Improving Reproductive Health through Participatory Intervention

Evidence from a Randomized Staged Field Experiment in Alta Verapaz, Guatemala Asociación Puente (AP) is a Guatemalan non-profit organization, which seeks to reduce extreme poverty and prevent malnutrition through the development of skills in women who live in extremely poor rural communities with unmet basic needs. Between 2011 and 2014 the organization implemented the community development program Aprendamos Juntas (AJ) in six different communities of Santa María Cahabón in Alta Verapaz, Guatemala. In these municipalities of Santa María Cahabón, 78.8% of the inhabitants live in extreme poverty. Stunted growth among schoolchildren is 51.1%, indicative of the malnutrition prevalence among children in these communities.1 AJ brings about community and societal change, through working with women to improve their lives and the lives of their families in accordance with a person’s dignity. It has five axes: food security and nutrition, health, education, entrepreneurship, and community agency. We carried out an impact evaluation of AJ, which was completed in 2014.2 The final sample for the evaluation included 1,112 subjects composed of women, their husbands, and two of their children, from ten different communities of Santa María Cahabón. Data collected comprised baseline and after-treatment data, from both control and treatment groups. The overall outcomes of the evaluation indicated a significant improvement in the lives of AJ’s participants and their families in all five areas. Findings also indicated areas where more efficiency could be achieved. Among the problems encountered in the reproductive health component of the program was a great dissatisfaction, on the part of the women, with the use of contraceptive injections (Depo-Provera or medroxyprogesterone). Specifically, women reported that the use of Depo-Provera caused menstrual disturbances, lower abdominal pain, sporadic spotting, and in some cases depression. In addition, we also disco
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