abstract: 'Introduction: The United Nations presented a set of Millennium

  Development Goals that aimed to improve social and economic development

  and eradicate poverty by 2015. Most low and middle-income countries will

  not meet these goals and today there is a need to set new development

  agenda, especially when it comes to health. The paper presents the

  findings from a community consultation process carried out within the

  Goals and Governance for Global Health (GO4Health) research consortium

  in Guatemala, which aims to identify community needs and expectations

  around public policies and health services.

  Methods: Through a participative and open consultation process with

  experts, civil society organizations and members of the research team,

  the municipalities of Tectitan and Santa Maria Nebaj were selected. A

  community consultation process was undertaken with community members and

  community leaders. Group discussions and in-depth interviews were

  conducted and later analyzed using thematic analysis, a qualitative

  method that can be used to analyze data in a way that allows for the

  identification of recurrent patterns that can be grouped into categories

  and themes, was used.

  Findings: Following the Go4Health framework''s domains for understanding

  health-related needs, the five themes identified were health, social

  determinants of health, essential health needs and their provision,

  roles and responsibilities of relevant stakeholders and community

  participation in decision-making. Participants reported high levels of

  discrimination related to ethnicity, to being poor and to living in

  rural areas. Ethnicity played a major role in how community members feel

  they are cared for in the health system.

  Conclusion: Achieving health goals in a context of deep-rooted

  inequality and marginalization requires going beyond the simple

  expansion of health services and working with developing trusting

  relationships between health service providers and community members.

  Involving community members in decision-making processes that shape

  policies will contribute to a larger process of community empowerment

  and democratization. Still, findings from the region show that tackling

  these issues may prove complicated and require going beyond the health

  system, as this lack of trust and discrimination has permeated to all

  public policies that deal with indigenous and rural populations.'
affiliation: 'Ruano, AL (Corresponding Author), Univ Bergen, Ctr Int Hlth, Bergen,
  Norway.

  Lorena Ruano, Ana, Univ Bergen, Ctr Int Hlth, Bergen, Norway.

  Lorena Ruano, Ana; Sanchez, Silvia; Jose Jerez, Fernando; Flores, Walter, Ctr Estudios
  Gobernanza Sistemas Salud, Guatemala City, Guatemala.'
article-number: '57'
author: Lorena Ruano, Ana and Sanchez, Silvia and Jose Jerez, Fernando and Flores,
  Walter
author-email: ana.lorena.ruano@cih.uib.no
author_list:
- family: Lorena Ruano
  given: Ana
- family: Sanchez
  given: Silvia
- family: Jose Jerez
  given: Fernando
- family: Flores
  given: Walter
da: '2023-09-28'
doi: 10.1186/1475-9276-13-57
eissn: 1475-9276
files: []
journal: INTERNATIONAL JOURNAL FOR EQUITY IN HEALTH
keywords: 'Guatemala; Community participation; Community consultations; Go4Health;

  Millennium development goals; Sustainable development goals'
language: English
month: OCT 10
number-of-cited-references: '34'
orcid-numbers: Ruano, Ana Lorena/0000-0003-3913-4228
papis_id: 3fad851dea1e53272512eaceaa633a31
ref: Lorenaruano2014makingpostmdg
researcherid-numbers: Ruano, Ana Lorena/AAA-1656-2021
times-cited: '10'
title: 'Making the post-MDG global health goals relevant for highly inequitable societies:
  findings from a consultation with marginalized populations in Guatemala'
type: Article
unique-id: WOS:000345533000001
usage-count-last-180-days: '0'
usage-count-since-2013: '11'
volume: '13'
web-of-science-categories: Public, Environmental \& Occupational Health
year: '2014'