| Resumen: |
Since the signing of the 1996 Peace Accords, Guatemala has made efforts to establish economic and political stability, and to improve its social indicators. The country s Constitution states that access to health care is a basic right of all Guatemalans. In practice, however, it has been challenging for the Government of Guatemala to guarantee this right using public facilities. As a result, it has been trying to improve access to health services using both Ministry of Public Health and Social Assistance (MOH) facilities and staff, and alternative health service providers, particularly nongovernmental organizations (NGOs).
In 1997, with support from the highest levels of government, the MOH established the Expansion of Coverage Program (Programa de Extensión de Cobertura, PEC). This decision was motivated by the need to rapidly demonstrate results to meet the health provision goals of the Peace Accords. Since there were already a number of NGOs providing services in the country, the Government of Guatemala decided to enter into formal agreements with them to provide a basic package of health and nutrition services, focusing mainly on young children and women in rural areas that do not have access to MOH services.
Since 1997, the PEC has expanded from three departments to 20 of the country s 22 departments, and to 206 of its 334 municipalities, increasing its coverage from 0.46 million in 1997 to 4.3 million people in 2012. The MOH estimates that currently the PEC serves the health and nutrition needs of 54 percent of the rural population in Guatemala.
Aside from increasing coverage of health and nutrition services to poor rural areas, the PEC has been credited with strengthening the primary health care system in various ways, including (a) the introduction of planning and monitoring tools; (b) improvements in administrative efficiency, particularly in the case of NGOs that were hired as service administrators of mobile health teams; and (c) the use of alternative personnel to address staffing constraints, that is, having auxiliary nurses instead of being dependent on doctors. |
