Círculos de Mujeres - Buena Semilla (Women’s Circles – Good Seed)
Becoming a mother is a unique experience, but it is far from being an easy task, as this comment from a mother in Guatemala reminds us: “I used to be mad all the time, and if my children did not obey me I hit them, and later I felt bad.” This emotional burden is particularly prevalent among pregnant women and mothers in low-income communities who report high levels of depression and anxiety that affect not only them but also their children and families. The Círculos de Mujeres – Buena Semilla project constitutes an innovation that uses a “living laboratory” approach in which communities co-design activities and become co-creators of solutions to their most pressing problems. In Círculos, the women share their experiences and build a support network with community health workers and midwives. Círculos aims to empower the women and improve their self-esteem, self-care, and self-efficacy that then translates into better interactions with their children. This project has showed promising results and has considerable potential to be scaled up and replicated.
Problematic
Women from indigenous communities in Guatemala report low levels of health and high levels of depression and anxiety – conditions that have important consequences for maternal health and child development. Psychological stress, insufficient support networks, extreme poverty, and violence affect the mental health of the mothers and limit their response capacity to provide adequate care for their babies. When the mental and emotional health of the mothers deteriorates, it affects their capacity to build a secure attachment with their children, in turn making it more difficult for the children to be able to develop to their full potential. Despite these negative consequences on mothers and children, health services often do not address mental health needs. And even when such services are available, they are often not used because of the stigma attached. This problem is larger among women from indigenous communities in Guatemala who have less access to health services.
Solution
This program provides multi-faceted assistance to mothers and pregnant women in indigenous communities in Guatemala. It provides care for their psycho-social health while promoting their wellbeing and active participation in the process of co-creating solutions and providing assistance. The intervention was designed jointly by researchers, community health workers, and midwives to address a set of mental health problems. In this process, women from the community develop a theory of change and identify the needs of the community and the resources necessary to implement the intervention. Activities include group dynamics, games, and artistic expression (drawings, dramatizations, music) directed toward motivating reflection by the groups and their participants. In addition, psycho-social group therapy sessions are conducted with components that include the management of emotions, breathing and relaxation exercises, problem resolution, and active listening. The aim of these activities is to build confidence and self-efficacy and to improve the self-esteem of the women who participate. In all, there are 12 sessions every two or four weeks during which the women of the community lead the activities.
Evaluation and Impact
A random assignment experiment was carried out in five communities of the Maya Mam ethnic group and three communities of the K’iche’ ethnic group. Eighty-four women were randomly assigned to the Círculos de Mujeres and 71 women were assigned to a control group that did not participate in the intervention (but were invited to join the Círculos once the study was completed). All of the women were either pregnant or had given birth within two years prior to the intervention. The intervention lased five months and the sessions were held every two weeks. The results show that the women who participated in the Círculos had better levels of wellbeing, self-care, and self-efficacy than the women in the control group. Women who attended a higher number of sessions showed the greatest benefits in terms of self-care and care of their children, as well as on indicators of their children’s early stimulation.