Guatemala

• People in need: 5 million¹
• People targeted: 2.3 million
• People in need of health assistance: 930,000
• Requirements (US$): 6.3 million

Recovery from COVID-19 has been challenging in Guatemala. As a result of the prolonged socio-economic impact of the pandemic, the average poverty rate nationwide has increased by almost 5%. This rise in poverty levels is further exacerbating preexisting vulnerabilities and eroding the limited safety nets available to populations living in precarious conditions.

Year after year, the historical social gaps that result in high levels of vulnerability, multidimensional poverty and overall deprivation of basic services among hundreds of thousands of Guatemalans, are further aggravated by recurrent disasters and humanitarian crises. According to the World Risk Report 2020, Guatemala has the tenth highest level of exposure to disaster in the world. Globally, it ranks 28th in terms of vulnerability according to the 2021 INFORM's risk index and 62nd in the Global Climate Risk Index 2021.

Well into 2022, the operational and functional capacity of the health services network is still recovering from the severe damages caused by Tropical Storms Eta and Iota at the end of 2020, with more than 180 health facilities still in need of repair. Sustained mass migration and increasing violence and social disturbance additionally impact the health system negatively, posing additional challenges to the delivery of essential health services, particularly to the most vulnerable.

Almost three years into the COVID-19 response, vaccination coverage in Guatemala is still far below target, with only 38.2% of the population completing a full vaccination schedule against COVID as of 28 October 2022. This low coverage leaves a large portion of the population vulnerable to new infections and hospitalization and continues to put the Guatemalan health system and its limited resources under strain.

The UN estimates that approximately 5 million people in Guatemala are in need of humanitarian assistance, including urgent medical care. Pregnant and lactating women, children, people with disabilities and individuals settled in the areas previously affected by Hurricanes Eta and Iota are among the most vulnerable.

Emergency response

WHO in Guatemala aims to protect and save the lives and dignity of severely affected people through effective and coordinated humanitarian response efforts, embracing a human rights approach and intersectional and differential perspective respectful of age, gender, diversity, cultural and linguistic relevance. WHO seeks to promote sustainable solutions that contribute to the right to health and foster self-sufficiency, empowerment and resilience of affected people with a focus on protection, intersectionality and diversity inclusion, as well as a comprehensive approach to emergency response from humanitarian action, recovery to resilience and development.

In 2023, WHO will continue to prioritize territories that have been most impacted by COVID-19, extreme weather events including tropical storms Eta and Iota and more recently Hurricane Julia, disruptive social phenomena including violence and mass migratory flows, as well as the increased burden of communicable diseases such as dengue fever.

Activities and interventions will restore and increase the capacity of local health networks to meet existing health needs, increase surge capacity to deal with outbreaks, post-traumatic stress derived from health emergencies and disasters and ensure continuity of essential health services, such as sexual and reproductive health, in the midst of adverse events. Prioritization will be given to persons with disabilities, the elderly, migrant populations and improving the right to health and access to health care for those in need, based on a rights-based and culturally relevant approach.

WHO will continue to strengthen coordination at the national and sub-national levels, including the health cluster, and promote strategic alliances and working agreements with local NGOs and civil society organizations that can contribute to the achievement of its objectives. Community engagement and empowerment will also be encouraged to support ownership and sustainability of appropriate actions.

Strategic objectives

Key activities

• Strengthen and reestablish capacity for the provision of critical and essential services in facilities impacted by disasters and emergencies. This will include rehabilitation works, recuperation of lost supplies and equipment and a surge in human resources capacity.
• Strengthen capacities of health institutions and communities to anticipate and respond to health emergencies and disasters, with a focus on primary health services and improving capacity for the early detection of infectious diseases.
• Priority response activities will include:
  • Update and implement the country’s multi-hazard health emergency plan, and emergency response protocols.
  • Rehabilitate target primary health care facilities in affected areas to ensure the operational capacity of prioritized health facilities and safety of operation through increased access to safe water and waste management.
  • Provide supplies, equipment, material and tools for epidemiological surveillance, the establishment of situation rooms in prioritized health facilities, the operation of water collection systems, monitoring and control of safe water quality in selected health care units.
  • Build capacity of health personnel on epidemiological surveillance, standards and protocols for sexual and reproductive health, clinical management of sexual violence, maternal and child health, nutrition and disability, with a focus on rights, cultural relevance and gender; psychosocial first aid and mental health care in emergencies; information management and reporting in emergency situations; risk analysis, management and timely response to health emergencies and disasters.
  • Strengthen community capacities for first response and health prevention and promotion, including sexual and reproductive health and infection prevention and control.

Funding requirements

Overall country funding requirements, including COVID-19, by pillar (US$ ‘000)

Success stories

Improving access to health services through emergency care modules in Guatemala

As a result of tropical storms Eta and Iota at the end of 2020, health services were severely disrupted, with more than 180 health facilities in Guatemala still in need of repair. To ensure sustained access to vital health care services for the population, the country needed an immediate solution to plug gaps in the system.

PAHO/WHO therefore partnered with the Guatemalan foundation ‘Un Techo para Mi País’ to install temporary wooden emergency care units (MAET). These were integrated into the socio-cultural and health environment of priority communities to provide health services, contributing towards strengthening health system resilience. They also improved access to services, and the health and welfare conditions of vulnerable communities, especially where infrastructure was precarious and in poor condition as a result of extreme weather events.

Given the technology used to develop the units, these can be disassembled and reinstalled at the request of local health authorities. The units can therefore be used as a sustainable, temporary intervention in response to future emergencies and disasters requiring immediate action.

To allow for effective, safe and collaborative action, PAHO/ WHO and Un Techo para Mi País established working practices. These have been implemented together with communities in Campur and Saquixim in Alta Verapaz, Tenedores and Sepur Zarco in Izabal, San Felipe in Retalhuleu and central Guatemala.

For more information

Gerardo Alfaro Canton| PAHO/WHO Representative, Guatemala | alfaroge@paho.org