Evaluation of Midwifery Care: A Case Study of Rural Guatemala
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Author(s): Goldman N, Glei D A
The objective of the present analysis is to describe and evaluate several aspects of pregnancy-related care in Guatemala, based on a large-scale sample survey -- the 1995 Encuesta Guatemalteca de Salud Familiar (EGSF), or the Guatemalan Survey of Family Health. As described in more detail below, these data are derived from structured interviews with women of reproductive age and with traditional and biomedical providers in 60 rural communities in Guatemala. This survey was not designed for an evaluation of midwife training programs or for an assessment of changes in treatment behavior over time. Nevertheless, the availability of data from randomly selected samples of women and providers in diverse geographic areas of Guatemala permits us to quantify several important dimensions of the integration of traditional and biomedical services and to move beyond existing studies in an effort to evaluate the quality of pregnancy-related care. In the next section of the paper, we briefly describe the social context, the nature of the health care system, and the content of midwife training programs in Guatemala. Subsequently, we discuss the detailed objectives of the analysis. Next, we describe the data collected as part of the EGSF, explore the availability of different providers who offer care during pregnancy and the characteristics of midwives, and discuss our analytical procedures. In the final two sections, we present the results and consider the implications of our findings.
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