Poor Maternal Health Outcomes Often Related to Geography, Infrastructure And Education1

Maternal Health outcomes in Guatemala are among the worst in the region (tied with Bolivia)2. Between 1990 and 2010, the maternal mortality rate has dropped from  240/100,000 live births to 120-1353. However, a maternal mortality baseline study conducted in 2000 estimated that there were serious issues of under-recording, perhaps as much as by 44% of maternal deaths that year alone4.

Increasing Awareness of maternal health in GuatemalaAs is common in countries with large rural and native populations, the maternal health risks women face in childbirth is not uniform across the country. “Maternal mortality is an indicator of disparity and inequality existing between men and women from different geographical areas and social backgrounds”5. Regions populated by the mostly rural, indigenous, and illiterate have a higher maternal mortality rate6. For every ladina woman that dies, three indigenous women die from the same causes7.  Maternal health risk have actually worsened among indigenous women while it has improved among non-indigenous women8.  Access to adequate healthcare plays a major role in these statistics. The majority of maternal deaths occur when the birth was conducted at home as opposed to a hospital setting. When giving birth in the home, women are commonly attended by a midwife, a relative, or themselves instead of a health care provider9.
This led the Ministry of Public Health and Social Welfare to seek to improve the conditions for women, particularly in rural regions. They instituted programs to train midwives in hopes of broadening access to healthcare10. Noting the great need for further action and improvement, the U.N. Population Fund began working with the Guatemalan Health Ministry to identity obstacles and create a plan to overcome them11.  The four key problems associated with maternal health were identified: not realizing there was a problem soon enough to act; the custom of seeking permission from a husband, mother-in-law, or other family member to get medical help, which permission may be withheld; lack of transportation from remote villages to medical facilities; and receiving the proper medical treatment once reaching the hospital12.
Thousands of midwives have since been trained and equipped with birthing kits to tackle the first problem, therefore raising awareness of signs leading to maternal fatality. To address the second problem, health care workers have begun working with male community leaders, teaching them that women should be encouraged to seek medical help and permission should always be granted. The third barrier has created the most problems for the groups actively working to decrease maternal mortality since vehicles and the money needed for the trip are often severely limited. In an attempt to overcome this, committees have been assigned to create response plans and raise funds for emergencies. The fourth problem – proper care once reaching the hospital — is exacerbated by the lack of doctors willing to work in the rural areas. Medical mission doctors from Cuba alleviate part of this strain, but the need for even more qualified personnel has yet to be addressed13.

There are a number of NGOs also at work in Guatemala to educate and serve, such as the Center for Economic and Social Rights, APROFAM, and AGES14. Databases such as WE Guatemala have been compiled to streamline and coordinate NGOs, from clinics to education based organizations15. The United States plays a significant role in empowering NGOs through funding to reduce maternal mortality through the Global Health Initiative. The Guatemala Strategy focuses on women, newborns, and children under five, and therefore seeks to reduce maternal mortality16.

Hopefully these changes will result in measurable improvements in maternal health over the next few years as NGOs work with the government to help Guatemala progress.


 

  1. Rachel Zirkle contributed this report 
  2. UN Economic and Social Rights 
  3. UN Statistical Database and World Health Organization, World Health Statistics, Part III, Global Health Indicators, Published 2012, Accessed 1 June 2012 
  4. Convention for the Elimination of all forms of Discrimination Against Women, Guatemala Country Report, 2008, p. 115 
  5. Convention for the Elimination of all forms of Discrimination Against Women, Guatemala Country Report, 2008, pp. 115 
  6. Convention for the Elimination of all forms of Discrimination Against Women, Guatemala Country Report, 2008, p. 117 
  7. Convention for the Elimination of all forms of Discrimination Against Women, Guatemala Country Report, 2008, p. 117 
  8. Convention on the Elimination of all forms of Discrimination Against Women, Responses to the List of Issues and Questions for consideration of the Sixth Periodic Report – Guatemala, 2006, 39, 43-44 
  9. Convention for the Elimination of all forms of Discrimination Against Women, Guatemala Country Report, 2008, p. 118 
  10. Convention on the Elimination of all forms of Discrimination Against Women, Responses to the List of Issues and Questions for consideration of the Sixth Periodic Report – Guatemala, 2006, 39, 43-44 
  11. Guatemalan mountains become maternal deathtrap, Women’s e News  
  12. ibid 
  13. ibid, Women’s News Organization January 15, 2007  
  14. UN Economic and Social Rights; Reproductive Rights Organization 
  15. WE 
  16. GHI 

  1. Rachel Zirkle contributed this report 

  2. UN Economic and Social Rights 

  3. UN Statistical Database and World Health Organization, World Health Statistics, Part III, Global Health Indicators, Published 2012, Accessed 1 June 2012 

  4. Convention for the Elimination of all forms of Discrimination Against Women, Guatemala Country Report, 2008, p. 115 

  5. Convention for the Elimination of all forms of Discrimination Against Women, Guatemala Country Report, 2008, pp. 115 

  6. Convention for the Elimination of all forms of Discrimination Against Women, Guatemala Country Report, 2008, p. 117 

  7. Convention for the Elimination of all forms of Discrimination Against Women, Guatemala Country Report, 2008, p. 117 

  8. Convention on the Elimination of all forms of Discrimination Against Women, Responses to the List of Issues and Questions for consideration of the Sixth Periodic Report – Guatemala, 2006, 39, 43-44 

  9. Convention for the Elimination of all forms of Discrimination Against Women, Guatemala Country Report, 2008, p. 118 

  10. Convention on the Elimination of all forms of Discrimination Against Women, Responses to the List of Issues and Questions for consideration of the Sixth Periodic Report – Guatemala, 2006, 39, 43-44 

  11. Guatemalan mountains become maternal deathtrap, Women’s e News  

  12. ibid 

  13. ibid, Women’s News Organization January 15, 2007  

  14. UN Economic and Social Rights; Reproductive Rights Organization 

  15. WE 

  16. GHI