry. When she saw him, she knew something was wrong but even still she had no idea what illness he had. Doctors told her that he was very sick, and that his head was under developed. There in the hospital, no one would tell her that her baby had microcephaly it wasn’t until much later that she knew. Jane’s story, unfortunately, was common for an area that was more remote and had more limited access to strong health facilities, but even more so because there were no systems yet in place to identify and provide follow up care for babies with microcephaly from complications of Zika or otherwise. 

In a country like Honduras where specialized medical care is difficult to obtain, the time it takes to see a specialist can be years. Currently, the earliest next appointment you could receive to see a neurologist is in 2020. Women who bring their babies to the hospital often ended up leaving because the process was so long, that it wasn’t possible to stay. For someone traveling over 2 hours to get to the hospital, waiting too long would mean missing the transportation to return home. The wait would be incredibly long only to be told that there was nothing the doctor could do, have others stare at your baby and to receive a referral for years in advance.

The USAID ASSIST project worked tirelessly with the Ministry of Health and hospital staff to create a referral system and standardize the process of care for mothers of child with Congenital Zika syndrome.

“Before the USAID ASSIST project, I didn’t see the value in treating children with microcephaly. I thought there was nothing that I could do for them. Now there is a standard process, now there is a way to help, now I see the value of giving these children the best quality of life. Now they are my first priority.”- Pediatrician at hospital Leonardo Martínez Valenzuela.

Hospital Leonardo Martinez Valenzuela and hospital Mario Catarino Rivas in San Pedro Sula have a standardized referral system and process of care. When a mother comes with her baby, they are met by a social worker who explains that they will meet with the ophthalmologist, otologist, pediatrician, and the mother will have a counseling session with the psychologist. Every month the neurologist sets aside one day specifically to meet with these mothers and children. The process allows for the child to be well documented and to meet with every specialist in one date. The support that these mothers feel is a great motivator for them to return with their babies for follow up care. The doctors feel connected to these children and responsible for their quality care. Community workers identify children in the hard to reach communities and document these cases and refer them to the hospitals. ASSIST has trained doctors, nurses and hospital staff in identifying these children and documenting their cases on a national level so that no matter where a mother takes her baby, she can receive the same quality care.

It’s due to this community outreach and documentation that Jane’s now 18-month old baby is now receiving the attention that he needs and deserves. Now she can take him to appointments and learn about stretches and stimulation that she can do at home for him. She works very closely with the community health center where she lives for follow up and referrals to the hospitals.

“Before I knew that my baby could be taken care of I felt so alone. I had gotten good at being alone, just me and my baby. Now I go to counseling sessions and I talk to someone about my baby. Now I see other mothers with babies like mine. Now I we have a routine. We do stretches everyday (even though he hates it) and I roll him over and show him colors and textures and toys. Now I have tools to work with my baby to make sure that he gets the best life.”

 

Countries: 
Report Author(s): 
Karina Y. Valenzuela
Organization(s): 
USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project/URC
ASSIST publication: 
ASSIST publication
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