Despite improvements over the last 20 years, Guatemala’s 14 million people continue to face significant political, economic, and social problems. Statistics published by the World Health Organization and the United Nations Children’s Fund illustrate these continued struggles: Guatemala holds one of the highest maternal mortality rates in Central America. Thus, Guatemala’s Ministry of Health and Social Welfare is faced with a significant challenge to address immediate and pressing needs.

Beginning in 1990 with the implementation of the Quality Assurance Project, URC has worked in Guatemala to raise awareness that quality improvement (QI) is an essential component of health system strengthening and that quality standards and QI capacity development are vital to the development of health care systems in even the most resource-constrained countries. Over the years, URC has implemented, among others, Global Fund Consulting Services and the Multi-Sector Alliance Program to improve the quality of and broaden access to clinical health services in Guatemala. URC has a history of supporting USAID-funded projects Guatemala. Completed projects include the Calidad en Salud (Quality in Health) I and II projects, implemented from 2000–2004 and 2005–2009; the global USAID Health Care Improvement (HCI) project, 2008–2012; Translating Research into Action (TRAction), 2009-2017; and the Nutri-Salud: Community Nutrition and Health project, 2012-2017.

URC also implements PEPFAR funded projects for CDC in the Central America Region based out Guatemala. The Strengthening the Response to TB, HIV and STIs in the Central America Region project (2010-2014), was implemented in Belize, Guatemala, El Salvador, Honduras, Nicaragua, Costa Rica, and Panama to improve the quality of the response to TB and STI coinfection with HIV. The project developed electronic tools to register and report laboratory and clinical data and integrated a complete TB electronic system into the national platform for TB patients care and follow-up.

The HIV Co-infection Surveillance Strategies for Program Planning in the Central America Region project (2014-2019) is improving TB/HIV case management and strengthening for laboratory diagnosis of TB and HIV, HIV provider-initiated counselling and testing, and supporting fungal diseases surveillance in HIV patients. The project is promoting HIV testing in TB suspected and confirmed cases, as well as the three I´s (Intensified TB case-finding and high quality TB treatment, TB prevention with IPT and early ART, and TB Infection control at HIV clinics) and facilitates linkage to care for TB/HIV patients, among others. It is also the pioneer in the current implementation of a tele-mentoring model under the ECHO Project for TB in the CAR.

The Strengthening Clinical Services for People Living with HIV (PLHIV) in Central America project (2017-2022) aims to improve the clinical skills of health care workers through e-learning and capacity building at participating sites. The project facilitates in-country workshops, online HIV courses, and case-based discussions with HIV experts from the region and the rest of Latin America, to strengthen clinical knowledge of health care personnel at HIV clinics to improve clinical outcomes of PLHIV.