sowm_2015__int__africa_full_report_low_res

Guatemala City, Guatemala
women of childbearing age reach high school
(45 percent) and more than 13 percent reach
the tertiary level. According to UNDP, the
literacy rate in the city was as high as 80 percent
in 2010. 114
Family planning is another important
contributor to higher child survival rates in the
metro area. The expected number of children
born per woman dropped from 4 in 1987 to
2.7 in 2008 and is expected to continue to fall.
In 1987 only 45 percent of women in union
between the ages 15 to 49 used any form of
contraception. This number had increased to
57 percent in 1999 and to 72 percent in 2008. 115
One of the main factors behind this increase is
the growth of the public sector as a source of
family planning methods. 116
The capital metropolitan area has the highest
concentration of health care facilities in the
country. The two largest providers, the Ministry
of Public Health and Social Assistance and the
Guatemalan Institute of Social Security, both
channel most of their human and financial
resources to the Guatemala City metro area.
This increase was dramatic in the period 1999
to 2003 when the budget for hospitals in the
metropolitan area tripled from about $32 million
to $121 million U.S. dollars, exceeding the
sum received by all other areas of the country
together since 2001. 117
What challenges remain? While Guatemala
City has a greater number of health care services,
with better infrastructure and access conditions
than the rest of the country, quality of
service is still not guaranteed. According to
local newspapers, during 2014, hospitals ran
out of budget several times during the year
because of prolonged delays in the allocation
and release of funds by the Ministry of Finance.
As a consequence, many hospitals periodically
suffered severe shortages of medicines, medical
supplies and even food and drinks needed to
meet patients’ dietary needs. In addition, the
human rights attorney’s office receives frequent
complaints of mistreatment by nurses and physicians
working in the hospital system. 118
Phnom Penh, Cambodia
The facts: Phnom Penh has cut its under-5
mortality rate by nearly two-thirds (from 50 to
18 deaths per 1,000 live births) since the first
Demographic and Health Survey was done in
2000. 119 In 2010, the city’s under-5 mortality
rate was reported at just 18 deaths per 1,000 live
births. This is the lowest child death rate reported
for any capital city in a low-income country
with available data and is roughly on par with
rates seen in Lima and Mexico City, both cities
in upper-middle-income countries.
STATE OF THE WORLD’S MOTHERS 2015 37