Análisis del Sistema de Salud de Guatemala

The analysis aimed to understand the key obstacles and areas requiring attention within the public health system in Guatemala. The system of public health in Guatemala has strong institutional and human foundations, with a well-established regulatory framework, experienced and dedicated human resources, and a lack of financial dependence on foreign sources. The country's economy, universities, and private sector are also dynamic and supportive of the health sector. However, two major themes define the national health context: the historical structural inequity and the termination of the Programa de Empleo Comunitario (PEC). The inequity in health outcomes is evident in the region, with the Noroccidente region having the highest maternal mortality rate of 202 per 100,000 live births, followed by Petén with 150, and the national average of 113. The maternal mortality rate is significantly higher among indigenous women, with a rate of 159 per 100,000 live births, compared to 70 among non-indigenous women. The density of healthcare workers in Guatemala is also a concern, with a rate of 2.3 workers per 10,000 inhabitants in the Noroccidente region, which is 4 times higher than the rate in the Metropolitana region. The termination of the PEC has resulted in a significant increase in the distance to a healthcare establishment, with an average increase of 2.3 kilometers in the Noroccidente region. This has exacerbated the existing inequities in healthcare access, particularly in rural areas. The analysis identified six key elements of the health system, including governance, financing for health, service delivery, human resources for health, health information systems, and medical supply chain management. The study used a rapid review methodology, combining document review, synthesis of available information, and interviews conducted in Guatemala in April 2015. The findings of the analysis highlight the need for a coordinated approach to strengthen the health system in Guatemala, with a focus on addressing the historical structural inequities and improving access to healthcare services, particularly in rural areas. The report provides a roadmap for the coordination of technical assistance from local, regional, and international partners to support the implementation of new activities and strengthen the health system.