Sasakawa Health Prize
Federation of Medicus Mundi Spain
Inequity in access to health care was a focus of the Federation of Medicus Mundi-Spain, which won the US$ 40 000 Sasakawa Prize 2016 for its 2 decades of work in using the principles of primary health care to transform public health systems in El Salvador, Guatemala, Peru and Bolivia.
“We saw there was a big problem,” said Carlos Mediano, who represents Medicus Mundi-Spain as vice president of the Executive Board of Medicus Mundi-International. “There were large pockets of poverty in indigenous areas; there were cultural barriers to access.” In other words, people were not going to health centres, even if they were located near where they lived. “They do not trust them.”
One way to build that trust was to change the way women gave birth. Many people in the community resisted the usual way, which entailed laying them on a table in an open room, exposed for all to see. “They think that a woman cannot be laid out like that, with so many people looking at her.”
Some Medicus Mundi health centres overcame the resistance by moving women in labour into a private room and encouraging them to give birth by squatting while holding on to a rope to keep their balance. Skilled health professionals were posted nearby but outside the room – available to intervene if needed.
Transforming public health systems in Latin America
By adapting to their patients’ sometimes unique demands and by strengthening primary care public health systems, the 53-year-old NGO sought to guarantee the right to health to rural, traditionally marginalized communities and indigenous people.
The efforts have paid off. For example, in Rabinal, a town of 45 000 residents in Guatemala’s department of Baja Verapaz, child mortality dropped from 40.4 deaths per 1000 live births in 2013 to 14.85 deaths per 1000 live births 2015, according to Mediano. And malnutrition among 2-year-olds dropped during that same period from 65.5% to 61.2%.
The idea is that the people use the health system,” Mediano said. “We try to see all the weaknesses the health system has … not only the materials, the skills, but these other barriers.”
Overcoming those barriers can require closing cultural gaps. One way to do that was to train health professionals to speak the language of the indigenous people they were serving.
Only through such efforts can a new model of health be shaped. The NGO organizers are hoping to apply the lessons learned in these 4 countries to others, “to push to this new way of seeing primary health care.”
To Mediano, the value of the award goes beyond the money, which will be used to improve the programmes. “We want to use this award to tell people what we can do,” he said.