Barrier to Healthcare Access Faced by Indigenous Women in the Guatemalan Highland

Abstract

Utilizing the Framework Method, qualitative research determined the effects of potential barriers to healthcare access faced by 15 self-selected, consenting Indigenous women living in three different communities in the Guatemalan highlands. The women were actively involved in the nutritional recuperation program of the Community Organization, a non-profit clinic. Data collection involved recorded interviews based on a questionnaire designed to ensure culture competency. Responses were grouped into categories based on their relation to potential barriers to healthcare access and were then coded based on impacts on healthcare seeking behaviours. Intercoder reliability was measured and negotiated agreement of results was conducted to reach 100% agreement.  Analyses of coded responses compared results between communities and between available sectors of healthcare (folk, public, and non-profit). Inductive reasoning was used to determine the effect of beliefs related to illness on healthcare seeking behaviour. Analyses showed significant differences in the impact of geographical barriers to healthcare access among communities across public and non-profit sectors of healthcare, p < 0.05, and demonstrated categorization of disease states and influence of beliefs related to illness on healthcare seeking behaviour. Results demonstrated a hierarchy of barriers, with barriers such as cost, perceived quality of care, trust of medical provider, and available time only showing a negative effect once the barrier of geography was overcome. Despite the sample bias, these results give insight into factors affecting healthcare seeking behaviours that could contribute to the low utilization of healthcare seen in this population.