An Institutional Analysis of Safe Motherhood in Guatemala

Jeremy Shiffman, Syracuse University
Ana Garces, Universidad Rafael Landivar

This paper analyzes safe motherhood initiatives in Guatemala over the past decade, with a view to showing the complex relationship between national context and safe motherhood outcomes. The paper is based on research conducted in 2003 in-country, involving in-depth interviews with officials involved in Guatemalan safe motherhood policy, and analysis of multiple reports and documents. Data confirm the persistence of high levels of maternal mortality in the country and ongoing neglect of safe motherhood issues at the national level. We posit that three contextual factors stand behind these adverse outcomes: the existence in Guatemala of a large indigenous population suspicious of modern medical practices and alienated from the state; political instability--a legacy of long-standing civil war--that has made it impossible to sustain policy continuity for safe motherhood; and the influence of ultra-orthodox elements of the Catholic Church that have obstructed safe motherhood initiatives.