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Prenatal and delivery care and childhood immunization in guatemala: Do family and community matter?*

  • Mortality and Health
  • Published:
Demography

An Erratum to this article was published on 01 August 1996

Abstract

In this paper we investigate family choices about pregnancy-related care and the use of childhood immunization. Estimates obtained from a multilevel logistic model indicate that use of formal (or “modern ”) health services differs substantially by ethnicity, by social and economic factors, and by availability of health services. The results also show that family and community membership are very important determinants of the use of health care, even in the presence of controls for a large number of observed characteristics of individuals, families, and communities.

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References

  • Adams, R.N. 1952. Un Análisis de las Creencias y Prácticas Médicas en un Pueblo Indígeno de Guatemala. Guatemala: Editorial del Ministerio de Educación Pública.

    Google Scholar 

  • —. 1956. La Ladinización en Guatemala. Guatemala City: Seminario de Integración Social Guatemalteca

    Google Scholar 

  • Annis, S. 1981. “Physical Access and Utilization of Health Services in Rural Guatemala.” Social Science and Medicine 15D: 515–23.

    Google Scholar 

  • Barry, T. 1989. Guatemala: A Country Guide. Albuquerque: Inter-Hemispheric Education Resources Center.

    Google Scholar 

  • Bossert, T.J. and E. Del Cid Peralta. 1987. “Guatemala: Health Sector Assessment.” Report prepared for the U.S. Agency for International Development.

  • Burleigh, E., C. Dandano, and J.R. Cruz. 1990. “Colors, Humors and Evil Eye: Indigenous Classification and Treatment of Childhood Diarrhea in Highland Guatemala.” Medical Anthropology 12:419–41.

    Article  Google Scholar 

  • Cosminsky, S. 1982. “Childbirth and Change: A Guatemalan Study.” Pp. 205–29 in Ethnography of Fertility and Birth, edited by C.P. MacCormack. New York: Academic Press.

    Google Scholar 

  • —. 1987. “Women and Health Care on a Guatemalan Plantation.” Social Science and Medicine 25:1163–73.

    Article  Google Scholar 

  • Cosminsky, S. and M. Scrimshaw. 1980. “Medical Pluralism on a Guatemalan Plantation.” Social Science and Medicine 14B:267–78.

    Google Scholar 

  • Das Gupta, M. 1990. “Death Clustering, Mothers’ Education and the Determinants of Child Mortality in Rural Punjab, India.” Population Studies 44:489–505.

    Article  Google Scholar 

  • Delgado, H., V. Valverde, and E. Hurtado. 1986. “Effects of Health and Nutrition Interventions on Infant and Child Mortality in Rural Guatemala.” Pp. 145–170 in Determinants of Mortality Change and Differentials in Developing Countries, edited by United Nations Population Division. New York: United Nations.

    Google Scholar 

  • Demographic and Health Surveys (DHS). 1991. DHS Newsletter 4(1):12. Calverton, MD: Macro International Inc.

    Google Scholar 

  • Entwisle, B., J.B. Casterline, and H.A.-A. Sayed. 1989. “Villages as Contexts for Contraceptive Behavior in Rural Egypt.” American Sociological Review 54:1019–34.

    Article  Google Scholar 

  • Gertler, P. and J. van der Gaag. 1990. The Willingness to Pay for Medical Care: Evidence from Two Developing Countries. Baltimore: Johns Hopkins University Press.

    Google Scholar 

  • Goldman, N. and A.R. Pebley. 1994a. “Health Cards, Maternal Reports, and the Measurement of Immunization Coverage in Guatemala.” Social Science and Medicine 38:1075–89.

    Article  Google Scholar 

  • —. 1994b. “Childhood Immunization and Pregnancy-Related Services in Guatemala.” Health Transition Review 4:29–44.

    Google Scholar 

  • Hausman, J.A. 1978. “Specification Tests in Econometrics.” Econometrica 46:1251–71.

    Article  Google Scholar 

  • Hawkins, J. 1984. Inverse Images: The Meaning of Culture, Ethnicity, and Family in Post-Colonial Guatemala. Albuquerque: University of New Mexico Press.

    Google Scholar 

  • Hurtado, E. and A. Esquivel. 1986. Guatemala. Guatemala City: INCAP Publication No. C-242.

  • Kleinman, A. 1978. “Concepts and a Model for the Comparison of Medical Systems as Cultural Systems.” Social Science and Medicine 12:85–93.

    Google Scholar 

  • Krotki, K. 1988. “Trends in Geographical and Socio-Economic Differentials in Early Age Mortality.” Mimeographed document, Centro Latinoamericano de Demografía.

  • Logan, M.H. 1973. “Humoral Medicine in Guatemala and Peasant Acceptance of Modern Medicine.” Human Organization 32:385–95.

    Google Scholar 

  • Longford, N.T. 1988. VARCL: Software for Variance Component Analysis of Data with Hierarchically Nested Random Effects (Maximum Likelihood). Princeton: Educational Testing Service.

    Google Scholar 

  • —. 1993. Random Coefficient Models. Oxford, UK: Clarendon Press.

    Google Scholar 

  • Mason, W.M., G.Y. Wong, and B. Entwisle. 1984. “Contextual Analysis through the Multilevel Linear Model.” Pp. 72–103 in Sociological Methodology 1983–4, edited by S. Leinhardt. San Francisco: Jossey-Bass.

    Google Scholar 

  • Melville, M. and M.B. Lykes. 1992. “Guatemalan Indian Children and the Sociocultural Effects of Government-Sponsored Terrorism.” Social Science and Medicine 34:533–48.

    Article  Google Scholar 

  • Ministerio de Salud Pública y Asistencia Social (MSPAS) and Instituto de Nutrición de Centro América y Panamá (INCAP) and Demographic and Health Surveys. 1989. Encuesta Nacional de Salud Materno Infantil 1987. Guatemala: MSPAS and INCAP.

    Google Scholar 

  • Parra, P.A. 1991. “La Mujer Rural, las Comadronas y el Sistema Mexicano de Salud.” Estudios Demográficos y Urbanos 6:69–88.

    Google Scholar 

  • Payer, L. 1988. Medicine and Culture. New York: Henry Holt.

    Google Scholar 

  • Prosser, R., J. Rabash, and H.I. Goldstein, 1991. Data Analysis with ML3. London: Institute of Education.

    Google Scholar 

  • Quezada R.A., C.H. Peidra, G.V. Delgado, E.C. Aguilar, and J.H. Cordova, 1988. La Práctica Medica Tradicional, Vol 1. Quito: IDICSA, Universidad de Cuenca.

    Google Scholar 

  • Rodríguez, G. and N. Goldman. 1995. “An Assessment of Estimation Procedures for Multilevel Models with Binary Responses.” Journal of The Royal Statistical Society, Series A, 158:73–89.

    Article  Google Scholar 

  • Rosenthal, C. 1987. “Santa Maria de Jesús: Medical Choice in a Highland Guatemalan Town.” Doctoral dissertation, Department of Anthropology, Harvard University.

  • Rosenzweig, M.R. and T.P. Schultz. 1983. “Estimating a Household Production Function: Heterogeneity, the Demand for Health Inputs, and Their Effects on Birth Weight.” Journal of Political Economy 91:723–46.

    Article  Google Scholar 

  • Rosenzweig, M.R. and K.I. Wolpin. 1986. “Evaluating the Effects of Optimally Distributed Public Programs: Child Health and Family Planning Interventions.” American Economic Review 76:470–82.

    Google Scholar 

  • SEGEPLAN and UNICEF. 1991. Análisis de la Mujer y Situación del Niño. Guatemala City: Secretaría General del Consejo Nacional de Planificación Económica and UNICEF.

    Google Scholar 

  • Self, S.G. and K.-Y. Liang. 1987. “Asymptotic Properties of Maximum Likelihood Estimators and Likelihood Ratio Tests under Nonstandard Conditions.” Journal of the American Statistical Association 82:605–10.

    Article  Google Scholar 

  • Tedlock, B. 1987. “An Interpretive Solution to the Problem of Humoral Medicine in Latin America.” Social Science and Medicine 28:925–37.

    Google Scholar 

  • —. 1992. Time and the Highland Maya. Albuquerque: University of New Mexico Press.

    Google Scholar 

  • Tienda, M. 1991. “Poor People and Poor Places: Deciphering Neighborhood Effects on Poverty Outcomes.” Pp. 244–62 in Macro-Micro Linkages in Sociology, edited by J. Haber. Newbury Park, CA: Sage.

    Google Scholar 

  • Tsui, A.O. 1985. “Community Effects on Contraceptive Use.” Pp. 77–99 in The Collection and Analysis of Community Data, edited by J. Casterline. Voorburg: International Statistical Institute.

    Google Scholar 

  • Vielman, L. and E. Hurtado. 1986. lnforme Final de la Investigación Etnográfica sobre Algunos Aspectos de Salud y Nutrición Realizada en la Colonia Juarez Guanagazapa. Guatemala: Instituto de Nutrición de Centro América y Panamá.

    Google Scholar 

  • Villatoro, E. and E. Hurtado. 1986. “Informe Final de la Investigación Etnografica sobre Algunos Aspectos de Salud y Nutrición en una Comunidad de Huehuetenango.” Report prepared for the Guatemalan Ministry of Public Health and Social Assistance. von Hoegen, M. 1986. Concentración Geográfica de Servicios en Guatemala. Guatemala: Asociación de Investigación y Estudios Sociales.

  • Warren, C., R.S. Monteith, J.T. Johnson, R. Santiso, F. Guerra, and M.W. Oberle. 1987. “Use of Maternal-Child Health Services and Contraception in Guatemala and Panama.” Journal of Biosocial Sciences 19:229–43.

    Article  Google Scholar 

  • Warren, K. 1989. The Symbolism of Subordination: Indian Identity in a Guatemalan Town. Austin: University of Texas Press.

    Google Scholar 

  • Wilk, R.R. 1991. Household Ecology: Economic Change and Domestic Life among the Kekchi Maya in Belize. Tucson: University of Arizona Press.

    Google Scholar 

  • Woods, C.M. 1977. “Alternative Curing Strategies in a Changing Medical Situation.” Medical Anthropology 3:25–54.

    Article  Google Scholar 

  • Young, J.C. 1981. Medical Choice in a Mexican Village. New Brunswick: Rutgers University Press.

    Google Scholar 

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Author information

Authors and Affiliations

  1. RAND, Santa Monica, CA

    Anne R. Pebley

  2. Office of Population Research, Princeton University, Princeton, USA

    Noreen Goldman & Germán Rodríguez

Authors
  1. Anne R. Pebley
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  2. Noreen Goldman
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  3. Germán Rodríguez
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Additional information

The authors gratefully acknowledge support for this research from NICHD Grants R01 HD27361 and R01 HD31327. Excellent research assistance during the early stages of this project was provided by Marisa Ramírez Sandoval. Mark Montgomery and Karen Gold provided valuable advice on statistical and methodological issues. This paper also benefited from discussions with and comments from Elena Hurtado, Sheila Cosminsky, and Jorge Hermida Córdova.

An erratum to this article is available at http://dx.doi.org/10.2307/2061760.

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Pebley, A.R., Goldman, N. & Rodríguez, G. Prenatal and delivery care and childhood immunization in guatemala: Do family and community matter?*. Demography 33, 231–247 (1996). https://doi.org/10.2307/2061874

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