Implications of the Past on the Present: Health Care Access and Ethnicity in Rural Guatemala Open Access

Renquist, Christina Marie (2015)

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The following literature review and qualitative study discusses the factors, both historic and present contributing to the unequal access to adequate health care experienced by indigenous Guatemalans in comparison to their ladino counterparts (Guatemalans of European descent). The principal investigator performed an extensive and systematic review of literature relating to Guatemalan history, human rights, the right to health, and indigenous rights. They then conducted in-depth interviews (IDIs) with key informants in-country in the towns of San Juan La Laguna and San Pablo La Laguna, Sololá, Guatemala in order to gain a more contextual, field-based perspective on the issues. These data were analyzed using the ICESCR General Comment 14's AAAQ Framework for health facilities, goods and services, as well as other international right to health legislation. The investigator found that the main factors contributing to unequal access were systematic and historic discrimination against indigenous Guatemalans, lower socioeconomic status, poor representation in political spheres of their health needs, cultural differences between ethnicities, and the concentration of health services in areas where primarily ladino Guatemalans reside. To address these deep-seated issues and improve the unequal burden of disease experienced by these populations, it is necessary to develop and implement a National Plan of Action for Guatemala that upholds the AAAQ Framework as its main objective as well as the right to health for those indigenous communities.

Table of Contents

Acknowledgements. ii

Table of Contents. iii

Table of Figures and Tables. iv

Acronym List. v

Glossary. vi

Introduction. 1

Methods for Literature Review. 2

Introduction. 2

Data Collection and Storage. 2

Inclusion and Exclusion Criteria. 3

Results. 4

Conclusion. 5

Literature Review. 6

Background Information: Guatemala Past and Present. 6

Human Rights in Guatemala. 25

Health and Health Care in Guatemala. 39

Field Work: In-depth Interviews (IDIs). 54

Methods for Data Collection and Analysis. 54

Recommendations for Further Research and Action. 74

References. 79

Appendix I: In-Depth Interview Guide. 85

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