Health and Education

The need to invest in people – their basic health and education - is critical in order to reduce poverty and advance socioeconomic development. The following facts provide a snapshot of the social indicators:

• Average schooling is only four years
• Only three of ten children graduate from sixth grade
• Net primary school enrollment rose sharply from 72% in 1991 to 85% in 2001 but more than 2 million children do not attend school – most of them are indigenous girls in rural areas
• Infant mortality rate of 39 per 1,000 live births is the highest in Central America and the third highest in the hemisphere
• Half of Guatemalan women have a child before the age of 19 and 20% have two or more children by their 18th birthday. By their early 30's, many women have given birth to seven or eight children.
• Total fertility rate is 4.4, the highest in Latin America
• Contraceptive prevalence is 43% among women in union, ages 15 – 49, and is second lowest in the hemisphere after Haiti
• Highest stunting rates in the Americas with 49% of Guatemalan children under five years of age chronically malnourished
• Maternal mortality is high at 153 per 100,000 live births
• Only 41% of births are attended by a nurse or doctor - also the lowest for the hemisphere

There have been notable achievements in education and health with USAID/Guatemala assistance in the last decade that include:

• Net primary school enrollment for girls in Quiché department increased significantly from 53% in 1997 to 94% in 2003
• Over 2,200 university scholarships given to rural indigenous youth from 19 ethnicities
• Community integrated literacy model and materials developed in three languages and used by 25 NGOs with women and youth
• Parents’ involvement in education management and learning increased and contributes to improved completion rates, especially in bilingual schools
• More than 700 at-risk indigenous youth trained in leadership and life skills
• Over 3.5 million indigenous poor gained access to basic health services delivered by over 100 NGOs working with the Ministry of Health
• Contraceptive prevalence rate increased from 38% to 43% among women 15-49, and demand for family planning is growing
• Immunization programs increased rural coverage and reached nearly 90% nationally by end of 2003
• Health information and services provided in Mayan languages to monolingual Mayan women
• Maternal mortality decreased from 219 to 153 per 100,000 live births since 1989

USAID/Guatemala continues to increase access to and improve the quality of health care delivery systems for women and children. The Mission supports initiatives to strengthen the capacity of health care networks and improve cooperation among the many groups involved in the health system, including local communities.

USAID/Guatemala helps improve access to education for all children who do not have the opportunity to attend schools. The success of pilot programs has encouraged other donors to become involved, resulting in greater educational equity. (for inclusive development policy and technical assistance in inclusive education click here)

The Government of Guatemala and USAID share the goal to increase the coverage, quality and effectiveness of basic health and education services, focusing attention on rural groups, the indigenous and girls from the poorest communities, as well as strengthening nutrition programs for children under two-years old. The health and education programs under the Country Plan for 2004-2009 will:

1. Help the Ministry of Health (MoH) and the Ministry of Education (MoE) increase and improve the quality of social sector investments; and
2. Increase the use of quality maternal-child and reproductive health services, particularly in rural areas.

Progress toward achieving this goal will be measured by the primary education completion rate, public expenditures for education as a percentage of the Gross Development Product (GDP), the total fertility rate, the infant mortality rate, the rate of chronic malnutrition (low height for age) in children 3-23 months and food security indicators.

Specific activities that are designed to increase and improve health and education sector investments are those designed to:

• increase and improve efficiency of public expenditures in health and education;
• decentralize investments in health and education;
• increase community involvement in health and education;
• achieve better-managed and more transparent public health and education programs;
• increase contraceptive security in the MoH;
• increase investment by the MoH in the extension of the basic health care coverage program; and
• establish an accountability-based primary education system.

Specific activities designed to increase use of quality maternal-child and reproductive health services, particularly in rural areas will:

• Reduce the unmet demand for family planning, reduce short inter-pregnancy intervals, and increase coverage and quality of family planning services and information education and communication;
• Improve and expand maternal and neonatal health services;
• Improve and expand child health services;
• Improve growth monitoring and promotion, and micronutrient supplementation, and better dietary and hygiene practices;
• Improve and expand services for preventing and treating sexually transmitted infections, including HIV/AIDS; and
• Increase access to basic health care for the populations not covered by the MoH‘s programs.

The USAID/Guatemala Country Plan also includes technical and financial resources for the Asociación Pro Bienestar de la Familia (APROFAM) that is and has been one of USAID’s key implementing partners.

For further information on USAID's regional HIV/AIDS assistance, please visit the following link

(See Where We Work for summary of programs, activities, partners and counterparts.)