Guatemala’s public health system benefits from a well-established regulatory framework, many years of institutional history, dedicated and experienced health sector workers, and an absence of dependence on external sources for financial support. Furthermore, the Peace Accords of 1996 established the basis for the future development of the system for the benefit all Guatemalans. Nevertheless, and in spite of its solid institutional legacy, during recent decades a number of problems have developed which have compromised the public health sector’s effectiveness. The result is a system which is fragmented, inefficient and fails to provide an equal level of health services to all Guatemalans. The country’s recent political instability has only brought these problems into sharper focus.

Strengthening Guatemala’s health system requires a thorough understanding of the system’s unique strengths and weaknesses. At the request of the USAID/Guatemala Mission, the Health Finance and Governance (HFG) project conducted a Health System Assessment (HSA) in Guatemala. The primary objective of the HSA was to map the health system’s strengths and weaknesses and to prepare a set of written recommendations intended to guide health system strengthening efforts in the country.