Intercultural maternal health care services in Guatemala

Background: Indigenous women in Guatemala cope with an alarming disadvantage in maternal health. Many social, cultural and health service-related factors contribute to this inequity, and previous research has identified the need for more culturally appropriate and respectful maternal health care. In recent years, the Guatemalan Ministry of Health (MOH) started the implementation of these “intercultural” services, that respect unharmful traditional practices and integrate them with biomedical care. We aimed to assess the implementation progress through a qualitative study.

Methods: We purposefully selected 19 public health hospitals that provided maternal health care to indigenous women, in nine departments in the country. We carried interviewed 107 healthcare providers, TBAs, and indigenous women who had used the services, between October and December 2009. We analyzed results using content analysis.

Results: Eleven hospitals in five departments had initiated the implementation of intercultural services. For example, some offered the possibility for a woman to be accompanied by a family member or TBA during delivery, the use of traditional teas, the free choice on birthing position, and/or attention in their indigenous language. Furthermore, a total of 206 traditional birth attendants were integrated in service provision, although only in one case she was allowed to attend the deliveries.

Conclusion: Guatemalan public hospitals have initiated the implementation of intercultural maternal health care services. Although these experiences still need adjustment, strengthening and further monitoring, this is a promising start to improve the quality of maternal health care for indigenous women in Guatemala.