Submission ID 131741
| Issue/Objective | What if health systems were understood not as institutions that deliver care, but as community-embedded systems shaped by collective knowledge, relationships, and shared power? Indigenous communities in Guatemala face persistent health inequities driven by culturally and linguistically inaccessible public services, with maternal mortality, reproductive health risks, and gender-based violence disproportionately affecting Indigenous women. Although Indigenous midwives (comadronas) attend up to 90% of rural births, they are systematically excluded, discriminated against, under-resourced, and underrecognized within formal health systems, undermining equitable care. |
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| Methodology/Approach | The Utz K'aslemal ("good life and wellbeing" in K'iche' Maya) Sexual and Reproductive Health and Rights (SRHR) project advances an ecological model of equity grounded in Indigenous worldviews and community leadership across 24 municipalities in the highlands of Quetzaltenango. It conceptualizes health as harmony and balance among individuals, families, communities, and the environment. In partnership with Global Affairs Canada, Horizons of Friendship, and Association PIES de Occidente, this perspective informs a seven-year initiative (2025 - 2032) that strengthens both community systems and public institutions through a rights-based, feminist, and intercultural perspective. |
| Results | Our ultimate outcome for this project is to improve the health status and the enjoyment of health rights on a gender responsive and culturally relevant basis for Indigenous communities experiencing poverty and marginalization. Our approach will directly address key structural barriers to health equity for Indigenous populations by strengthening the personal and professional capacity and resources for 710 comadronas, fostering collaboration and the exchange of knowledge and experiences across health systems, ensuring care in maternal languages (language mobilization), and valuing ancestral Maya knowledge. |
| Discussion/Conclusion | A cornerstone of this project is advancing the implementation of Guatemala's new National Policy on Comadronas (2026-2036), which has previously remained unfulfilled. By supporting comadronas as a recognized pillar of the health system, expected results will address the bottleneck in maternal and neonatal care for Indigenous women. These actions will move national policy from paper to practice, improving the accountability of implementation, while reinforcing Indigenous self determination. Utz K'aslemal demonstrates that resilient health systems are built within communities, where sustainable equity emerges through partnerships that respect cultural knowledge, redistribute power, and support community-led pathways to wellbeing. |
| Presenters and Affiliations | Gladis Perez Asociación PIES de Occidente Norma Itzep Asociación PIES de Occidente |
