Completed Research

Bridging the Maternal Care Gap: Mobile Antenatal Care in Rural and Indigenous Guatemalan Communities

University of Toronto

Maternal mortality is disproportionately prevalent in low-income countries. Of the 295,000 women who died of complications from pregnancy or childbirth worldwide in 2017, 94 per cent lived in low-income and resource-limited settings. Guatemala’s Alta Verapaz region, where 78 per cent of the population lives in rural areas and 48 per cent live in extreme poverty, reported a maternal mortality rate of 273 in 2012. The EHAS Foundation (Hispanic American Health Link) is combating the issue of maternal mortality in rural Guatemala with the Healthy Pregnancy Project (HPP), a portable prenatal care kit that is designed specifically for use in remote areas. EHAS trains and equips local health personnel with a backpack that includes a computer, a portable ultrasound scanner – powered by a foldable solar panel – and, blood and urine analysis systems that use immediate test strips. Local health personnel organize days in their respective communities where women can come and be tested for possible pregnancy-related complications. Test results and ultrasound images are examined by local health personnel for any possible complications and health risks.

The Hard to Reach

Pregnant women in rural Guatemala lacking access to health care services.

Key Takeaways

In addition to its overall success in mitigating systemic barriers contributing to regional inequity, the Healthy Pregnancy Project (HPP) showcases important strategies that should be considered in other healthcare intervention contexts. Overall, its success in reaching difficult-to-reach populations included the following strategies.


This research was made possible through the Reach Alliance, a partnership between the University of Toronto’s Munk School of Global Affairs & Public Policy and the Mastercard Center for Inclusive Growth. Research was also funded by the Ralph and Roz Halbert Professorship of Innovation at the Munk School of Global Affairs & Public Policy. We express our gratitude and appreciation to those we met and interviewed. We are also grateful to support staff, including translators, who helped make our research possible.

This research was vetted and received approval from the Ethics Review Board at the University of Toronto. Research was conducted remotely during the COVID-19 pandemic.