IDEAS home Printed from
   My bibliography  Save this article

Utilization of care during pregnancy in rural Guatemala: does obstetrical need matter?


  • Glei, Dana A.
  • Goldman, Noreen
  • Rodríguez, Germán


This study examines factors associated with the use of biomedical care during pregnancy in Guatemala, focusing on the extent to which complications in an ongoing or previous pregnancy affect a woman's decisions to seek care. The findings, based on multilevel models, suggest that obstetrical need, as well as demographic, social, and cultural factors, are important predictors of pregnancy care. In contrast, measures of availability and access to health services have modest effects. The results also suggest the importance of unobserved variables-such as quality of care-in explaining women's decisions about pregnancy care. These results imply that improving proximity to biomedical services is unlikely to have a dramatic impact on utilization in the absence of additional changes that improve the quality of care or reduce barriers to access. Moreover, current efforts aimed at incorporating midwives into the formal health-care system may need to extend their focus beyond the modification of midwife practices to consider the provision of culturally appropriate, high-quality services by traditional and biomedical providers alike.

Suggested Citation

  • Glei, Dana A. & Goldman, Noreen & Rodríguez, Germán, 2003. "Utilization of care during pregnancy in rural Guatemala: does obstetrical need matter?," Social Science & Medicine, Elsevier, vol. 57(12), pages 2447-2463, December.
  • Handle: RePEc:eee:socmed:v:57:y:2003:i:12:p:2447-2463

    Download full text from publisher

    File URL:
    Download Restriction: Full text for ScienceDirect subscribers only

    As the access to this document is restricted, you may want to search for a different version of it.


    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.

    Cited by:

    1. Gouws, Eleanor & Bryce, Jennifer & Pariyo, George & Armstrong Schellenberg, Joanna & Amaral, João & Habicht, Jean-Pierre, 2005. "Measuring the quality of child health care at first-level facilities," Social Science & Medicine, Elsevier, vol. 61(3), pages 613-625, August.
    2. Güneş, Pınar Mine, 2015. "The role of maternal education in child health: Evidence from a compulsory schooling law," Economics of Education Review, Elsevier, vol. 47(C), pages 1-16.
    3. Nandini Thogarapalli & Paul Mkandawire & Joseph Kangmennaang & Isaac Luginaah & Godwin Arku, 2016. "Gestational age at first antenatal visit in Namibia," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 61(9), pages 1089-1097, December.
    4. Spangler, Sydney A. & Bloom, Shelah S., 2010. "Use of biomedical obstetric care in rural Tanzania: The role of social and material inequalities," Social Science & Medicine, Elsevier, vol. 71(4), pages 760-768, August.
    5. Guliani, Harminder & Sepehri, Ardeshir & Serieux, John, 2012. "What impact does contact with the prenatal care system have on women’s use of facility delivery? Evidence from low-income countries," Social Science & Medicine, Elsevier, vol. 74(12), pages 1882-1890.
    6. Lindstrom, David P & Muñoz-Franco, Elisa, 2006. "Migration and maternal health services utilization in rural Guatemala," Social Science & Medicine, Elsevier, vol. 63(3), pages 706-721, August.
    7. Edmonds, Joyce K. & Hruschka, Daniel & Bernard, H. Russell & Sibley, Lynn, 2012. "Women’s social networks and birth attendant decisions: Application of the Network-Episode Model," Social Science & Medicine, Elsevier, vol. 74(3), pages 452-459.
    8. Becker, Stan & Fonseca-Becker, Fannie & Schenck-Yglesias, Catherine, 2006. "Husbands' and wives' reports of women's decision-making power in Western Guatemala and their effects on preventive health behaviors," Social Science & Medicine, Elsevier, vol. 62(9), pages 2313-2326, May.
    9. Gordon Abekah-Nkrumah & Patience Abor, 2015. "Socioeconomic determinants of use of reproductive health services in Ghana," Health Economics Review, Springer, vol. 6(1), pages 1-15, December.
    10. repec:unt:japsdj:v:25:y:2018:i:2:p:53-75 is not listed on IDEAS
    11. Po Wong, 2011. "Mothers’ Marital Status and Type of Delivery Medical Care in Guatemala," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 30(1), pages 43-57, February.
    12. Gordon Abekah-Nkrumah & Patience Aseweh Abor, 2016. "Socioeconomic determinants of use of reproductive health services in Ghana," Health Economics Review, Springer, vol. 6(1), pages 1-15, December.
    13. Sharmistha Self & Richard Grabowski, 2012. "Son Preference, Autonomy and Maternal Health in Rural India," Oxford Development Studies, Taylor & Francis Journals, vol. 40(3), pages 305-323, September.
    14. Trani, Jean-Francois & Browne, Joyce & Kett, Maria & Bah, Osman & Morlai, Teddy & Bailey, Nicki & Groce, Nora, 2011. "Access to health care, reproductive health and disability: A large scale survey in Sierra Leone," Social Science & Medicine, Elsevier, vol. 73(10), pages 1477-1489.
    15. Smith, Kimberly V. & Sulzbach, Sara, 2008. "Community-based health insurance and access to maternal health services: Evidence from three West African countries," Social Science & Medicine, Elsevier, vol. 66(12), pages 2460-2473, June.


    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:57:y:2003:i:12:p:2447-2463. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Dana Niculescu). General contact details of provider: .

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    We have no references for this item. You can help adding them by using this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.