An Evaluation of the Maternal Infant Program in Rural Santiago Atitlan, Guatemala





Project Summary

Along with three other bright-eyed and ambitious Penn students, I embarked on an 11-week journey of personal discovery and professional gain in the rural highlands of Guatemala. The Guatemalan Health Initiative (GHI) aims to evaluate and focus on medical programs in Hospitalito Atitlan, a rural, non-profit hospital funded by donors and patient donations. As a GHI student, I, along with another Penn undergraduate, evaluated the Maternal Infant Program in the Hospitalito and assessed the impact of access to free medical care on health care utilization. The program was originally created to help the maternal mortality crisis among indigenous women; at-home births increase the risk of maternal death during birth, and in the Tz’utujil culture of the highlands, the home is the traditional location of births. The Maternal Infant Program provides high-risk mothers of the indigenous community in Santiago Atitlan, Guatemala, with free prenatal care and postnatal care for the first five years of the child’s life. Monthly educational meetings with the Hospitalito’s social worker, and a free hospital birth are also included. High-risk mothers are identified by a social worker, predominantly using socioeconomic evaluations. As indigenous women, the mothers are already at a heightened risk for pregnancy and birth complications due to language barriers between towns, traditional at-home births, high rates of diabetes, and a resistance to family planning methods. 

An evaluation of the efficacy of the Maternal Infant Program was performed, as well as an assessment of the difference in utilization of free health care and cost-dependent health care. Interviews with current and past participants of the program were conducted, and over 130 medical records were reviewed. After 11 weeks, findings and recommendations were presented to the administration of the Hospitalito. A majority of the graduate children of the Program are malnourished by international percentiles, and free medical care encourages earlier and more frequent care utilization.

Above all, as a student researcher, having flexibility separates self-fulfilling research from selfless research. Research is supported by everyone around the student; nothing is achieved in a social vacuum. Especially with qualitative research, the cooperation and enthusiasm of others is vital in carrying out and finalizing a project. And many times, the cooperation of others can be guaranteed when it is known that the research will benefit not only the academic community, but the greater-good of a population or place.  Forming relationships not only makes researching more enjoyable, but it makes it easier to logistically organize a project.

GHI reminded me that research is not simply meant to be published in a journal. Research is meant to yield specific recommendations to be of use to the improvement of the studied community. During my presentation of findings to the hospital administration, after 30 minutes of speaking about malnourished children, the audience seemed to perk up when I began speaking in accessible language to the betterment of the Maternal Infant Program. Turns out statistical evidence is nominal compared to the relatable recommendation to change a simple phrase from “mandatory hospital birth” to “free hospital birth”. The goal of the change would be to encourage mothers to view a hospital birth as an opportunity and not a cultural wrong – after all, who wants to go to the hospital when told?