Family Planning for Guatemalans Living in Poverty

2022 was a year of forward motion for WINGS. We were able to reactivate clinical services to near pre-pandemic levels and reinitiate the high-growth strategic plan that was paused during the pandemic. We largely succeeded in establishing our historical mix of contraceptive methods, in particular tubal ligation services, the contraceptive method most impacted by the lack of reliable access to hospitals. By working alongside valuable hospital partners, we were able to begin to address the significant demand for this service and finished the year having performed 34% more tubal ligation operations than projected. We are still operating with a waiting list for voluntary surgical contraception, and a major goal of 2023 will be addressing this need.

In addition to our reproductive health clinical services, last year we launched our second Youth Peer Education Program in Quetzaltenango (also known as Xela), the second largest city in Guatemala. This first cohort underwent year 1 of training and began to provide community and one-on-one peer discussions, touching on themes of consent, relationships of power, and pregnancy prevention. WINGS also began a second Community Advisory Board in the northern region of Alta Verapaz. This group of local community leaders act as a voice for their communities, conduct observations and provide recommendations to our team each year that we incorporate into our work plans to better serve communities. Both the addition of a Youth Peer Education Program in Xela and the addition of another Community Advisory Board complement the services we already provide in these regions, enabling us to reach more individuals in a comprehensive manner, with a focus on continuous quality improvement.

WINGS work in 2022 prevented 31,599 unplanned pregnancies, 7 maternal deaths and 156 infant deaths (calculated using the Marie Stopes International “Impact 2” model). 

Your support was critical in achieving these goals. For that, we’d like to say muchas gracias. 

Thank you.

From the entire team at WINGS Guatemala

During a recent team training, we split into small groups to do a Círculo de Diálogo - Dialogue Circle. The first discussion question was what motivates us to work at WINGS. When it came time for Tatiana, one of our lead nurses, to share, she answered with this story: 

“The patient was 17 and came in alone, while her mother and her partner, who was 7 years older, waited outside the school where we were putting on the clinic.  She approached me, explaining - no tengo hijos y no los quiero ahora - I don’t have children and don’t want them right now. I was recently trained in differentiated care for teenagers and went through the age-appropriate counseling that I’d learned, explaining the long-term reversible contraceptive methods we provide, how they are placed, and the advantages and disadvantages of each. The patient decided that a hormonal implant was the best option for her and left to take a pregnancy test. 

After a few minutes, she returned with a negative result but looked discouraged. She told me, “I’m actually not going to get any method today.” I was confused by the sudden change in attitude and asked why. She replied, “When I told my partner I wanted the implant, he discussed it with the health center nurse that is outside. That nurse said that implants - se chupe la matriz - suck away the uterus, making my uterus too small to have children. Because of this, my mom and my partner tell me I can’t get the implant.”

I showed the patient the small, plastic implant, explained again that it is placed in the arm and does not affect the ability to have children. I also reminded her that it is her fundamental right to be able to choose a contraceptive method that works best for her. She asked me if I would be willing to explain all of that again, but this time to her partner and mother. I agreed, and when they came in, I reviewed again the information about the implant and answered the questions that they had. I remember the patient’s mother saying, “if I had known this, I wouldn’t have used short-term injections for so many years!” Her partner mentioned that he thought implants were made of metal. He asked the patient if he could watch the implant being placed so that he could feel confident sharing this information with his friends, who, he said, also had a lot of questions about this topic. 

The patient received the implant and left content with and sure of her decision, and I talked to the local health center about organizing a training session with their staff.”

The communities WINGS serve face not only a lack of access to dignified reproductive healthcare, but also a lack of evidence-based information. We thank you for your continued support that enables Guatemalan women and men to make informed, personal decisions about their reproductive health. 

2022 marks the beginning of our expansion into two new departments - Izabal and Baja Verapaz. These two departments border the department of Alta Verapaz, where we have had a presence since 2013.  As part of our expansion, WINGS established a fourth mobile unit team, consisting of a new vehicle, equipment, and additional team members in the region, including Nancy, a nurse who joined us in January. 

In March, Nancy led a jornada (clinic day) in the community of La Cresta in Alta Verapaz where 15 women arrived to receive a long-acting reversible contraceptive (LARC). As Nancy met and interacted with the patients, she found that 8 of those patients were carrying a small “tarjeta de recordatorio,”  a reminder card that WINGS provides to indicate the date that a LARC was placed and the date that it needs to be replaced. These 8 patients had visited a WINGS jornada 5 years ago and kept the card ever since, choosing to return to WINGS for the removal.

As Nancy got to know each of the patients, she discovered that 5 of the patients came to remove and replace subdermal hormonal implants to receive 5 more years of protection; 2 patients requested the removal without replacement, as they had decided they and their family were ready to have a child; and the final patient was securely in menopause and no longer needed a contraceptive. 

At WINGS, we are proud to be part of our patient’s reproductive lives - proud to be able to provide the resources that enable them to decide if, when, and with whom to grow their families. We are grateful for your continued support which allows us to provide reproductive health services in two new departments in 2022 and, one day, throughout Guatemala. 

Wishing you all the best,

Elissa and the entire team at WINGS Guatemala

We are so grateful to each of our supporters for celebrating our 20th anniversary with us throughout 2021. In the face of the ongoing COVID-19 pandemic, we not only survived but thrived, albeit with a vastly different distribution of services than what we had originally projected. Leading up to 2020, tubal ligations had become one of our most sought-after services. But because hospital access was limited due to pandemic priorities, we could not offer the number of clinics originally intended. We provided 466 out of a projected 1,609 tubal ligations (29%). Fortunately, vasectomies can be performed in almost any clinical setting. As a result, we aimed to provide 580 and provided 945 vasectomies (163%). This is a true success story of 2021.

As is clearly visible from our Short-Acting Total, we nearly tripled our projection for short-acting contraceptive methods thanks to the efforts of our Youth Leader Program and Volunteer Promotor Network. We are grateful to these groups for their continuous dedication to serving their local communities despite the continual access challenges posed by the pandemic.

In addition to this clinical highlight, we also launched our first Community Advisory Board, established a legacy giving program, and grew our social media engagement of our Youth Peer Education Program. We did all of this while acting as a national leader in pandemic precaution adherence, as well as welcoming a new Executive Director.

These notable accomplishments in building an ever stronger community of supporters means that we can look forward to providing even more reproductive health services  over the next 20 years.

Thank you for being a part of this journey with us,

The entire team at WINGS Guatemala

In the past few weeks at the helm of WINGS, I have had the opportunity to reflect on the incredible work that we have been doing for the past 20 years. As we look to finish up this year, I have specifically been reflecting on WINGS’ goals and practices around diversity, equity and inclusion, something that has always been central to our mission and vision and is only that much more relevant and necessary as we embark on our next 20 years of organizational growth and success.

Knowing that the content of our work pulls on diverse and complex cultural contexts, taboos, and values and requires that patients feel trust and deep respect from our staff, WINGS makes a point of hiring staff from the communities we serve. In 2021, we launched our first Community Advisory Board, ensuring that the voices of our patients, community partners, and program participants are meaningfully reflected in our program design and evaluation. To ensure transparency and accountability, this advisory board has direct communication with staff leadership as well as with our Board of Directors. The person-centered work culture of trust, care, and open dialogue that we have established at WINGS has laid the groundwork for us to now dig into more complex DEI work as a team. This must include both inward and outward focused needs - working, for example, to make our services more accessible to marginalized groups including indigenous communities, the LGBTQIA+ community, and individuals with disabilities, but also looking at how, as a team, we might better listen and understand the diverse representation that exists on our staff, and create hiring and staff development practices that hold space for increased diversity, equity, and inclusion over time.

While the implications of the global COVID-19 pandemic continue to guide our daily routines at WINGS, I am excited to look toward the future, knowing that we are always striving to make our service delivery and our workplace even more inclusive.

We are so grateful to our supporters for making the past 20 years possible and we look forward to sharing with you as we embark on the next 20 years together.