This is an application for a competing continuation of an NICHD grant, in which we have been examining family choices about use of health services and their consequences for children's health in Guatemala. In the continuation period we propose to collect new and considerably more detailed data using both ethnographic and sample survey methods, in rural areas of Guatemala. The objectives of the study are: 1) to describe the process by which families and individuals cope with childhood illness and pregnancy in an environment in which a variety of different forms of treatment are often available and 2) to examine the role of family and community characteristics, including ethnic identity, social support systems, availability of modern and non-modern health services, social class, and financial resources, in families, choices about treatment during pregnancy and childhood illness. The structure of Guatemalan society provides a unique opportunity to understand the complex associations among ethnic identity, health beliefs, social support, poverty and social class, choices about use of health care and health outcomes, as discussed below. These issues are central to health and social policy in the United States, as well as in other countries. The large scale immigration of Central Americans and Mexicans to the United States also makes it important to understand the health care environment from which immigrants come and the ways in which they have been accustomed to making treatment choices before coming to the U.S.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Research Project (R01)
Project #
5R01HD027361-08
Application #
2378513
Study Section
Social Sciences and Population Study Section (SSP)
Project Start
1992-02-01
Project End
1999-02-28
Budget Start
1997-03-01
Budget End
1999-02-28
Support Year
8
Fiscal Year
1997
Total Cost
Indirect Cost
Name
Rand Corporation
Department
Type
DUNS #
City
Santa Monica
State
CA
Country
United States
Zip Code
90401
Goldman, Noreen; Glei, Dana A (2003) Evaluation of midwifery care: results from a survey in rural Guatemala. Soc Sci Med 56:685-700
Glei, Dana A; Goldman, Noreen; Rodriguez, German (2003) Utilization of care during pregnancy in rural Guatemala: does obstetrical need matter? Soc Sci Med 57:2447-63
Goldman, Noreen; Pebley, Anne R; Gragnolati, Michele (2002) Choices about treatment for ARI and diarrhea in rural Guatemala. Soc Sci Med 55:1693-712
Goldman, N; Pebley, A R; Beckett, M (2001) Diffusion of ideas about personal hygiene and contamination in poor countries: evidence from Guatemala. Soc Sci Med 52:53-69
Goldman, N; Heuveline, P (2000) Health-seeking behaviour for child illness in Guatemala. Trop Med Int Health 5:145-55
Pebley, A; Hurtado, E; Goldman, N (1999) Beliefs about children's illness. J Biosoc Sci 31:195-219
Goldman, N; Vaughan, B; Pebley, A R (1998) The use of calendars to measure child illness in health interview surveys. Int J Epidemiol 27:505-12
Pebley, A R; Goldman, N; Rodriguez, G (1996) Prenatal and delivery care and childhood immunization in Guatemala: do family and community matter? Demography 33:231-47
Pebley, A R; Goldman, N (1995) Social inequality and children's growth in Guatemala. Health Transit Rev 5:1-20
Goldman, N; Pebley, A R (1994) Health cards, maternal reports and the measurement of immunization coverage: the example of Guatemala. Soc Sci Med 38:1075-89

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