Among one country, or even one community, various factors such as cultural practices, religion, education, and socioeconomic status alter the health experiences an individual faces during their lifetime. All of these factors can be considered social determinants of healthcare, and can widely affect different people in numerous ways. I chose to focus on a more specific social determinant in Guatemala rather than the broad areas I listed above. In Guatemala, location, rather rural or urban, can drastically affect the people of Guatemala’s health care, especially for women and mothers seeking care. In a scholarly article posted from San Francisco they noted, “because of their lack of education, their gender, and their ethnicity, they are commonly devalued by those in the formal health care system, and comadronas are often the scapegoat for the high mortality rates in the country,” (Walsh, 2006). This quote showing that on top of all these other factors, living in a rural location decreases chances even more of adequate health care for mothers and their newborns. This difference in health care based on location is one of the leading health determinants associated with infant and maternal mortality rates within the country of Guatemala.
It may be obvious to most that similarly to other countries with a lack of medical care, Guatemala faces most health issues and lack of access to treatment in its rural areas. Women especially face added risks during pregnancy and delivery. According to UNICEF, barely half of all mothers have a skilled attendant at the birth, which correlates with the high mortality rate (UNICEF, 2008-2012). Adding to these rates, 80% of births are aided by a comadrona, a woman within the community who has virtually no medical education, rather experiences wisdom through spiritual callings (Hemphill, 2011). These women are more common in rural areas, where few medical physicians travel. The World Health Organization noted that out of 1,000 births, 23 children died before the age of 5, and 15 died as infants and newborns. All of these statistics are synonymous with economic status because economic status directly effects where families can live in Guatemala. “The Public Health Ministry acknowledged that Guatemala continues to have reproductive health problems, with higher mortality rates than those in most other Latin American countries,” noted another scholarly article from Guatemala City, (michiganelibrary.org) going on further to discuss how these health problems and mortality rates are even higher in the few non urban areas of Guatemala.
While it may be difficult for a country such as Guatemala to provide, it is important that whether living in a rural or urban environment, providing equal and adequate health care and resources for both the wealthy and the poor of Guatemala in order to decrease the high infant and maternal mortality rate numbers is vital. There has been some progress made in decreasing these numbers, however they are still extremely high. Providing medical care evenly can be done by increasing the number of health care facilities available, educating more people in medicine and resourcing in order to reach out to the people living in the rural and deescalate areas of Guatemala. Because no matter where you live, rural or urban, health care should still be a resource that can be taken advantage of for both men and women alike.
“Country Cooperation Strategy at a Glance – Guatemala.” World Health Organization (2014): n. pag. Apr. 2014. Web. 31 July 2015. <http://www.who.int/countryfocus/cooperation_strategy/ccsbrief_gtm_en.pdf>.
“Guatemala’s Maternal, Infant Mortality Rates Drop.” Michiganelibrary.org. EFE World News Service, 28 Mar. 2003. Web. 31 July 2015. <http%3A%2F%2Fgo.galegroup.com.proxy2.cl.msu.edu%2Fps%2Fi.do%3Fp%3DITOF%26u%3Dmsu_main%26id%3DGALE%257CA99276639%26v%3D2.1%26it%3Dr%26userGroup%3Dmsu_main%26authCount%3D1>.
Hemphill, Margaret, and Copeland. “The Comadrona and Response to Obstetrical Emergencies: Maternal Mortality in Highland Guatemala.” Msulibraries. ProQuest, UMI Dissertations Publishing, Jan. 2011. Web. 31 July 2015. <http://msulibraries.summon.serialssolutions.com/?l=en&ho=t&q=guatemala+maternal+mortality#!/search?ho=t&l=en&q=guatemala%20maternal%20mortality>.
“Statistics.” UNICEF. N.p., n.d. Web. 24 July 2015. <http://www.unicef.org/infobycountry/guatemala_statistics.html>.
Walsh, Linda V. “Beliefs and Rituals in Traditional Birth Attendant Practice in Guatemala.” Journal of Transcultural Nursing (2006): 148-54. Wunrn.com. Apr. 2006. Web. 17 July 2015. <http://www.wunrn.com/news/2006/07_03_06/070906_guatemala_beliefs.pdf>.