AUTHOR(S)
Cristian J. Huchim-Pena

ABSTRACT
Guatemala is an upper-middle-income country in Central America, with a high poverty rate and significant inequality. The health care system is divided into three large sectors: the private sector, the Guatemalan Social Security Institute, and the public sector. However, the government's health care expenditure is low, which has resulted in inadequate access to medical services for many citizens, especially for the indigenous population, who face disproportionately high poverty levels and limited health care services compared to non-indigenous individuals. Over the past 63 years, various international efforts have tried to address the inequity in health care access, with one example being the Behrhorst program. This program aimed to offer basic medical care to impoverished rural communities in the late 20th century and was a success but faced significant challenges due to the widespread violence and oppression that took place in the late 1970s and the early 1980s.  Despite many efforts, significant challenges remain, particularly in addressing the health disparities between urban and rural areas.

DOI
https://doi.org/10.59016/avaghj.78634

  • 1. Instituto Nacional de Estadística de Guatemala. Proyecciones Nacionales Estimaciones y proyecciones de población 1950-2022 [Internet]. Guatemala City, Guatemala: Instituto Nacional de Estadística de Guatemala; 2019 [Accessed Feb 11, 2023]. Available from: https://www.ine.gob.gt/proyecciones/.

    2. The World Bank. New Country Classifications by Income Level: 2018-2019 [Internet]. World Bank Blogs; 2018 [Accessed Feb 12, 2023]. Available from: https://blogs.worldbank.org/opendata/newcountry-classifications-income-level-20182019.

    3. International Monetary Fund. World Economic Outlook Database [Internet]. World Economic and Financial Surveys; 2022 [Accessed Feb 17, 2023]. Available from: https://www.imf.org/en/Publications/WEO.

    4. The World Bank. Total population in Guatemala [Internet]. The World Bank Group; 2023 [Accessed Feb 13, 2023]. Available from: https://data.worldbank.org/indicator/SP.POP. TOTL?locations=GT.

    5. Parra-Osorio J. Poverty & Equity Brief in Latin America & the Caribbean: Guatemala [Internet]. The World Bank; 2020. [Accessed February 14, 2023]. Available from: https://databankfiles.worldbank.org/public/dd pext_download/poverty/33EF03BB-9722-4AE2-ABC7-AA2972D68AFE/Global_POVEQ_GTM.pdf.

    6. Cabrera M, Lustig N, Morá H. Fiscal Policy, Inequality, and the Ethnic Divide in Guatemala [Internet]. Washington DC: Center for Global Development; 2015 Mar. Report No.: 397. [Accessed February 15, 2023]. Available from: https://www.cgdev.org/publication/fiscalpolicy -inequality-and-ethnic-divide-guatemalaworking-paper-397.

    7. Labonté R, Crooks VA, Valdés AC, et al. Government roles in regulating medical tourism: evidence from Guatemala. Int J Equity Health. 2018;17(150):2-3. Available from: https://doi.org/10.1186/s12939-018-0866-1.

    8. Cerón A, Crooks VA, Labonté R, Snyder J, Flores W. Medical Tourism in Guatemala: Qualitatively Exploring How Existing Health System Inequities Facilitate Sector Development. Int J Health Serv. 2019;49(4):754-772. Available from: doi:10.1177/0020731419866085.

    9. Instituto Nacional de Estadística de Guatemala. Encuesta Nacional de Condiciones de Vida 2014 Tomo 1 [Internet]. Guatemala City, Guatemala: Instituto Nacional de Estadística; 2016 [Accessed Feb 16, 2023]. Available from: https://www.ine.gob.gt/sistema/uploads/2016 /02/03/bwc7f6t7asbei4wmuexonr0oscpshkyb. pdf.

    10. Green T, Green H, Scandlyn J, et al. Perceptions of short-term medical volunteer work: a qualitative study in Guatemala. Global Health. 2009;5(4):1-13. Available from: https://doi.org/10.1186/1744-8603-5-4.

    11. Becerril-Montekio V, López-Dávila L. Sistema de salud de Guatemala. Salud Publica Mex. 2011;53 supl 2: S197-S208.

    12. Bowser D, Mahal A. Guatemala: The economic burden of illness and health system implications. Health Policy. 2011;100(2-3):159-166. Available from: https://doi.org/10.1016/j.healthpol.2010.11.011

    13. Roche S, Brockington M, Fathima S, Nandi M, Silverberg B, Rice H, et al. Freedom of choice, expressions of gratitude: Patient experiences of short-term surgical missions in Guatemala. Social Science & Medicine. 2018;208:18-25. Available from: doi: 10.1016/j.socscimed.2018.05.021.

    14. Ministerio de Salud Pública y Asistencia Social de la República de Guatemala. Cuentas nacionales en salud: financiamiento de la salud en Guatemala, período 1995-2014 [Internet]. Guatemala City, Guatemala: Ministerio de Salud Pública y Asistencia Social; 2015 [Accessed Feb 18, 2023]. 14 p. Available from: https://transparenciapresupuestaria.minfin.gob.gt/wpcontent/uploads/2021/06/MSPAS2015Financi amientodelaSaludenGuatemalaal952014.pdf

    15. Rolland A. History and current context of philanthropy in Guatemala [Internet]. Indianapolis, IN: Indiana University, Lilly Family School of Philanthropy; 2020 [Accessed Feb 19, 2023]. Available from: https://blog.philanthropy.iupui.edu/2020/06/ 10/history-and-current-context-ofphilanthropy-in-guatemala/.

    16. Mota L. Guatemala Health Care Infrastructure [Internet]. United States: International Trade Administration, Market Intelligence; 2020 [Accessed Feb 20, 2023]. Available from: https://www.trade.gov/marketintelligence/guatemala-healthcareinfrastructure

    17. Behrhorst C. A New Dawn in Guatemala: Toward a Worldwide Health Vision. 1st ed. Prospect Heights, IL: Waveland Press, Inc; 1993.

    18. Green LB. Consensus and Coercion: Primary Health Care and the Guatemalan State. Med Anthropol Q. 1989;3(3):246-257.

    19. Advance Local Development through Empowerment and Action (ALDEA). A timeline of impact [Internet]. New York, United States of America: ALDEA; 2023. [Accessed Febraury 19, 2023]. Available from: https://aldeaguatemala.org/our-history/.

    20. "El remedio de nuestros males: Un análisis sobre los mecanismos, costos y formas de financiamiento para mejorar el sistema de salud pública en Guatemala, 2012-2021." Serie de documentos de análisis, Boletín ¡Contamos! N° 6. Ciudad de Guatemala: Instituto Centroamericano de Estudios Fiscales y Fondo de las Naciones Unidas para la Infancia; 2011.

    21. Lawton A. The Right to Health in Indigenous Guatemala: Prevailing Historical Structures in the Context of Health Care. Health and Human Rights Journal. 2015. Available from: https://www.hhrjournal.org/2015/08/theright-to-health-in-indigenous-guatemalaprevailing-historical-structures-in-the-contextof-health-care/

    22. Lao Pena C. Improving access to health services through the Extension Coverage Program. UNICO Studies Series; No. 19. Washington, DC: World Bank; 2013. Available from https://openknowledge.worldbank.org/handle/ 10986/13283.

Current Challenges to Health Care Access in Guatemala

PDF
A colorful painting of Earth with a fiery explosion around it, representing global catastrophe, with the title 'Aid Via Action Global Health' and the date January 2023.

2023, Volume 1, Issue 1