Felix Brizuela: Teenage pregnancy is a risk because of the high maternal mortality rate

Felix Brizuela: Teenage pregnancy is a risk because of the high maternal mortality rate

Dr. Felix Brizuela is Head of Outpatient Clinic and Statistics at the San Pablo Maternity Hospital and now coordinator of the new Espacio Ñangareko, inaugurated on 11 March. He points out that almost 100% of teenage pregnancies are unplanned, and with the opening of this new space, the aim is prevention and health promotion through continuous training and the provision of available planning methods. “The idea is to offer prevention to our adolescent women who generally come to us with an unplanned pregnancy”. 

Brizuela reports that the adolescent area of the San Pablo Hospital had a relatively inconsistent functioning, firstly because of the pandemic and secondly because of the lack of a physical space. In terms of care at the San Pablo Maternity and Children’s Hospital, more than 20% of births correspond to adolescent pregnancies and 17% of maternal mortality in Paraguay, which means that adolescent pregnancy constitutes a risk, which is why it is essential to make more serious efforts in the area of adolescent sexual and reproductive health care, with a focus on women.

We share an audiovisual with the narration of Dr. Brizuela about the expectations of Nangareko’s opening at the San Pablo Hospital.

Dr. Felix Brizuela is the Head of Outpatient Clinic and Statistics at the San Pablo Maternity Hospital


In addition to the work carried out in Paraguay, the Rassmuss family carries out philanthropic initiatives in other countries. One of the most important initiatives is in Chile, with the sister foundation Sara Raier de Rassmuss http://www.fsrr.cl, which works to strengthen early education in that country. There are also initiatives in Peru and Argentina. In order to consolidate and increase these efforts, two experienced professionals have been brought on board: Chris Wade as Board member and Katherine Hutter as Executive Director of the Rassmuss Foundation Network. Both visited Asunción to learn more about the work of FJRE. Their visit took place at the same time as the inauguration of the Ñangareko Hospital San Pablo, which was a pleasant event. The Director of the FJRE, Patricia Abed and all the staff of the Foundation warmly welcome and thank them for their contribution to the strengthening of our work.

Chris Wade, Board member. Katherine Hutter, Executive Director of the Rassmuss Foundation Network. Lara Apesteguia, Preeclampsia Challenge Coordinator. Dr. Carol Lole-Harris, Senior Medical Advisor
Katherine Hutter visiting a health care unit in the outskirts of Asuncion
Chris Wade, Juan Enrique Rassmuss, Guillermo Sarubbi, participating in the opening of the Ñangareko Adolescent Space at the San Pablo Hospital

The fifth Ñangareko was inaugurated at the San Pablo Maternal and Child Health Hospital

The fifth Ñangareko was inaugurated at the San Pablo Maternal and Child Health Hospital

With the presence of directors of the Juan Rassmuss Echecopar Foundation (FJRE) and other special guests, the opening of the fifth Ñangareko adolescent space was celebrated at the nationally renowned hospital for maternal health.

On Friday 11 March, the Foundation, together with the Ministry of Health and the San Pablo General Maternal and Child Hospital in Asunción, inaugurated the new Ñangareko Adolescent Space.  For the FJRE it represents the fifth space to be set up in strategic health care centres for the public health system. The Ñangareko Adolescent Centres have a seal of excellence and quality. The initiative has been promoted by the Rassmuss Foundation since 2017, in close collaboration with the Ministry of Public Health. 

In line with national efforts, we have contributed to the reduction of teenage pregnancies in Paraguay, from 20,000 in 2017 to 13,500 in 2021.

Dr. Vicente Acuña Appleyard, director general of San Pablo, stated that thanks to this collaboration, a long-cherished project of the hospital is being fulfilled. “Of the 4,000 births attended at San Pablo, 25 per cent were women under the age of 19. There has been a gradual decrease thanks to educational campaigns, but there is still a long way to go. It is precisely this space that will allow easy access for adolescents – girls and boys – to consultations and sexual education to reduce the risk of unplanned pregnancies and prevent sexually transmitted diseases. Acuña also highlighted the accessibility of the space, which is located at the hospital’s front entrance, providing differentiated care for the adolescent population attending Ñangareko. A multidisciplinary team has been set up to provide comprehensive care, with specialists in gynaecology, obstetrics, nutrition, psychology and social services, among others. Attention is provided from Monday to Friday during continuous hours. 

Juan Enrique Rassmuss, Founder and Vice President of the Foundation, thanked the Ministry of Health for constantly opening its doors to work in a symbiotic and collaborative manner. He reflected, “We fundamentally believe that these achievements are possible thanks to public-private collaboration. Individuals, civil society and companies working together with the government to achieve these important challenges. He also recalled that the Foundation has just celebrated its fifth anniversary, “We are inaugurating the fifth Ñangareko, and we are also very proud of the work being done on pre-eclampsia, of which San Pablo Hospital is also a part. The Pre-eclampsia Challenge, whose aim is to eliminate maternal deaths from this disease” he said.

It is worth mentioning that companies and individuals also contributed funds, materials, supplies and equipment to set up this new Ñangareko adolescent space. The infrastructure was improved, setting up consultation rooms and a waiting area, which were specially designed and equipped to receive adolescent population. The total investment was around U$D 13,000. The executive director, Patricia Abed, emphasised that “generosity is a value that many people think is being lost, but the truth is that it is not. There are always people who give without expecting anything in return and the inauguration of this fifth Ñangareko space is proof of this”, she said during her speech. The event was attended by representatives of the Ministry of Health, medical advisors, officials of the San Pablo hospital and other special guests.


Ñangareko (care, protect, welcome, in Guaraní), reflects the spirit of the space: an environment where adolescents feel protected, allowing them to access a new concept of differentiated, friendly, comprehensive health care, available without the need to request an appointment, and providing access to all services in just one place and in a quick and efficient manner.

Once the cooperation agreement between the foundation and the hospital has been signed, commitments are made to provide care with high quality standards. To this end, the foundation provides ongoing training and education for healthcare professionals through the foundation’s medical advisors. These trainings cover the full spectrum of medical competencies needed to provide excellent service, as well as soft skills for a warm, respectful and empathetic care. The foundation’s support includes infrastructure improvements and the provision of certain equipment and supplies. Emphasis is placed on making the full spectrum of planning methods available at all times.

The FJRE is a philanthropic foundation that has been working in the country for 5 years under a collaboration agreement with the Ministry of Public Health, and focuses on two strategic axes: prevention and early detection of pre-eclampsia as the leading cause of maternal death in the country, and adolescent health with an emphasis on sexual and reproductive health, through the strategy Espacios Adolescentes Ñangareko (Ñangareko Adolescent Spaces).