Guatemala is home to extreme disparities between the indigenous and non-indigenous segments of the population. The indigenous population in Guatemala has disproportionately lower health outcomes when compared to their non-indigenous counterparts. These poor health outcomes can be associated with lower utilization of formal services which, specific to maternal care, can lead to higher rates of maternal mortality and morbidity. As part of an effort to understand deterrents to skilled maternal care, this project explores how experiences with disrespect and abuse affect maternal health care decisions. Findings will be leveraged to inform future efforts which work to increase the demand for formal care and improve the quality of services rendered.
Guatemala: Ixil Health Area, Quiche Department
The Ixil Health Area in the Department of Quiche has been selected as the site for the implementation assessment because it has great need for a more efficient and effective health system and has some of the poorest education, economic and health indicators in Guatemala. Maternal mortality is estimated at 277 deaths per 100,000 births (national average being 153); infant mortality rates reach 66 deaths per 100,000 live births (national average being 471) and 82% of residents live on less than two dollars a day (52% nationwide). Furthermore, the chronic malnutrition rate for Quiche is 72.2%, and 1% of it is acute malnutrition (compared with a national average of 49.8% chronic malnutrition with 1% of it being acute).
The objectives of the study are as follows:
Click on the image below to view a poster summarizing research on facility-based births and disrespect & abuse from the client's perspective. The study, titled "Using Qualitative Methods to Improve Health System Responsiveness in the Western Highlands of Guatemala," found that the majority of women in the Ixil Health Area prefer home-based births due to economic, geographic, social and knowledge barriers. Those who seek facility-based birth do so because of obstetric complications. Women who gave birth in facilities shared negative experiences and perceptions consistent with the Disrespect and Abuse Framework.