Matrones as accompagnateurs: A model for accompaniment

Accompaniment is an approach for working with, supporting, and providing needed services to historically marginalized or vulnerable groups. It involves multiple stakeholders going through an experience together in solidarity to achieve a shared goal, ensuring that the vulnerable do not bear the load alone. Despite this, there has been limited research describing accompaniment. Per the existing literature, no study has explored the traditional birth attendant (known as a matrone in Haiti) as an accompagnateur. This paper explores accompaniment as an approach, harnessing the wisdom, connections, and love of matrones serving pregnant women as they labor and give birth. In doing so, this work further operationalizes accompaniment through a conceptual model that describes its various components. Matrones serving pregnant women in the Mirebalais commune of Haiti were purposively and conveniently sampled to participate in focus group discussions. Using thematic analysis, multiple themes emerged. Four themes represent the core components of the accompaniment model: physical support, economic support, emotional support, and advocacy. Four themes represent values that undergird accompaniment: spirituality, compassion, commitment, and conviction. The final theme is the applied, practical aspect of accompaniment: pragmatic solidarity. The layers of the accompaniment model, positions accompaniment as a rubric for programmatic design (core components), philosophical stance (undergirding values), and practice (pragmatic solidarity). We believe these findings demonstrate an accompaniment model that is practical, moral, value-driven, and can be adapted for use in various programmatic settings. This model can be taught and would support better health outcomes for pregnant women from historically, socially or economically vulnerable groups. • What is already known on this topic – Limited research has described accompaniment as an approach for working with vulnerable groups in maternal child health. • What this study adds – This paper explores accompaniment as an approach used by traditional birth attendants servicing pregnant women in Haiti. • How this study might affect research , practice or policy –This work operationalizes accompaniment as a philosophy, practice and rubric for programmatic design in healthcare & beyond.