Enhancing healthcare capacity at migrant transit points: development and implementation of a maternal and child health and nutrition training program in Costa Rica, Guatemala, and Panama

Abstract Background In 2024, over 300,000 migrants—including over 64,000 children—crossed the Darién Gap into Panama and continued through Central America. Children, adolescents, and pregnant women are particularly vulnerable due to hazardous conditions and limited access to care. To respond effectively, frontline health care workers (HCWs) need skills to address migration-related health and nutrition needs, yet few training resources exist for those serving migrants in transit. This study aimed to [1] identify existing training materials and clinical guidance, [2] assess knowledge of frontline HCWs before and after a pilot training on maternal, newborn, child, and adolescent health (MNCAH) and nutrition, and [3] document training priorities and implementation lessons. Methods The study was conducted between August and October 2024 at four migrant transit points in Costa Rica, Guatemala, and Panama. A desk review of available migrant health training materials was conducted, followed by a needs assessment through key informant consultations. Based on identified gaps and priorities, a context-adapted modular training covering MNCAH, nutrition, and intercultural competence was developed and delivered to 83 frontline HCWs. Change in knowledge was assessed using pre- and post-training questionnaires, and participant feedback and priorities were collected through evaluation surveys. Results No programs addressing MNCAH and nutrition for migrants in short-term transit in Central America were identified. Pre- and post-test scores improved from 60% to 85% in Costa Rica (+ 25% points), 69% to 89% in Guatemala (+ 20), and 57% to 81% in Panama (+ 24). Participant satisfaction was high (94%, 100%, and 93%, respectively). Participants requested more training time and identified priorities including psychological first aid, gender-based violence, and reproductive health. Checklists were developed to support a standardized approach to care, in response to the absence of clinical guidance for short-term transit settings. Conclusions This study found a lack of training materials and clinical guidance for HCWs serving migrants in short-term transit in Central America and showed that a modular, context-adapted training improved short-term knowledge. Participating HCWs identified mental health, gender-based violence, and reproductive health as priorities for future training. Effects on clinical practice, service quality, and health outcomes remain to be evaluated.