Bringing sexual and reproductive health services to Indigenous communities in Paraguay

Indigenous midwife Teresa Aguirre has been providing care to women for decades in the town of Ñacunday, a small community of Mbya-Guarani people in Eastern Paraguay, near the border with Argentina. Teresa is who women and girls turn to when they have an issue related to sexual and reproductive health. Her traditional knowledge has allowed her to deliver several generations of children in her community. 

Like most indigenous communities in the area, Ñacunday does not have a public health clinic where people can access other services such as modern contraceptives, dental care, or screenings for different types of cancer. In situations like this one, the work of Fòs Feminista’s partner CEPEP becomes crucial.  

Paraguay is one of the countries with highest levels of poverty in South America and it has one of the highest levels of adolescent pregnancy. Women, girls, and gender-diverse people have limited access to sexual and reproductive health services but CEPEP has been working there for more than 50 years reaching the most vulnerable population, first in the main cities, Asunción and Ciudad del Este. Then, in rural communities through the UMOSA, “Unidad móvil de salud”. In addition to their services in rural areas, CEPEP has four main city clinics where they provide free testing for HIV, syphilis, and hepatitis B. They also provide many other services like contraception, prenatal visits, screenings for cervical cancer and colon cancer, nutrition, and mental health care. 

The UMOSA is essentially a clinic on wheels that brings care directly to people in rural areas for free. They offer a wide range of services, including long-acting contraceptives like injections and implants. And importantly, their health care providers are bilingual in Spanish and Guaraní, Paraguay’s second official language that is spoken by many Indigenous people, including Teresa. 

During their visits, CEPEP’s staff has been learning from Teresa about community-based approach to delivery and at the same time, Teresa has learned about techniques to prevent infections given that most of the times, she is the only person in Ñacunday who can provide reproductive care.  

Across Latin America, Indigenous communities have a lower access to health services compared to the general population. Living in rural areas also increases the possibility of not having a certified health-care provider nearby to provide basic services and that’s why CEPEP staff and volunteers bring a truck and tents where they provide different services, including sexuality education for adolescents and young people.  

CEPEP is one of one of the organizations that benefited by Fòs Feminista’s Impact Fund that was used to purchase property for a clinic, rather than renting a building, which allows them to customize the space and make it more welcoming for everyone. Having more resources allows CEPEP to provide more services in the cities and also bring the UMOSA to more communities where the team works alongside community leaders like Teresa to provide comprehensive care to those who need it.