Equity in healthcare : the law, the rhetoric and the reality in San Cristobal, Verapaz, Guatemala

Degree Name

MA in International and Intercultural Management

First Advisor

Nikoi Kote-Nikoi


ith the global push towards decentralization in healthcare, Guatemala is in the midst of many kinds of reform. After 36 years of internal conflict, the country nears ten years in the peace process. However, the ideals declared in the Peace Accords, the national constitution, and laws demanding justice are just now reaching the rural areas of the country. In this capstone paper, the author explores the law and public health policy of Guatemala and how they are influencing the pursuit and practice of equitable health care in the highlands of San Cristóbal, Guatemala. Through an extensive literature review, on site interviews, and participation in focus groups, the author examines past and present healthcare practices in relation to stated policies in the county of San Cristóbal Verapaz, Alta Verapaz, Guatemala to reach her conclusions. A central conclusion drawn from the study is that, even though some quantitative data suggest that San Cristóbal has a comparatively moderate level of equity in its public healthcare system, a substantial amount of qualitative data establishes the lack of equity in the region. This means that while the quality of distribution of healthcare services and their applications are in place, the quantity of resources and the infrastructure to support it are extremely weak. Thus, if municipal and health authorities of San Cristóbal do not institute systematic change, the established level of equity is at a high risk of regression. Results and recommendations of this capstone paper can be used not only by organizations interested in promoting equity in healthcare, but also by academics to better understand the problems of achieving fair public healthcare systems and practices in Guatemala.

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