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The Problem

Despite decades of international aid, maternal and child mortality is still at an unacceptable level throughout Guatemala, and at crisis levels in the rural regions. 60% of a population of 15 million are indigenous, living in isolated rural areas. A significant number of infant deaths are connected to a lack of knowledge and poor handling of high-risk pregnancies. The health of indigenous Mayan Guatemalans is among the worst in the global south, especially in the rural Western Highlands region, which is vulnerable to natural disasters and drought. The country places among the three worst Latin American countries for maternal and child mortality. Furthermore, chronic malnutrition has resulted in the country having the highest stunting rates in Latin America.

The problem in Guatemala is complicated, but the bottom line is that the maternal and infant mortality rates are EXTREMELY high. Mothers and babies are dying during pregnancy, on the way to the hospital, while giving birth, or shortly after birth. Many of these deaths are preventable. Some of these mothers are as young as 13 years old.

The statistics are impacted greatly by extreme poverty, which has remained relatively constant over the past 20 years. Pregnant and nursing mothers have limited access to safe and affordable prenatal care. Their ability to care for themselves and their babies is further impacted by limited knowledge of prenatal and infant health and nutrition.


In rural areas of Guatemala, 'midwives' (known as TBAs) are not trained to recognize high-risk pregnancies. TBAs handle up to 95% of births in rural Guatemala. They are often bound by culture and tradition, and their expertise varies greatly. Most TBAs are illiterate, do not speak Spanish and cannot use a calendar or tell the time let alone understand basic resuscitation skills. The government provides some basic training, but the curriculum focuses on typical birth scenarios, and does not prepare TBAs for at-risk pregnancies. Without proper training, TBAs may overlook complications that require more advanced medical care. Avoidable causes of death in mothers include hypertension (eclampsia) and sepsis with predisposition resulting from malnutrition, diabetes and anemia. Infant mortality causes include asphyxia and sepsis due to lack of basic knowledge.

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