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We investigate two perspectives about the effects of reduced discrimination and greater social and economic opportunities on ethnic identity in rural areas of contemporary Guatemala. Our analysis contrasts the effects of new opportunities in Indigenous communities on language use and dress, using data from the 1995 Encuesta Guatemalteca de Salud Familiar (EGSF). While the use of both dress and language has changed substantially in recent years, language use has changed considerably more than dress. We conclude that, in this context, economic opportunities have not necessarily diminished ethnic solidarity, but may have instead reshaped it. [ABSTRACT FROM AUTHOR]

In an effort to reduce infant and maternal morbidity and mortality in developing countries, the World Health Organization has promoted the training of traditional birth attendants (midwives) and their incorporation into the formal health care system. In this paper, we examine several aspects of the integration of traditional and biomedical maternity care that are likely to reflect the quality of care received by Guatemalan women. Specifically, we examine the extent to which women combine traditional and biomedical pregnancy care, the frequency with which midwives refer women to biomedical providers, the content and quality of care offered by midwives, and the effects of midwife training programs on referral practices and quality of care. The analysis is based on data from the 1995 Guatemalan Survey of Family Health. The results offer a mixed assessment of the efficacy of midwife training programs. For example, although trained midwives are much more likely than other midwives to refer their clients to biomedical providers, most pregnant women do not see a biomedical provider, and the quality of midwife care, as defined and measured in this study, is similar between trained and untrained midwives. [Copyright &y& Elsevier]

This paper uses the 1995 Guatemalan Survey of Family Health (EGSF) to analyze the relationship between child illness and health seeking behavior. The EGSF contains detailed calendar data on the nature and timing of illness and treatment behavior for children age five and below; extensive information about the characteristics of mothers, families and communities; and data on the accessibility of traditional and biomedical providers within and near the community. The analysis is based on 870 children who began a diarrheal or respiratory illness during a 2-week period prior to interview. Estimates are derived from a multinomial logit model of the probability of seeing a specific type of provider on a given day of illness, as a function of characteristics of the illness, child, mother, and community. The results indicate that modern medical care plays a major role in the treatment of infectious illness among children in rural Guatemala. The symptoms associated with the illness, their perceived severity, and mother's beliefs about their causes are important determinants of whether a child is brought to a provider and the type of provider visited. Poverty is a serious constraint on a family's choices about how to treat children's illnesses, whereas education and ethnicity have little effect on treatment behavior when income is held constant. In addition, the availability of modern health facilities within the community—both government-sponsored facilities and private doctors—has a substantial impact on the type of providers sought to treat children's illnesses. [ABSTRACT FROM AUTHOR]

Explores the diffusion of beliefs pertaining to the causes of childhood diarrhea in rural Guatemala. Importance of interpersonal and impersonal contacts as conduits for information and norms related to hygiene and contamination; Evidence of a diffusion process through social contacts.

Relying on data from the 1995 Guatemalan Survey of Family Health (EGSF), we analyse the relationship between child illness and health-seeking behaviour. Information on illness was collected for 3193 children. This analysis is based on 870 of these who became ill with diarrhoeal or respiratory disease during a 13-day period prior to interview. Estimates are derived from logistic models of the probability of seeing any or a specific type of health care provider as a function of characteristics of the illness on a given day and the child. The results indicate that modern medical care plays a major role in the treatment of infectious illness among children in rural Guatemala, with visits to pharmacists, doctors and the staff at government health facilities occurring much more frequently than visits to curers and other traditional practitioners. In general, families are much more likely to seek out a health care provider when a child experiences fever and gastrointestinal symptoms than when suffering from respiratory and other symptoms, and when a mother perceives the illness to be serious. The results also indicate that infants, low parity children, and children assessed as having generally been in good health are more likely to visit health care providers than other children. However, the particular associations often vary by type of health care provider. [ABSTRACT FROM AUTHOR]

Objectives. This study examines the relatively low use of modern pregnancy-related care in Guatemala, especially among indigenous women, and explores the role of socioeconomic status, social and cultural variables, and access to biomedical health facilities in accounting for ethnic differences in care. Methods. The data for the analysis come from the Guatemalan Survey of Family Health—a population-based survey of rural women that contains detailed data on care received during pregnancy and delivery along with extensive background information. Binomial and multinomial logit models are used to identify the variables that affect the likelihood of receiving different types of care during pregnancy and delivering in a medical facility and the extent to which sociocultural factors and measures of access account for the observed ethnic differences. Results: The estimates not only confirm previous findings of a large ethnic difference in the use of modern pregnancy-related care, but also extend them by identifying a gradient within the indigenous population. The analysis demonstrates that, in general, sociocultural variables are more strongly associated with modern pregnancy-related care than are measures of access and that the former variables explain more of the ethnic variation in care than the latter. The results also demonstrate that pregnant women, especially indigenous women, are more likely to seek biomedical care in conjunction with traditional midwifery care rather than to rely solely on the former. Conclusion. The findings suggest that midwives are likely to continue to be key providers of pregnancy-related care in the future, even as access to modern health facilities improves. Current efforts directed toward the training and integration of midwives into the formal health system are likely to be much more effective at improving pregnancy-related care than the replacement of midwives with biomedical providers. [ABSTRACT FROM AUTHOR]

Highlights the use of a new calendar design in the collection of data on diarrheal and respiratory illness among children in Guatemala. Improved descriptions of child illness; Measurement of illness frequency; Classification of illness into various categories; Reliance of families on biomedical personnel trained in the Western traditions of health care.

This article focuses on family choices about pregnancy-related care, and the use of childhood immunization in Guatemala. In Guatemala, as in many countries, the public and the private sectors developed alongside and generally in isolation from several other preexisting medical belief and treatment systems. Although the use of government health services and private formal practitioners appears to have grown over the past two decades, the use of formal medical services is still low relative to other Latin American countries, and traditional providers remain a common source of treatment. Guatemalan families typically are poor and have limited access to health services. Among the family's social and economic characteristics, the respondent's education is related most consistently to use of prenatal care, delivery assistance, and immunization. More highly educated women are both more likely to use any kind of care and more likely to use formal care and to have their children immunized completely. Mothers who have worked outside the household are also more likely to use formal delivery care and to have their children immunized fully. The effects of the husband's characteristics are mostly consistent with hypothesized relationships. In particular, women whose husbands completed at least some secondary school are much more likely than others to seek formal pre-natal and delivery care, and their children are more likely to have received at least some immunizations.