Identifying Communities’ Perspectives on their Health Needs in Impoverished Villages to Guide Non-government Organizations’ Health Promotion Efforts in Guatemala




Global health, Guatemala, community health, health needs, faith-based organizations, health promotion


Objective: The aim of this mixed-methods study is to capture and understand impoverished Guatemalan community members’ perspectives of their own health needs on a community level in order to guide Hope of Life (HOL) Non-Profit organization’s health promotion interventions in the villages they serve.

Methods: A modified health needs assessment survey was conducted with 96 participants from four impoverished villages in the department of Zacapa, Guatemala. Survey responses were analyzed for significant differences in 4-item individual, family, and community health scores across demographic variables and significant correlations with reported personal health conditions and children’s health conditions. Five semi-structured interviews were also conducted with community leaders from three of the villages surveyed. Interviews were audio recorded and responses were transcribed verbatim and translated from Spanish to English. Thematic analysis using HyperRESEARCH qualitative analysis software version 4.5.0. was conducted to identify major themes.

Results: The mean age of the 96 participants surveyed was 40.4 years and the majority were women, married or in Union, and have children. Women reported a significantly lower individual and family health score than men. The most rural village included in the study had significantly lower family health scores than the three sub-urban villages in the study. Among the personal health problems reported by participants, alcohol consumption, dental problems, and malnutrition were significant predictors of lower individual health scores. Themes that emerged from the interview analysis included the greatest community health needs, perceived negative community health behaviors, barriers to health care access, HOL’s impact, and suggestions for community health promotion.  

Conclusion: The results of this study reveal many unmet health needs and barriers to healthcare that Guatemalan village communities face. Community-based participatory research using a mixed approach voices communities’ perspective on their perceived needs and is an important tool to guide non-profit aid and intervention serving impoverished communities.


World Bank. Project appraisal document on a proposed loan in the amount of US$100 million to the Republic of Guatemala for a Crecer Sano: Guatemala Nutrition and Health Project [Internet]. Washington (DC): International Bank for Reconstruction and Development; 2017 March. Report No: PAD1922. Available from:

Guatemala Ministry of Health and Social Assistance, University of Valle and Division of Reproductive Health-Centers for Disease Control and Prevention (CDC). Atlanta, United States: Centers for Disease Control and Prevention (CDC); 2009. Available from:

Braveman P, Tarimo E. Social inequalities in health within countries: not only an issue for affluent nations. Soc Sci Med. 2002;54:1621–35.

United Nations Development Programme (UNDP). Human development indices and indicators: statistical update [Internet]. New York: UNDP; 2018.

Clarke M, Ware, V. Understanding faith-based organizations: how FBOs are contrasted with NGOs in international development literature. Prog Dev Stud. 2015;15(1):37-48.

Contraloría General de Cuentas. Informe de auditora financiera y de cumplimiento organización Cristiana de Beneficio Social, Esperanza de Vida “ONG”, 01 de enero al 31 de diciembre de 2018; [Comptroller general of accounts. Financial auditor report and compliance of Christian social benefit organization, Hope of Life “NGO”, from 01 January to 31 December 2018]. 2019 May. Available from: Hope of Life International [Internet]; Cranston, RI. c2020 [cited 2020 Sept 30]. Available from:

World Help Organization. Village transformation in Guatemala [Internet]. Forest, VA. [Cited on 2020 Sept 30]. Available from:

Minkler M, Wallerstein N, eds. Community based participatory research for health: process to outcomes. [2nd ed.] San Francisco, CA: Jossey Bass; 2008.

Wallerstein N, Duran B. Using community-based participatory research to address health disparities. Health Promot Practice. 2006 Jul;7(3):312-23.

Hernandez A, Ruano A, Hurtig A, Goicolea I, Sebastian M, Flores W. Pathways to accountability in rural Guatemala: a qualitative comparative analysis of citizen-led initiatives for the right to health of indigenous populations. World Dev. 2018 Oct;113:392-401.

John Hopkins. 2018 community health needs assessment (CHNA) and implementation strategy for John Hopkins Bayview Medical Center [Internet]. 2018; 1–116. Available from:

World Bank. Poverty in Guatemala. World Bank Country Study. Washington (DC): World Bank; 2004. [License: CC BY 3.0 IGO].

Misra A, Khurana L. Obesity and the metabolic syndrome in developing countries. J Clin Endocr Metab. 2008;93(11_supplement_1): 9–30.

Instituto Nacional de Estadística — Guatemala. Encuesta Nacional sobre Condiciones de Vida ENCOVI 2014: La Pobreza en Guatemala, principales resultados. [Institute of National Statistics—Guatemala. National survey of living conditions, ENCOVI 2014: The poor of Guatemala, principle results] [Internet]; 2015. Available from:




How to Cite

Bale, C. (2020). Identifying Communities’ Perspectives on their Health Needs in Impoverished Villages to Guide Non-government Organizations’ Health Promotion Efforts in Guatemala . Christian Journal for Global Health, 7(5), 9–20.