Improving Access to Health Care Services through the Expansion of Coverage Program : The Case of Guatemala

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 challe...

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Bibliographic Details
Main Author:	Lao Pena, Christine
Format:	Working Paper
Language:	en_US
Published:	World Bank, Washington DC 2013
Subjects:	ability to pay Access to Health Care Access to Health Care Services access to health services aged auxiliary nurses baby basic health care Basic Health Services basic nutrition beds birth attendant birth attendants breast cancer breastfeeding burns capitation care during pregnancy Care for Children cervical cancer Child Care child health child mortality child mortality rates chronic malnutrition civil society organizations civil war clinics communicable diseases community health community participation complications condoms counseling counselors deaths debt developing countries development goals diphtheria doctors emergencies emergency care emergency obstetric care emergency plan families family health family health services family planning family planning methods financial management folic acid food security fractures General Health System government agencies government support gross domestic product gross national income Health Administration Health Care health care expenditures Health Care System Health Centers Health Expenditure Health Expenditures health facilities health information health information systems health insurance Health Management Health Organization health outcomes health posts health professionals health providers Health Reforms health risks health sector Health Service Health Service Delivery health service providers health services health services administration Health Strategy Health System health systems hepatitis B high-risk pregnancies HIV Home visits Hospital Hospital beds hospitals Hunger hygiene ill health illness immunization immunizations income indigenous peoples indigenous populations Infant infant health Infant mortality Infant mortality rate influenza Information System injuries inpatient care institutional capacity Insurance Integrated Health Care Integrated Management of Childhood Illnesses iron legal status Life expectancy live births Living Standards malaria maternal deaths maternal health maternal mortality maternal mortality rate maternal mortality rates maternity care measles medical professionals medical records medical services medical staff medicines micronutrient supplementation midwife midwives military personnel Millennium Development Goal Ministry of Health morbidity mortality mother mumps neonatal services newborn newborns nurse nurses nursing nutrition nutritional deficiencies nutritionists patients Peace pediatric care pharmacies pharmacy Physician Physicians police force polio polio vaccine political support population groups postpartum care pregnancy pregnant women prenatal care primary care primary health care primary health care services primary health care system process evaluation progress provision of care psychologists Public Health Public health expenditure public health programs public health services public health spending public hospitals Public Information public services purchasing power purchasing power parity quality of health quality of health care quality of services rabies radiotherapy rehabilitation reproductive age resource flows respect rural areas rural communities rural population rural women Service Provider service provision services for children sexually transmitted diseases skilled staff social programs Social Security social work TB control tertiary level tetanus Traditional birth attendant traditional birth attendants Tuberculosis under-five mortality unions universal access urban women use of family planning vaccination vaccines waste waste disposal whooping cough workers World Health Organization young children
Online Access:	http://hdl.handle.net/10986/13283

Description
Summary:	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). This case study reviews the experience implementing the Expansion of Coverage Program (Programa de Extension de Cobertura, PEC) that was established by the Government of Guatemala in 1997 to improve coverage of health and nutrition services to poor, rural, and largely indigenous areas by contracting NGOs. It describes its origins; its package of services; contracting, financing, monitoring, and supervision mechanisms; and its contributions to improving access and strengthening primary health care services in Guatemala. It also discusses opportunities and challenges that need to be addressed to continue to improve health services coverage in the country.

Improving Access to Health Care Services through the Expansion of Coverage Program : The Case of Guatemala

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