Guatemala - Population, nutrition and health sector review

Report No. 6183-GU Guatemala Population, Nutrition and Health Sector Review July25, 1986 Population, Health and Nutrition FOR OFFICIAL USE ONLY Document of the World Bank This document has a restricted distribution and may be used by recipients only in the performance of their official duties. Its contents may not otherwise be disclosed without World Bank authorization.  CURRENCY EQUIVALENTS Currency Unit = Quetzales (Q) Official Foreign Exchange Rate US$ 1.00 = Q 1.00 Parallel Foreign Exchange Rate US$ 1.00 = Q 2.5 WEIGHTS AND MHASUNEh' Metric System FISCAL YEAR January 1 to December 31 Main Acronyms and Terms Used in the Revort APROFAM - Asociacion Pro Familia CDR - Crude Death Rate FP - Family Planning IGSS - Social Security Institute IMR - Infant Mortality Rate IPPF - International Planned Parenthood Fund LEB - Life Expenctancy at Birth MCH - Maternal and Child Health MOH - Ministry of Health ORT - Oral Rehydration Therapy PHC - Primary Health Care TFR - Total Fertility Rate  FOR OFFICIAL USE ONLY GUATEMALA Population, Nutrition and Health Sector Review Table of Contents Pafe No. Selected Social Indicators Executive Summary .. .. ............... i - v I. Introduction.. *. * ....... 1 II. Population Sector...... .. ..... 2 A. Population Status ........ . ...... 2 B. Policies and Programs... ......... 8 III. Nutrition... .... ..... ....13 A. Present Status ..... ... .............................. 13 B. Policies and Prograsn . .........14 IV. Health . ..... .................16 A. Present Status. . ...... 16 B. Main Health Care Providers... 18 C. MOH's Sector Policies and Programs ..19 D. Financing ..... 19 E. Resource Use. .......... 20 F. MOH's Performance..... ...28 G. Future Prospects.. . ... ......... 32 V. Population, Nutrition and Health Sector Issues and Recommendations . . ..... . 33 A. Population .... ...... * . 33 B. Nutrition .........................35 C. Health Care . . . .... ..... .. .. .... .37 This document has a rtricted distribution and may be used by rocipiets only In the perfoman of their officl dutisu Its contents may not otherwise be disclsed without Wofld Bank authorization.  Tables Included in the Text gge Ea.- Table 2.1 Population Growth, 1943, 1963 and 1983....................3 Table 2.2 Total Fertility Rate Distribution by Socioeconomic Indicators, 1980 ....... Table 2.3 Projected Levels of Fertility, Mortality and Migration, 1985-2025 .................**.6 Table 2.4 1985 Population Estimate and Alternative Population Projections for 2000 and 2015 7 Table 2.5 Projected Rates of Population Growth and Doubling Times.... 7 Table 2.6 Projected Dependency Ratios and Proportion of P'opulation under 15 Years of Age According to Alternate Assumptions: 198, 2000 and 2015............ .. ........ ..8 Table 2.7 Contraception Prevalence, 1978 and 1983, .......o.,.....1O0 Table 2.8 Married Women (X) Using Modern Contraception Methods, 1983.E$.... ...... o.... 11 Table 2.9 Contraceptive Sources, 1983 ........... Table 3.1 Growth Retardation, 1965 and 197 7.. Table 4.1 Main Causes of Death, 1985 .......... .. .... 16 Table 4.2 Mortality by Age Groups, 1979, 1983 and 1985 ..............17 Table 4.3 Mortality Trends, 1970 to 1985 ............................17 Table 4.4 Distribution of Human Resources per Departament, According to Level of Care, 1983 ........26 Table 4.5 Outpatient Visits per Departament, 1982 ..29 Table 4.6 Hospital Beds and Discharges, 1981 and 1982 ...............30 Table 4.7 Hospital Indicators per Departamento, 1981 and 1982 ........31 Chart- MOH's Organizational Structure  GUATENALA POPULATION, HEALTH AND NUTRITION SECTOR REVIEW S4L