Trends in Prenatal Care Among the Ngöbe Population of Panama [34M

Abstract

INTRODUCTION: Maternal and infant mortality rates in Panama are reported as being within the best in Latin America, however there is a sharp contrast between rates reported in urban and rural populations. Maternal death rates among indigenous populations, such as the Ngöbe, reach as high as 658 per 100,000 live births. This study assesses the impact of poverty and geographic isolation on women's decisions to deliver at home versus a healthcare facility in this understudied population. Additionally, the use of prenatal vitamins and contraception are evaluated. METHODS: Given high rates of illiteracy, an oral questionnaire was administered, consisting of: 1. Preferences in delivery location 2. Use of prenatal vitamins 3. Experience with prenatal healthcare and family planning. Surveys were administered in Spanish to participants receiving services through the non-profit organization Floating Doctors. RESULTS: 101 pregnant Ngöbe women participated. The majority of women preferred to deliver in a healthcare facility if possible (61%) and wished to use contraception (59%). Age was not a significant factor in the interest in using contraceptives (p=0.74), but the number of living children in the household was (p=0.02). The use of prenatal vitamins during pregnancy did not correlate with age (p=0.27) and was as low as 45%. CONCLUSION: This data further demonstrate the need for improved access to transportation to hospitals in order to reduce maternal and fetal morbidity and mortality among the Ngöbe population. Prenatal education and family planning could positively contribute to maternal and fetal health outcomes.