A Global Community-Based Participatory Research Collaboration to Improve Maternal Newborn Health Care in the Dominican Republic

Thursday, July 14, 2011: 10:15 AM

Jennifer Foster, CNM, MPH, PhD
School of Nursing, Emory University, Atlanta, GA

Learning Objective 1: describe the relevance of cultural humility when conducting global, cross-cultural nursing research

Learning Objective 2: design a research project using a community-based participatory research approach


We will report upon our community-based participatory research (CBPR) study in the Dominican Republic. Preventable maternal-newborn mortality and morbidity is an enormous global health disparity; innovative forms of research that empower vulnerable communities to engage with healthcare personnel are needed. This study, based on Paolo Friere’s theory of critical consciousness, assumes that when individuals are able to reflect upon their own social situation, they become empowered to change it. Our research team, made of Dominican nurses and lay community health workers, in partnership with US nurse-midwifery researchers, used a rigorous research platform to document the community’s perceptions of maternity services in their public hospital, disseminate their findings, and organize for improvements.


From 2008-2010, Dominican maternity nurses, community leaders, and US nurse-midwifery researchers assembled to  train as a unified research team and conduct and record 12 focus groups and 12 individual interviews across 4 geographically representative, but vulnerable, neighborhoods in the Dominican public hospital’s catchment area. The sample consisted of  systematically recruited adult women and adolescent girls, and a purposeful sample of men who had experienced the loss of a significant other perinatally. The team went on to analyze the Spanish language transcripts of the interviews;  give oral presentations back to the neighborhoods and hospital under study; invite community and healthcare volunteers to join their team; and  identify group projects to improve care.


The volunteers formed a  group that has involved the mayor’s office to ensure consistent running water to the hospital, devised a new system of garbage disposal, conducted a pilot project using nurses and community members to track pregnant women and conduct postpartum visits, tracked the quality of the communications in the pilot, and reflected on next steps for further research.


Nursing CBPR projects can make important health contributions to the global practice-research interface.