Covid 19 Update: Due to travel restrictions arising from the pandemic, the Dox Foundation has temporarily suspended travel grants. We will resume providing grants when the situation improves. We thank you for all you do to help those in need.

Danielle Bulinski
Danielle Bulinski
Certified Nurse Midwife · Aurora, CO


Adolescent Pregnancy Training: Guatemala


February 15th
Coatepeque, Guatemala

Project Description

I plan to implement an evidence based training and clinical guideline on adolescent pregnancy at the Trifinio Center for Human Development. The center was developed as a collaboration between the Center for Global Health at the University of Colorado and AgroAmerica, a Guatemalan banana and palm oil agricultural business. The project aims to improve the health and wellness of families in the area by increasing access to primary care services, including maternal and newborn care. This includes prenatal care, referrals for high risk pregnancies, and access to family planning services. This project aims to increase local capacity to respond to the challenge of adolescent pregnancies by recognizing the unique needs of these patients, better understanding cultural norms and attitudes, reinforcing evidence based clinical guidelines, and encouraging shared decision making surrounding adolescent pregnancy. This work will be done mainly with nurses and birth attendants in training through focus group and didactic activities. Nurses currently are the main point of contract with women receiving prenatal care, going out into the communities to complete assessments. Through focus groups, norms and attitudes surrounding adolescent pregnancy and childbirth will be elucidated. Participants will then receive training on current best practices, and a tip sheet will be developed for future reference. Pre and post testing will be utilized to measure learning goals.
In addition, during my time in Guatemala, I will be helping facilitate emergency drills on often requested topics such as postpartum hemorrhage and shoulder dystocia.

Population Served

The Trifinio (triangle) region in Southwest Guatemala is named for the confluence of the three departments: San Marcos, Quetzaltenango, and Retalhuleu. This area is home to approximately 25,000 people, many of whom moved from other departments for work. Guatemala has an adolescent pregnancy rate of about 21%. This population is particularly vulnerable due to recent migration and the isolated nature of working on the banana and palm fields. This population as well as the clinical staff at the Trifino Center for Human Development will benefit from capacity building regarding adolescent pregnancy.

Expected Impact

The expected impact is the nurses and birth attendants will be better prepared to care for adolescent pregnancies, and will have more practice counseling young people on pregnancy prevention. The clinical guidelines will be incorporated into the existing structures of the center, which the nurses and birth attendants are currently using in an agreement with supporting providers.


Trip Photos & Recap

This project aims to increase local capacity to respond work with pregnant adolescents by better understanding cultural norms and attitudes, reinforcing evidence based clinical guidelines, and encouraging shared decision making. This project included nurses and health workers who completed trainings through focus group and didactic activities.