260553 Intercultural maternal health care services in Guatemala

Wednesday, October 31, 2012

Marta Julia Ruiz, MPH , Consultant for Population Council, Antigua, Guatemala
Alejandra Munguia, MPH , Consultant for Population Council, Antigua, Guatemala
Marieke van Dijk, MD, MA , Consultant for Population Council, Mexico City, Mexico
Sandra Garcia, ScD, ScM , Mexico Office, Population Council, Mexico City, Mexico
Tahilin Karver, MPH , Population Council, Mexico Office, Program Researcher, Mexico City, Mexico
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.

Learning Areas:
Diversity and culture
Provision of health care to the public

Learning Objectives:
To describe the inequity in maternal health indicators between the indigenous population compared to the non-indigenous population in Guatemala To assess the level of uptake of intercultural maternal health care services by Guatemalan public hospitals To list recommendations to further improve the intercultural maternal health care services

Keywords: International MCH, Quality of Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have significant experience with reproductive health topics in the LAC region and have collaborated in this study.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.