Health indicators Life expectancy 73.50 years Infant mortality 25 deaths (per 1,000 live births) Fertility rate 2.52 children Sanitation 78.8% of population Smoking 10.9% Obesity in Adults 21.2% Malnutrition (Total) 50%Malnutrition (Rural) 70% HIV/AIDS 0.54%
Health in Guatemala is focused on many different systems of prevention and care. Guatemala's Constitution states that every citizen has the universal right to health care. However, this right has been hard to guarantee due to limited government resources and other problems regarding access. The health care system in place today developed out of the Civil War in Guatemala. The Civil War prevented social reforms from occurring, especially in the sector of health care.
The Human Rights Measurement Initiative finds that Guatemala is fulfilling 81.6% of what it should be fulfilling for the right to health based on its level of income. When looking at the right to health with respect to children, Guatemala achieves 94.8% of what is expected based on its current income. In regards to the right to health amongst the adult population, the country achieves only 87.3% of what is expected based on the nation's level of income. Guatemala falls into the "very bad" category when evaluating the right to reproductive health because the nation is fulfilling only 62.9% of what the nation is expected to achieve based on the resources (income) it has available.
Health care system Today, there have been many reforms to the health care system, but the current system continues to have significant problems. The country is on its way to develop a solid health care system, and is working toward achieving many of the Millennium Development Goals in place. However, the inequalities that are associated with outcomes and access have not been addressed, making it difficult for Guatemala to move forward in the field of health care. The ratio of doctors to residents is low, at .9 doctors per 1,000 citizens. The system requires a lot of change in order to serve the whole Guatemalan community.
History
When the Civil War broke out in Guatemala, social improvements in health care were brought to a halt. The period of the 34-year Civil War (from 1954-mid 1980s) resulted in many changes within the health sector. The focus on health care was generally abandoned throughout the period of war when the country experienced a period of "privatization through attrition," which generated poor service and low health care coverage for decades to follow. As Verduga mentions, the total GDP expenditures on health was only about 1 to 2 percent during this period of war. Therefore, it was the emergence of NGOs and other community organizations that allowed for basic health care to be provided to the general population.
Once the Guatemalan Civil War ended in 1996 with the signing of the Peace Accords, health care was placed in the hands of a new democratic government. Immediately after the war, Guatemala saw little change in the healthcare sector. However, starting in 1999, the health care system was improved with increased government spending and aid. Although this was a drastic improvement from the times of war, the system was still insufficient and did not come close to meeting all of the needs of the Guatemalan people.
Structure and coverage Today, the Guatemalan health care system is split into three separate divisions: the public, private nonprofit, and private for-profit sectors. Within the public sector, there is the Ministry of Health and Social Security (MOH), the Guatemalan Social Security Institute (IGSS), and the Military Health Service. This sector of the health care system formally covers about 88% of the population. The private sector, which accounts for about 12% of the population, includes many for-profit providers, non-profit entities, and traditional local providers. The public sector works to provide care through hospitals, health facilities, and various health centers, whereas the private sector allocates resources within private offices, clinics, and hospitals.
Very few funds are allocated to health care within Guatemala. As a share of GDP, health care spending in Guatemala is one of the lowest in Central America (2.6 percent). The GDP expenditure shows that few funds are allocated to the health care system in Guatemala. In total, the Guatemalan government's expenditures on health were about $196 US dollars in 2010. This amount was significantly less than the total Central American average ($350) and the average Latin American and the Caribbean (LAC) expenditures ($672). The health care system requires more funds to improve the coverage and overall health care system in Guatemala.
The Peace Accords, which were signed in 1996, called for a change in health provision goals. In 1997, the MOH established a program called the Expansion of Coverage Program (PEC), which worked to improve the availability of health and nutrition services to young children and women in rural areas of Guatemala. As Pena explains, current MOH services do not cover the poor, rural population of Guatemala, making the PEC critical to the rural population. Ever since its creation, the PEC has expanded immensely, now covering about 54% of the health and nutrition needs of rural Guatemalans. The coverage program works with NGOs in the area to promote good health and nutrition to populations who lack sufficient health care. However, important accountability systems regarding transparency and progress were not installed, limiting the program's effectiveness. The services covered by the PEC include care for women and infants, illnesses and emergency care, and environmental care.
There is also an informal sector of healthcare that is often overlooked. Termed the "Maya Mobile Clinic" or the "Other Public Health", traveling salespeople (often men) are a medical resource for Guatemalans living in the highlands. These salespeople offer raw and natural ingredients to mainly indigenous populations and give talks about their health qualities. Maya Mobile Clinics act as a midpoint between the physical distance of the Guatemalan highlands and public clinic locations, and as a midpoint between the cultural gap that separates Maya medicinal norms and values from Guatemala's public health sector's medicinal norms and values.
Conditions There are many communicable diseases and conditions that threaten the livelihood of the Guatemalan people on a day-to-day basis. Infectious diseases are still the number one cause of death for people in developing countries, whereas in the developed world, infectious diseases are no longer a significant problem. Furthermore, in Guatemala, parasites, diabetes, and malnutrition are huge health problems. Diabetes threatens development in many rural Mayan communities within Guatemala. In order to attack this problem head-on, "health service efforts must be culturally appropriate and emphasize awareness, prevention, early detection, and universal treatment". Also, malnutrition remains a huge problem among children and adults in Guatemala. Given the prevalence of poverty, many residents have limited access to quality nutrition, limited education, and higher rates of disease. Even though there have been improvements, Guatemala is still characterized by high infant and maternal morbidity and mortality rates, pervasive malnutrition, and high incidences of infectious diseases."Poverty in Guatemala: Guatemala poverty assessment. Poverty reduction and economic management unit for the Latin American and the Caribbean region." World Bank. 1995. Washington, DC: World Bank. p. 64 http://documents.worldbank.org/curated/en/1995/04/697460/guatemala-assessment-poverty Also, in Guatemala, the prevalence of Type 2 diabetes and obesity has risen.
Communicable diseases In Guatemala, communicable diseases for which treatment exists are still one of the major causes of death. Wealthy, more industrialized developed nations have been able to eliminate communicable diseases due to an epidemiological transition, in which death rates due to degenerative diseases have surpassed those of communicable and infectious diseases. The opposite is apparent in Guatemala. The high mortality rate for infants is a direct result of communicable and infectious diseases. Similarly, the epidemiological profile of Guatemala shows that some of the most prevalent infectious diseases, like diarrhea and acute respiratory infections, are a direct result of poverty. In Guatemala, 56 percent of the population lives below the poverty line. Poverty levels are greatest in the indigenous communities of Guatemala, which account for about 81 percent of those living in poverty, and make up about 43 percent of Guatemala's total population. High levels of poverty make the population more vulnerable to communicable diseases, which is why government funding of health care is necessary for the rural areas of Guatemala.
Even though Guatemala has improved its health care system substantially since the end of the Guatemalan Civil War, mortality rates for communicable diseases still show that considerable progress needs to be made to remove the burden of infectious diseases on the population. In a country like Guatemala, water is poor and frequently contaminated. In order to decrease common communicable diseases like diarrhea, tuberculosis, pneumonia, and respiratory disease, clean water and sanitation are necessary. With the health care system's provision of both clean water and food, the incidence of infectious and communicable diseases will decrease.
Parasites Parasites present one of the biggest threats to health in Guatemala. Many of the common parasites in developing countries like Guatemala are spread through contamination of both water and food. Some of the effects of parasites include intestinal obstructions, which can hinder the body from absorbing nutrients, lead to a loss of appetite, impair long term growth, induce vomiting, cause anemia and anorexia, and in severe cases, cause death. Symptoms can also include intense abdominal pain, loss of appetite, nausea, diarrhea, and fever.
It has been seen that the prevalence of parasites is significantly higher among younger children and those who are malnourished. Parasites are usually transferred through contaminated water, making them dangerous because they are able to induce malnutrition by consuming the body's nutrients, thus impeding a child's physical development. For school children who are infected with parasites, cognitive functioning can drastically decrease, directly impacting their education. School children who have been treated for parasites immediately perform significantly better in school settings. Parasite infections can also vary based on access to clean water and whether or not sewage disposal is present. The Millennium Development Goals discussed the importance of deworming to help meet the goals set by the United Nations. Parasites can have serious long-term consequences in that they directly affect development and health for decades after. However, inexpensive, single-dose medications exist that can fully treat these parasitic infections.
Diabetes Diabetes is a significant problem within the Guatemalan population. As a rising public health concern, diabetes largely threatens the indigenous population of Guatemala. Because this population frequently has limited access to the Guatemalan health care system, knowledge about the emergence of diabetes is also incredibly limited. Indigenous areas are particularly under-resourced with respect to doctors and overall health care programs.