Back to Annual Meeting

Back to Annual Meeting

APHA Scientific Session and Event Listing

Meredith Fort, MPH, Health Alliance International, 1107 NE 45th Street, Suite 427, Seattle, WA 98105, 206-543-8382, meredithfort@yahoo.com and Alejandro Ceron, MD, MPH, Clinica Maxeña, Santo Tomas la Union, Suchitepequez, Guatemala.

This presentation will provide an analysis of the health sector reform at the primary care level in Guatemala, describe an alternative proposal that is currently being implemented as a pilot effort, detail initial findings from the first two years of pilot project implementation, and offer lessons learned for improved service delivery.

Health sector reform at the primary care level in Guatemala was initiated with a loan from the InterAmerican Development Bank and was launched in 1997. The Ministry of Health has implemented the new model of service delivery through signed agreements with non-governmental organizations. With government funding, the NGOs provide a basic package of services to designated communities. The current government evaluated the model in 2003 and is considering important modifications.

In response to the reform, grassroots organizations that had been working in community health efforts for decades formed a coalition called the Instancia Nacional de Salud in 1998. The coalition, after an analysis of the reform, developed an alternative proposal for primary care; the alternative model is organized in three programs (individual, family and community) and has three guiding principles: the right to health, multiculturality and gender equity. The coalition is implementing the alternative proposal in coordination with three government health districts, with funding from 2004-2008.

We will present recommendations for improving service delivery in Guatemala based on studies and analyses of the national health sector reform carried out by the authors, the Ministry of Health, and the Instancia Nacional de Salud, and initial findings from the first two years of implementing the alternative proposal.

Learning Objectives:

• Describe key characteristics of the Guatemalan health sector reform at the primary care level.
• Describe key characteristics of the alternative model being implemented in two pilot sites in Guatemala and initial results of project implementation.
• Identify lessons learned for improving service delivery in Guatemala, based on the experiences of the national and alternative models.

Keywords: Primary Care, International Public Health

Presenting author's disclosure statement:

Any relevant financial relationships? No