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Geographical Locations - Guatemala
 The WWW Virtual Library: Public Health
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- (Statistical) Number of Inhabitants per Doctor: 2,356
- CIA - World Factbook : Guatemala
Organisations and Networks
UN and Multinational
Government
Non-Government
- CSS - Centrale Sanitaire Suisse - Zürich - Politische Solidarität durch medizinische Hilfe ( French & German ) - Guatemala
- Escuela de la Calle - "a Guatemalan indigenous organization dedicated to improving the lives of street children and children at risk of living on the streets in Quetzaltenango (Xela), Guatemala"
- Foundation for Human Rights in Guatemala - "located in Chicago. It was founded in May, 1993, by a group of North Americans and Guatemalans concerned about the human rights situation in Guatemala. The organization was created with a mission to educate, make known, monitor and be vigilant for the full respect of human rights. Now our principal objective is to work for the complete fulfillment of the Global Accord on Human Rights, signed between the Guatemalan Revolutionary National Unity (URNG) and the government of Guatemala. Another objective of FHRG is to help demolish the wall of impunity that continues to exist in Guatemala"
- Medical Mission Exchange - Medical Mission Exchange aims to facilitate referrals of underserved patients to appropriate medical specialists in Central America and the Caribbean. MMEX provides a free, online database of short- and long-term medical missions serving Belize, Dominican Republic, Guatemala, Haiti and Honduras. The information provided includes when and where these groups are working and what medical specialties are represented. Long-term missionaries, health care workers, NGOs, and short-term medical health care providers will be able to determine when and where people with various health problems can be medically evaluated and treated, both at long-term facilities and short-term missions. Patients can be offered a specified date and place to see a specialist. The goal of the MMEX Web site is to enable referrals to be made to short-term mission groups prior to their arrival, thereby better utilizing the physicians and other health care providers who are volunteering their services
- La Sociedad Latinoamericana de Nutrición
- MSF - Médecins Sans Frontières / Doctors Without Borders
Academic Institutions
National Policy and Related Documents
Reports, Guidelines, and Projects
- A report of a midwifery model for training traditional midwives in Guatemala
Objective: to describe the specific characteristics of one model of training traditional birth attendants (TBAs) in Guatemala. Design: participant observation, unstructured and semi-structured interviews undertaken between 1997 and 2003 to gather the data to report on the characteristics of this training programme as it is evolving in the field. Setting: the birth centre site of Ixmucane in Antigua, Guatemala, as well as community sites in the Departments of Saquetepequez, Chimaltenango, and Quetzaltenango in the western highlands of Guatemala. Participants: traditional midwives, certified nurse-midwives and certified professional midwives, as well as many allied health professionals and volunteers. Intervention: training philosophy, participant selection, curriculum content, intensity, and planned follow-up are the key components of the training programme described. Measurement and findings: 93 TBAs have received training through the development of a 150 hrs contact course for self-selected TBAs in the Midwives for Midwives Program. Formal evaluation of this training is underway but results are not yet available. Key conclusions and implications for practice: the value of incorporating midwifery philosophy and praxis in TBA training has received scant attention in the TBA literature. This report suggests that TBA training programme characteristics are important considerations in any evaluation of training efficacy of TBAs to improve maternal–child health. [author abstract] [Midwifery (2004) 20 (3), 217–225]
- Abortion and Postabortion Care in Guatemala: A Report from Health Care Professionals and Health Facilities
"In Guatemala, which has the highest fertility rate in Central America, women currently have more than four children; among the indigenous population, which accounts for 43% of the total population, women have more than six. Although the proportion of married women who use a modern contraceptive method has risen in recent years — it now stands at 34% — increases in use are not keeping pace with declines in desired family size. Nearly one-third of recent births to Guatemalan women were unintended, and 28% of women have an unmet need for contraception. Unfortunately, and sometimes with tragic results, many Guatemalan women turn to abortion when they lack the means to carry out their reproductive goals. Induced abortions are illegal in Guatemala, except for those that are necessary to save the life of the pregnant woman. As a result, women who resort to abortion to resolve an unwanted pregnancy do so secretly and under conditions that pose a grave risk to their health and future fertility. The procedure’s illegality means that no official data are available to measure its true extent; studies from other Latin American nations with similar cultural and legal contexts suggest that unsafe abortion contributes to unacceptable levels of maternal morbidity and mortality in Guatemala. The study reported on here represents a first attempt to grapple with clandestine abortion in Guatemala, a country that until recently did little to promote family planning and has the lowest prevalence of modern method use in Spanish-speaking Latin America. The current lack of information on the problem of unsafe abortion means that, as yet, essential details that are needed to plan effective solutions are also lacking. This report details the findings of a study that aimed to describe and quantify the level of a deliberately underground activity." [Guttmacher Institute, New York – Occasional Report No. 18, December 2005]
- Active Management of the Third Stage of Labor: Data obtained from National Health Network Hospitals in Guatemala
"Postpartum hemorrhage is of the world’s leading causes of maternal mortality. Active management of the third stage of labor (AMTSL) is a feasible and inexpensive intervention that can help save thousands of women’s lives. AMTSL involves three basic procedures: the use of a uterotonic agent (preferably oxytocin) within one minute following the delivery of the baby, delivery of the placenta with controlled cord traction, and massage of the uterus after delivery of the placenta, with palpation of the uterus to assess the need for continued massage for the twohour period following delivery of the placenta. Based on conclusive evidence from clinical trials, the International Confederation of Midwives (ICM) and the International Federation of Gynecology and Obstetrics (FIGO) issued a joint statement in 2003 stating that every woman should be offered AMTSL as a means of reducing the incidence of postpartum hemorrhage. The World Health Organization (WHO) Making Pregnancy Safer Technical Update on Prevention of Postpartum Haemorrhage by AMTSL recommends that “AMTSL should be practiced by all skilled attendants at every birth to prevent postpartum haemorrhage.” Currently, very little is known about the actual practice of AMTSL. The aim of this study is to provide ministries of health and their international partners with the descriptive information necessary to assess AMTSL practices and identify major barriers to its use." [Prevention of Postpartum Hemorrhage Initiative (POPPHI), Washington DC, July to August 2006]
- Childhood sexual abuse among women in El Salvador, Guatemala, and Honduras: Research brief
"This research brief is one in a series of related publications intended to contribute to understanding the complex dimensions of violence against women in three Central American countries: El Salvador, Guatemala, and Honduras. This brief focuses on the prevalence of child sexual abuse among women, the perpetrators of that abuse, and the associations of child sexual abuse with two health outcomes: (1) having a premarital pregnancy and (2) being in a violent relationship later in life." [The Centers for Disease Control and Prevention/Division of Reproductive Health and the U.S. Agency for International Development, USA, c2005]
- Data Exclusivity and Access to Medicines in Guatemala
"According to the World Health Organization (WHO) and UNAIDS, more than 78,000 Guatemalans live with HIV/AIDS, and annual AIDS-related deaths totaled 5,800 in 2003. Approximately 13,500 of all those living with HIV/AIDS now are in urgent need of antiretroviral (ARV) treatment. Yet only 3,600 Guatemalans were receiving it in December 2004. Doctors Without Borders/Médecins Sans Frontières (MSF) has been providing ARVs to Guatemalans since 2001 and is currently treating more than 1,600 people (approximately half of all those on ARV treatment in the country) in one clinic and one hospital in Guatemala City as well as clinics in Coatepeque and Puerto Barrios. Most of the patients in MSF’s treatment programs are receiving generic medicines, which allows MSF to treat the largest possible number of people. Our clinical outcomes parallel those found in the United States and other industrialized countries." [Doctors Without Borders/Médecins Sans Frontières: Campaign for Access to Essential Medicines, February 2005]
- Dietary intakes and food sources of fat and fatty acids in Guatemalan schoolchildren: A cross-sectional study
Background: Consumption of healthy diets that contribute with adequate amounts of fat and fatty acids is needed for children. Among Guatemalan children, there is little information about fat intakes. Therefore, the present study sought to assess intakes of dietary fats and examine food sources of those fats in Guatemalan children. Methods: The study subjects consisted of a convenience sample of 449 third- and fourth-grade schoolchildren (8-10 y), attending public or private schools in Quetzaltenango City, Guatemala. Dietary data was obtained by means of a single pictorial 24-h record. Results: The percentages of total energy (%E) from total fat, saturated fat (SFA) and monounsaturated fat (MUFA) reached 29%E for total fat and 10%E for each SFA and MUFA, without gender differences. %E from fats in high vs. low socio-economic status (SES) children were significantly higher for boys, but not for girls, for total fat (p = 0.002) and SFA (p < 0.001). Large proportions of the children had low levels of intakes of some fatty acids (FA), particularly for n-3 FA, with >97% of all groups consuming less than 1%E from this fats. Fried eggs, sweet rolls, whole milk and cheese were main sources of total fat and, SFA. Whole milk and sweet bread were important sources of n-3 FA for high- and low-SES boys and girls, respectively. Fried plantain was the main source of n-3 FA for girls in the high-SES group. Fried fish, seafood soup, and shrimp, consumed only by boys in low amounts, were sources of eicosapentaenoic (EPA) and docosahexaenoic (DHA) acids, which may explain the low intakes of these nutrients. Conclusions: α-linolenic acid, EPA and DHA were the most limiting fatty acids in diets of Guatemalan schoolchildren, which could be partially explained by the low consumption of sources of these nutrients, particularly fish and seafood (for EPA and DHA). This population will benefit from a higher consumption of culturally acceptable foods that are rich in these limiting nutrients. [author abstract] [Nutrition Journal 2010, 9: 20]
- Experience of a pediatric HIV clinic in Guatemala City
Objectives: To describe the clinical experience of a Guatemalan pediatric HIV clinic and referral center, and fill the gap in literature available on pediatric HIV in Guatemala, a country facing a growing HIV epidemic. Methods: Analyses were performed on data available from the clinical databases maintained by the Clínica Familiar Luis Ángel García within the Hospital General San Juan de Dios in Guatemala City, Guatemala. Results: From January 1997–June 2006, a total of 536 children (individuals under 13 years of age) were registered at the clinic, 54% of them female. At the initial visit, 241 were known to be HIV infected, while 295 were known to have been exposed to HIV, but were of undetermined infection status. Of the 295 with undetermined status, serostatus was determined in 173, and 57 (33%) were HIV positive. The patients came from all 24 departments of Guatemala, but the majority (64%) was from Guatemala City. Most had perinatal exposure; three patients had been sexually exposed to HIV (all male); and the mode of infection could not be determined for six children. In the cohort of children whose infection status was initially undetermined, the provision of antiretroviral (ARV) medication (both pre- and neonatal), in addition to Cesarean section, was associated with an odds ratio of 0.06 for HIV infection (P < 0.001) when compared to children who had no interventions. Highly active antiretroviral therapy (HAART) was administered to 167 HIV-infected children. There were 44 known deaths in this cohort; no deaths occurred among the children who were not infected. Conclusions: Pediatric HIV/AIDS is present in all parts of Guatemala. Programs to prevent mother to child transmission and to provide appropriate treatment to families living with HIV/AIDS must be a public health priority. [author abstract] [Rev Panam Salud Publica 2009; 25(1): 51–55]
- Getting results used: evidence from reproductive health programmatic research in Guatemala
This article reviews 44 operations research projects aiming to improve reproductive health services in Guatemala, conducted by the Population Council from 1988 to 2001. It documents the experience of the research programme, traces the extent to which research results are identifiable in existing programmes, and analyses factors influencing utilization. Utilization of research results occurs as a gradual process of information sharing, where researchers influence decision-makers through a continual stream of information rather than a single set of findings. Utilization depends on leadership, collaborative planning and implementation, close monitoring, and feasible research designs, among other factors. To influence policy formulation, organizations should form enduring links among institutions and develop critical research skills among personnel who collaborate with or manage service programmes. To understand how operations research affects policy and programme change, one must consider not just individual projects, but rather the synergistic impact of multiple projects on a broad range of themes over time. [author abstract] [Health Policy and Planning 2007; 22: 234–245]
- Health and Poverty in Guatemala
"The objective of this document is to provide up-to-date information on the characteristics and patterns of the health status of the Guatemalan population and recommend possible solutions to the institutional, financing, and implementation problems that exist within the health sector… As in most of Latin American countries, the major actors in Guatemala’s health sector are the Ministry of Public Health and Social Assistance (MPSAS), the Guatemalan Social Security Institute (IGSS), the private for-profit sector, and private voluntary organizations. Neither the public nor the private sector is providing adequate health services to the population, which has limited contact with both the public and private delivery system… The combination of poor health indicators and low rates of utilization of public health facilities suggest that the type, quantity, and quality of the services being provided by the government do not match what is needed to improve health indicators or what is demanded by the public… Public health facilities tend to be underutilized. If they can afford it, Guatemalan people prefer to use private facilities that provide health care services. Only the poor, people who live in rural areas, and the indigenous population use public health facilities more often than private facilities… In the late 1990s, Guatemala had the second lowest per capita public spending on health in Latin America. The majority of public resources (about 80 percent) are allocated for current activities… Guatemala’s poor health indicators are due, in part, to problems that are outside of the control of public health authorities and not likely to be solved in the short run. These problems include: (i) widespread poverty due to limited household resource availability; (ii) poor environmental conditions; (iii) the limited availability of private sector providers of an adequate quality; and (iv) a general lack of knowledge about the benefits of modern medicine, especially among the indigenous population." [World Bank Policy Research Working Paper 2966, January 2003]
- Health in the Americas 2007: Guatemala
As a health agency, the Pan American Health Organization’s core discipline is epidemiology, which enables the measurement, definition, and comparison of health problems and conditions and their distribution from the perspectives of population, geography, and time. This publication on Guatemala addresses the issue of health as a human right, taking into account both the individual and community contexts, and examines various critical determinants of health, including those of a biological, social, cultural, economic, and political nature. That examination reveals the existence of gaps, disparities, and inequities that persist in Guatemala, especially those related to access to basic services, health, nutrition, housing, and adequate living conditions as well as to the lack of opportunities for human development—all of which contribute to the greater vulnerability to diseases and health risks of some population groups. [Adapted from the preface of Health in the Americas 2007]
- Increasing Access to Family Planning among Indigenous Groups in Guatemala
"This report describes an initiative to promote equitable access to family planning and reproductive health services (FP/RH) among indigenous women in Guatemala. The lessons learned from this approach and its application in five districts can be applied to other settings… In partnership with the Ministry of Public Health and Social Welfare (MSPAS), the Guatemalan Institute for Social Security (IGSS), and the Association for the Wellbeing of the Family (APROFAM), the Health Policy Initiative (1) collected and analyzed information related to access to services and unmet need for FP among indigenous groups; (2) discussed the findings with key stakeholders and supported policy dialogue to identify strategies and service delivery practices to address the issues identified; (3) tested the strategies and practices; (4) conducted follow-up interviews with program implementers; and (5) identified lessons learned that can guide future work to make FP/RH services more accessible to disadvantaged groups. This report discusses the background and rationale for this work, reviews efforts to reach the underserved, and describes the process of identifying barriers and implementing the recommended strategies. The final section provides lessons learned and recommended actions for other countries to reduce barriers to access and use of FP/RH services among poor and marginalized groups." [USAID, December 2008]
- Informe Nacional sobre los Progresos Realizados en el Seguimiento a la Declaración de Compromiso Sobre el VIH y SIDA – UNGASS Guatemala, 2007
"De acuerdo a la información presentada por el Centro Nacional de Epidemiología del Ministerio de Salud Pública y Asistencia Social de enero de 1984, hasta octubre de 2007, se han reportado 10,667 casos de SIDA. De éstos, 7,447 (69.75%) son varones y 3,219 (30.15 son mujeres). La razón de masculinidad del total de casos es de 2.31, la que se ha mantenido similar desde 1994. El mayor porcentaje de casos de SIDA reportados según grupos de edad es el siguiente: 25 a 29 años con 2,110 casos (19.76%), 30 a 34 años con 1,781 casos (16.68%) y 20 a 24 años con 1,511 (14.15%). Lo anterior evidencia que la epidemia continua afectando a la población joven, sexual y económicamente activa. La principal vía de transmisión del VIH es por medio de relaciones sexuales, correspondiente a 10,077 casos (94.38%). En segundo lugar se encuentra la transmisión de madre a hijo(a) con 519 casos reportados (4.86%). En 81casos se desconoce la vía de transmisión."
- Maternal and childhood nutrition and later blood pressure levels in young Guatemalan adults
Background: Low birth weight and subsequent rapid child growth are associated with later blood pressure levels. The role of maternal and child nutrition in this association remains unclear. Methods: We studied 450 men and women (ages 21–29 years) born during a randomized trial of protein-energy supplementation (Atole) vs low energy/no protein supplementation (Fresco) in pregnancy and early childhood in four rural Guatemalan villages from 1969 to 1977. Results: Protein-energy supplementation was not associated with differences in blood pressure in adulthood (diastolic blood pressure (DBP): β = 0.69 mm Hg, 95% confidence internal (CI) (–0.82–2.19); P = 0.37; systolic blood pressure (SBP): β = 0.17 mm Hg, 95% CI (–1.68–2.02); P = 0.86). Within the Atole group, maternal height was associated with later SBP (0.22 mm Hg/cm, 95% CI (–0.002–0.45); P = 0.05). No other associations between maternal nutritional status, birth size, child growth, or supplement intake were observed for adult blood pressure. Conclusions: Our data do not support the role of maternal nutrition during pregnancy, birth size, or early child growth in programming adult blood pressure. Likewise, we found no effect of protein-energy supplementation in pregnancy or in early childhood on blood pressure in young adults. [author abstract] [International Journal of Epidemiology 2005; 34: 898–904]
- Micronutrient supplementation may reduce symptoms of depression in Guatemalan women
Evidence for the impact of micronutrient supplementation trials on depression in women from developing countries is limited. This study examines this association and compares the impact of weekly versus daily combinations of micronutrient supplements on symptoms of depression. A randomized, positive-controlled trial was conducted in Guatemala. A total of 459 women were assigned randomly to 4 groups to receive weekly (5,000 or 2,800μg) or daily (400 or 200 μg) folic acid (FA) plus iron, zinc and vitamin B-12 for 12 weeks. Depression was measured using the Center for Epidemiologic Studies-Depression 20-item Scale (CES-D). A score=16 was used as an indication of depression. The association between micronutrient status and depression was assessed using baseline data. Generalized linear regression models were used to assess treatment effects. The baseline mean CES-D score was 17.1±8.5 and the prevalence of depression was 49.3%. Women in the lowest tertile of red blood cell folate (RBC) were 1.7 times more likely to be depressed than those in the highest tertile (OR=1.71; 95% CI: 0.91, 3.18). There were no associations between depression and serum folate, homocysteine, vitamin B-12, hemoglobin, ferritin or zinc (p > 0.05). Mean depression scores decreased by 2.3 points post-intervention and depression decreased to 37.7%, with no differences in degree of improvement by group (p = 0.64). Low RBC folate was associated with elevated symptoms of depression at baseline. Supplementation with FA-containing micronutrients may be equally efficacious in improving symptoms of depression when provided daily or weekly. Our findings that poor folate status may increase depression needs to be further investigated. [author abstract] [Archivos Latinoamericanos de Nutrición, 59(3): 278-286 (2009)]
- Mobilizing for Impact: Engaging Guatemalan Communities to Save Mothers
"Guatemalan women, their families, and their neighbors exposed to an innovative safe motherhood program now know what to do in case something goes wrong during pregnancy, childbirth, or postpartum… Taking action in a timely manner helps save women’s lives and reduce maternal mortality." [Johns Hopkins University, Bloomberg School of Public Health, Center for Communication Programs and the Ministerio de Salud Pública y Asistencia Social de Guatemala, Programa Nacional de Salud Reproductiva, May 2004]
- Reducing HIV/AIDS Vulnerability in Central America: Guatemala: HIV/AIDS Situation and Response to the Epidemic
"The main objectives of the study were to establish a baseline for measuring progress and identifying new challenges for the Central America HIV/AIDS Regional Project, and to support policy dialogue regarding the political leadership and commitment to prepare a regional HIV action plan with common policies and coordinated strategies." [Latin America and the Caribbean and The Global HIV/AIDS Program of the World Bank, December 2006]
- Secondhand Smoke Exposure in Public Places in Guatemala: Comparison with other Latin American Countries
Objective: To measure secondhand smoke levels in workplaces in Guatemala and to compare exposure to levels in other Latin American cities. Methods: Exposure was estimated by passive sampling of vapor phase nicotine using a filter badge. Filters were placed in 1 hospital, 1 school, 2 universities, 1 government building, the airport, and 10 restaurants/bars. In total, 103 filters were deployed (plus 7 duplicates and 10 blanks). Nicotine (Mg/m3) was measured by gas chromatography. Medians [interquartile ranges (IQR)] of nicotine concentrations were reported and compared with other Latin American cities. A survey about attitudes for smoke-free workplaces was distributed among employees. Results: Nicotine was detected in most (68%) locations surveyed (including workplaces where smoking is banned). The highest levels were found in bars [median, 4.58 Mg/m3 (IQR, 1.71-6.44)] and restaurants [median, 0.56 Mg/m3 (IQR, 0.46-0.71)]. Nicotine concentrations in bars and restaurants were 710 and 114 times higher, respectively, compared with hospital concentrations after adjustment for smoking ban signs, type of ventilation, and volume of the area. Support for smoke-free environments was high, except in bar/restaurant and airport workers. Airborne nicotine levels in Guatemala were similar to those found in other Latin American cities. Conclusion: In Guatemala, exposure to secondhand smoke is highly prevalent. Workers in bars and restaurants are disproportionately exposed to secondhand smoke compared with other workers. There is an urgent need for complete smoke-free legislation and for educating workers about the benefits of smoke-free workplaces. [Cancer Epidemiol Biomarkers Prev, 2007; 16(12): 2730–2735]
- Setting Prices for Reproductive Health Services in a Public Hospital in Guatemala
The Hospital Roosevelt is Guatemala’s largest hospital, and serves as a referral and training facility for the entire country. Within the Hospital Roosevelt, the Department of Obstetrics and Gynecology established a Reproductive Health Unit (RHU) to offer family planning information and services to obstetrics inpatients and OB/GYN outpatient clients, and to serve as a training site for medical residents completing their OB/GYN rotations. Several entities provided financial and in-kind resources to the RHU. The Hospital Roosevelt provided the physical infrastructure, the Ministry of Health (MSPAS) contributed contraceptive commodities (donated by USAID/Guatemala), and other international agencies purchased equipment and trained staff to provide various reproductive health services. The RHU itself was tasked with covering the costs of some staff and medical supplies through user fees. Hospital administrators requested assistance from the Frontiers in Reproductive Health Program (FRONTIERS) to help establish a fee schedule for the RHU. The RHU had set the goal of paying its own personnel costs after one year of operation. The FRONTIERS study included three elements: a cost study to calculate full economic costs of the RHU as well as ongoing financial requirements; a willingness-to-pay (WTP) and ability-to-pay (ATP) survey to gauge demand for services and to assess the economic status of potential RHU clients; [and] scenarios showing different ways for the RHU to expand services and reduce prices, while earning enough revenue to cover its monthly financial obligations. The FRONTIERS study found that the RHU was easily earning enough revenue to break even, but was unable to meet demand for tubal ligation because of limited access to surgical facilities. Several options were outlined for increasing production of tubal ligation while continuing to generate revenue to cover the expenditures for which the RHU is responsible. [publication summary] [Population Council, 1 May 2001]
- The emergence of AIDS in Guatemala: inpatient experience at the Hospital General San Juan de Dios
Little is known about the effect of human immunodeficiency virus (HIV) infection on the Central American healthcare system. We describe HIV-related admissions in a Guatemalan medical service. The study was conducted at Guatemala City’s largest public hospital. Data were derived from standardized data collection sheets maintained by the HIV testing service and by HIV clinic physicians. Data were collected for 295 medicine admissions of 257 HIV-infected adults during an 18-month period in 1999 and 2000; 30% of the patients were women. Average age was 33 years. Only 12.5% of the patients had been diagnosed with HIV infection prior to 1999 and nearly all had symptomatic AIDS. 60.3% of the patients were diagnosed with HIV infection during their hospitalization. The most common discharge diagnoses were tuberculosis (13.9%), toxoplasmosis, diarrhoea, candida and other fungal infections, and meningitis. Mean length of stay for HIV-positive patients was 17 days. 23.7% of the patients died during their hospitalization; this was double the mortality of non-HIV patients. HIV-infected patients represented 5.8% of the total admissions of the general medical wards. In a country where HIV prevalence is thought to be less than 1%, AIDS is now responsible for over 5% of admissions to a large medical service at a cost of $500,000 per year. These findings underline the importance of HIV infection in Central America and demonstrate the utility of tracking hospital admission data as a method of surveillance. [author abstract] [International Journal of STD & AIDS 2003; 14: 810–813]
- The mental health status of Mayan refugees after repatriation to Guatemala
Objective: Only one previous study had examined the epidemiology of mental health in Guatemalan refugees. The objective of this new study was to estimate the prevalence of mental illness and to assess factors associated with poor mental health among Guatemalan Mayan refugees who had been repatriated to Guatemala after spending 12–18 years in refugee camps in Mexico, and to compare the results for the repatriated Guatemalans with those for Guatemalan refugees who were continuing to live in Mexico. Methods: In 2001 a cross-sectional survey of adults (≥ 16 years) was conducted with random household sampling proportional to the population size in each of the five repatriation villages surveyed. Posttraumatic stress disorder (PTSD), anxiety, and depression were measured by the Harvard Trauma Questionnaire and the Hopkins Symptom Checklist-25. Results: Together, the five repatriation villages had 565 households. Of the 565 households, 203 of them were approached to solicit study participation. A total of 179 households (one adult per household) agreed to participate, representing an overall participation rate of 88%, and one-third of all the households in the five communities. The respondents had personally experienced a mean of 5.5 trauma events and had witnessed a mean of 7.3 other trauma events. Of the respondents, 8.9% met the symptom criteria for PTSD, 17.3% for anxiety, and 47.8% for depression. PTSD was associated with being seriously wounded and with having relatives or friends mutilated. Logistic regression analyses indicated that anxiety was associated with being sexually assaulted, being female, having friends or family mutilated, being seriously wounded, and having 6–12 children (vs. having 1–5 children). Depression was associated with having 6–12 children. Anxiety was significantly more prevalent among the refugees remaining in Mexico (54.4%) than it was among the repatriated refugees (17.3%). The difference in the prevalence rates was not significant for PTSD (11.8% for refugees remaining in Mexico vs. 8.9% for those repatriated) or for depression (38.8% for refugees remaining in Mexico vs. 47.8% for those repatriated). Conclusions: Psychiatric morbidity was common among the repatriated Mayans. The repatriation of refugees involves moving an already vulnerable, often traumatized population back to a place of distressing memories and still-unsettled conditions. There is a need to consider and plan for adequate mental health services for repatriating refugees. [author abstract] [Rev Panam Salud Publica, 2006; 19(3): 163–171]
- Training traditional birth attendants in Guatemala
Many women choose to deliver with traditional birth attendants in Guatemala — a fact that can’t be ignored, argue local public-health officials. They hope a new, culturally sensitive approach to training TBAs will help improve their quality of care and save lives. [publication summary] [The Lancet, Vol 369, pp.177-178, 20 January 2007]
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