Ethnic diversity in reproductive behaviour in Guatemala : a focus on the Ch'orti area

Abstract

This thesis highlights the extent of ethnic diversity in reproductive behaviour in terms of fertility, use of family planning and modern pregnancy related care in Guatemala and explores some of the reasons behind this diversity. Guatemala is one of the poorest countries in Latin America and is characterised by extremely unequal distributions of socio-economic resources between its different social and ethnic groups. This study uses various existing data sources, original data, methodologies and a qualitative and quantitative approach to pursue its aim.

This thesis consists of four papers and includes a case-study of the understudied Ch’orti area. The first paper contributes to the understanding of fertility patterns in urban and rural areas by using the existing survey and census data for Guatemala. The analysis identified a very slow fertility decline since the early 1980s in rural areas, stagnation in fertility trends in urban areas until the end of the 1990s and a sharp decline in overall fertility since then. The analysis of the census data showed the impact of the ethnic composition and diversity on fertility at the level of the municipio. The second and third paper present the results of two household surveys, one undertaken in 1994 in two indigenous villages (aldeas) and one in 2001 in Jocotán town, the capital of the Ch’orti area, on the use of family planning and modern pregnancy related care among different ethnic groups. This survey used the alternative approach of classifying ethnic groups, who were not identifiable by language and dress, according to self-identification and place of birth. The results showed significant differences in reproductive behaviour between the ethnic groups living in close proximity of one another, demonstrating the extent of ethnic diversity in reproductive behaviour in Guatemala. The fourth and last paper explores which factors could be responsible for the lower uptake of contraception among the indigenous communities in the Ch’orti area. The results suggest that geographical access, quality of care and medical barriers such as provider bias, at existing family planning services and lack of prioritisation of family planning policies contribute to persistent low uptake of contraception among the indigenous communities in Guatemala.

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