Center for Research in Indigenous Health

Since 2007, Maya Health Alliance has been a leader in developing practical solutions to improve the quality of medical care in rural and indigenous communities in Guatemala. The Center for Research in Indigenous Health was founded by a multidisciplinary group of researchers at Maya Health Alliance, with the goals of advancing scientific investigations into the health needs of these communities.

Researchers in the Center come from diverse backgrounds, but we share an interest in core themes (noncommunicable diseases, like cancer and diabetes; chronic malnutrition and food security; civil society and the study of “development”; and gender and health). We also share an interest in certain methodological approaches, especially in “mixed methods”, applied anthropology, and implementation science.

Researchers

Peter Rohloff, MD PhD. Chief Medical Officer. Interests: noncommunicable chronic diseases, pediatric growth and development, chronic malnutrition, implementation science
Anita Chary, MD PhD. Research Director. Interests: cervical cancer, medical anthropology

Kirsten Austad, MD MPH. Director of Women’s Health. Interests: family planning, cervical cancer, implementation science
Caitlin Baird, PhD. Research Scientist. Interests: pediatric nutrition, medical anthropology, diabetes
Meghan Farley Webb, PhD. Research Scientist. Interests: food security, migration, medical anthropology
David Flood, MD. Affiliating Researcher. Interests: chronic kidney disease, diabetes, child nutrition
Pablo Garcia, MD. Affiliating Researcher. Interests: chronic kidney disease
Nora King, MD. Affiliating Researcher. Interests: women’s health

Stephen Alajajian, RDN. Research Fellow. Interests: malnutrition, food security
Marcela Colom, MD. Research Fellow. Interests: women’s health
Ana Cordón, MD. Research Fellow. Interests: pediatric nutrition, civil society, social entrepreneurship
Andrea Guzman, RDN. Staff Nutritionist. Interests: malnutrition, food security
Michel Juarez, MD. Research Fellow. Interests: obstetrical continuum of care, neonatal care
Boris Martinez, MD. Research Fellow. Interests: pediatric nutrition, early child development

Enma Coyote. Research Coordinator. Interests: midwifery, obstetrical emergency
Eloin Dhaenens. Junior Research Scientist. Interests: chronic kidney disease
Yolanda Juarez. Senior Research Coordinator. Interests: midwifery, obstetrical emergency

Lilian Ajú. Research Assistant.
Damaris Cabrera. Research Assistant.
Ingrid Chicol. Research Assistant.
Marta Quina. Research Assistant.

Projects and Funding

Scaling up self-management interventions for type 2 diabetes (2018-).

Using an implementation science framework to evaluate the impact of a home-based self management intervention for adults with type 2 diabetes in two health districts in central Guatemala.

Funding: World Diabetes Foundation

Flood, Hawkins J, Rohloff P. Evaluation of a Home-Based Type 2 Diabetes Self-Management Intervention in Rural Guatemala, 2014–2016. Preventing Chronic Disease 2017; doi: 10.5888/pcd14.170052.

Flood D, Douglas K, Goldberg V, Martinez B, Garcia P, Arbour M, Rohloff P. A quality improvement project using statistical process control methods for type 2 diabetes control in a resource-limited setting. Int J Qual Health Care 2017; doi: 10.1093/intqhc/mzx051.

Population-based survey of chronic kidney disease (2018-).

Representative, population-based study surveying prevalence and risk factors for traditional and nontraditional chronic kidney disease in adults in rural Guatemala.

Funding: NIH/FIC

Flood D, Garcia P, Douglas K, Hawkins J, Rohloff P. Screening for chronic kidney disease in a community-based diabetes cohort in rural Guatemala: a cross-sectional study. BMJ Open 2018 Jan 21:8(1):e019778.

Care navigation to improve obstetrical care (2017-).

Using a quality improvement framework and care navigation to improve patient satisfaction and emergency obstetrical referral outcomes.

Funding: Grand Challenges Canada

Austad K, Chary A, Martinez B, Juarez M, Martin YJ, Ixen EC, Rohloff P. Obstetric care navigation: a new approach to promote respectful maternity care and overcome barriers to safe motherhood. Reprod Health. 2017 Nov 13; 14(1):148.

mHealth technology to support obstetrical care. (2015-).

Using smartphones and decision support mHealth applications to support identification and referral of high-risk pregnancies by lay midwives.

Funding: NIH/NICHD (PI Gari Clifford, Emory University)

Trial Registration: NCT02348849

Martinez B, Hall-Clifford R, Coyote E, Stroux L, Valderrama CE, Aaron C, Francis A, Hendren C, Rohloff P, Clifford GD. Agile Development of a Smartphone App for Perinatal Monitoring in a Resource-Constrained Setting. J Health Informatics in Dev Countries. 2017; 11:158.

Stroux L, Martinez B, Ixen EC, King N, Hall-Clifford R, Rohloff P, Clifford GD. (2016). An mHealth monitoring system for traditional birth attendant-led antenatal risk assessment in rural Guatemala, Journal of Medical Engineering & Technology.

Individualized home-based interventions to improve diet quality and developmental outcomes in stunted children (2015-2017).

Investigating optimal strategies for empowering caregivers and improving nurturing care for infants at risk.

Funding: Grand Challenges Canada

Trial Registration: NCT02509936

Martinez B, Webb MF, Rodas P, Gonzalez A, del Pilar Grazioso M, Rohloff P. (2016). Field report: Early child development in rural Guatemala. Perspectives in Infant Mental Health. 24(1-2):6-8.

Brown K, Henretty N, Chary A, Webb MF, Wehr H, Moore J, Baird C, Díaz AK, Rohloff P. Mixed-methods study identifies key strategies for improving infant and young child feeding practices in a highly stunted rural indigenous population in Guatemala. Matern Child Nutr. DOI: 10.1111/mcn.12141

Key Collaborators

Dr. Joaquin Barnoya, Unidad Cardiovascular de Guatemala

Dr. Gari Clifford, Department of Biomedical Informatics, Emory University

Dr. Alejandra Colom, Department of Anthropology, Universidad del Valle de Guatemala

Dr. Meredith Fort, Department of Family Medicine, University of Colorado

Dr. Rachel Hall-Clifford, Department of Anthropology, Agnes Scott College

Dr. Maria del Pilar Grazioso, Department of Psychology, Universidad del Valle de Guatemala

Dr. Carlos Mendoza, Instituto de Nutrición de Centro América y Panamá

Dr. Ann Miller, Department of Global Health and Social Medicine, Harvard Medical School

Publications

Public Data Repository

2018

Flood D, Rohloff P. Indigenous language and global health. Lancet Glob Health 2018 Feb;6(2):e134-135.

Flood D, Garcia P, Douglas K, Hawkins J, Rohloff P. Screening for chronic kidney disease in a community-based diabetes cohort in rural Guatemala: a cross-sectional study. BMJ Open 2018 Jan 21:8(1):e019778.

Colom M, Austad K, Sacuj N, Larson K, Rohloff P. Expanding access to primary healthcare for women through a microfinance institution: A case study from rural Guatemala. Healthc (Amst). 2018 Feb 7. Doi: 10.1016/j.hjdsi.2017.12.003.

2017

Austad K, Chary A, Martinez B, Juarez M, Martin YJ, Ixen EC, Rohloff P. Obstetric care navigation: a new approach to promote respectful maternity care and overcome barriers to safe motherhood. Reprod Health. 2017 Nov 13; 14(1):148.

Flood DC, Chary AN, Austad K, Garcia P, Rohloff PJ. A patient navigation system to minimize barriers for peritoneal dialysis in rural, low-resource settings: case study from Guatemala. Kidney Int Reports 2017; https://doi.org/10.1016/j.ekir.2017.02.020

Chary A, Flood D, Austad K, Colom M, Hawkins J, Cnop K, Martinez B, Lopez W, Rohloff P. Accompanying indigenous Maya patients with complex medical needs: A patient navigation system in rural Guatemala. Healthc (Amst). 2017 Sep 14. pii: S2213-0764(17)30177-X. doi: 10.1016/j.hjdsi.2017.08.006.

Hall-Clifford R, Roche S, Fathima S, Palmius N, Hollingworth K, Kennedy J, Merida J, Stephens M, Lavalley R, Rohloff P, Garcia P, Patrick S, Clifford G. Sustainable Technology for Surgical Referrals: Pilot Implementation of an Electronic Referral System for Short-Term Surgical Missions. J Health Informatics in Dev Countries. 2017; 11(2).

Martinez B, Hall-Clifford R, Coyote E, Stroux L, Valderrama CE, Aaron C, Francis A, Hendren C, Rohloff P, Clifford GD. Agile Development of a Smartphone App for Perinatal Monitoring in a Resource-Constrained Setting. J Health Informatics in Dev Countries. 2017; 11:158.

Flood D, Douglas K, Goldberg V, Martinez B, Garcia P, Arbour M, Rohloff P. A quality improvement project using statistical process control methods for type 2 diabetes control in a resource-limited setting. Int J Qual Health Care 2017; doi: 10.1093/intqhc/mzx051.

Moore J, Webb MF, Chary A, Kraemer Díaz A, Rohloff P. Aid and gendered subjectivity in rural Guatemala. Journal of Development Studies. 2017;53:2164

Flood D, Mathieu I, Chary A, Garcia P, Rohloff P. Perceptions and utilization of generic medications in Guatemala: A mixed-methods study with physicians and pharmacy staff. BMC Health Services Research 2017; 17:27.

2016

Stroux L, Martinez B, Ixen EC, King N, Hall-Clifford R, Rohloff P, Clifford GD. (2016). An mHealth monitoring system for traditional birth attendant-led antenatal risk assessment in rural Guatemala, Journal of Medical Engineering & Technology.

Martinez B, Webb MF, Rodas P, Gonzalez A, del Pilar Grazioso M, Rohloff P. (2016). Field report: Early child development in rural Guatemala. Perspectives in Infant Mental Health. 24(1-2):6-8.

Chary A, Flood D, Austad A, Moore J, King N, Martinez B, Garcia P, Lopez W, Dasgupta-Tsikinas S, Rohloff P. (2016). Navigating Bureaucracy: Accompanying Indigenous Maya Patients with Complex Healthcare Needs in Guatemala. Human Organization. 75:305-14.

Flood F, Chary A, Austad K, Kraemer Díaz A, Garcia P, Martinez B, Lopez Canu W, Rohloff P. (2016). Insights into global health practice from the agile software design movement. Global Health Action. 9:29836. doi: 10.3402/gha.v9.29836.

Austad K, Chary A, Colom A, Barillas R, Luna D, Menjivar C, Metz B, Petrocy A, Ruch A, Rohloff P. Fertility awareness methods are not modern contraceptives: defining contraception to reflect our priorities. Glob Health Sci Pract. 2016;4:342-5.

Flood D, Mux S, Martinez B, García P, Douglas K, Goldberg V, Lopez W, Rohloff P. Implementation and outcomes of a comprehensive type 2 Diabetes program in rural Guatemala. PLoS One. 2016; 11:e0161152.

Webb MF, Chary AN, De Vries TT, Davis S, Dykstra M, Flood D, Rhodes MH, Rohloff P. Exploring mechanisms of food insecurity in indigenous agricultural communities in Guatemala: a mixed methods study. BMC Nutrition. 2016; 2:55.

2015

Chary A and Rohloff P (Eds). (2015). Privatization and the New Medical Pluralism: Shifting Healthcare Landscapes in Maya Guatemala. Lanham: Lexington Books.

King N, Chary A, Rohloff P. (2015). “Leveraging Resources in contemporary Maya midwifery.” In Privatization and the New Medical Pluralism: Shifting Healthcare Landscapes in Maya Guatemala. Chary A and Rohloff P (Eds). Lanham: Lexington Books. Pp 123-140.

Flood D and Rohloff P. (2015). “This Disease is for Those Who Can Afford It”: Diabetes in Indigenous Maya Communities. In Privatization and the New Medical Pluralism: Shifting Healthcare Landscapes in Maya Guatemala. Chary A and Rohloff P (Eds). Lanham: Lexington Books. Pp 51-68.

Rohloff P and Henderson B. (2015). Development, Language Revitalization, and Culture: The case of the Mayan Languages of Guatemala, and Their Relevance for African Languages. In Language Documentation and Endangerment in Africa (Eds Essegbey J, Henderson B, and McLaughlin F). Amsterdam: John Benjamins Publishing company. Pp 177-194.

2014

Stroux L, King NE, Fathima SN, Hall-Clifford R, Rohloff P, Clifford GD (2014). A low-cost perinatal monitoring system for use in rural Guatemala. Appropriate Healthcare Technologies for Low Resource Settings.

Fathima SN, Palmius N, Clifton D, Rohloff P, Clifford GD, Hall-Clifford R.(2014). Sanitation-related disease surveillance using community health promoters and mobile phone technology. Appropriate Healthcare Technologies for Low Resource Settings.

Wehr H, Chary A, Webb MF, Rohloff P. (2014). Implications of gender and household roles in Indigenous Maya communities in Guatemal for child nutrition interventions. International J of Indigenous Health 10:99-112.

Chary AN, Rohloff PJ. (2014). Major challenges to scale up of visual inspection-based cervical cancer prevention programs: the experience of Guatemalan NGOs. Glob Health Sci Pract. 2:307-17.

Brown K, Henretty N, Chary A, Webb MF, Wehr H, Moore J, Baird C, Díaz AK, Rohloff P. Mixed-methods study identifies key strategies for improving infant and young child feeding practices in a highly stunted rural indigenous population in Guatemala. Matern Child Nutr. DOI: 10.1111/mcn.12141

Henderson B, Rohloff P, Henderson R. (2014). More than words: towards a development-based approach to language revitalization. Language Documentation and Conservation Journal 8:75-91.

2013 and earlier

Chary A, Messmer S, Sorenson E, Henretty N, Dasgupta S, Rohloff P. (2013). The normalization of childhood disease: An ethnographic study of child malnutrition in rural Guatemala. Human Organization 72:88-97.

Chary A, Kraemer Díaz A, Henderson B, Rohloff P. (2013). The changing role of indigenous lay midwives in Guatemala: New frameworks for analysis. Midwifery 29:852-858.

Kraemer A and Rohloff P. (2013). Guatemala. In Building Partnerships in the Americas: A Guide for Global Health Workers. (M Krasnoff, Ed). Dartmouth: University Press of New England.

Tummons E, Henderson R and Rohloff P. (2012). Language Revitalization and the Problem of Development in Guatemala: Case Studies from Health Care. Symposium on Teachng and Learning Languages of Latin America. University of Notre Dame.

Chary A, Greiner M, Bowers C, Rohloff P. (2012). Determining adult type 2 diabetes related health care needs in an indigenous population from rural Guatemala: A mixed methods preliminary study. BMC Health Services Research 12:476.

Rohloff P, Kraemer Diaz A, Ajsivinac Sian J. (eds). (2011). Nïm chuwäch k’iyirisanem: Tajin runuk’ik’ ruk’aslem ri chwa’q kab’ij pan Iximulew. Bethel, VT: Wuqu’ Kawoq.

Tummons E, Henderson R and Rohloff P. (2011). “So that we don’t lose words:” Reconstructing a Kaqchikel medical lexicon. First Biennial Symposium on Teaching Indigenous Languages in Latin America. Indiana University.

Chary A, Messmer S, Rohloff P. (2011). Male Influence on Infant Feeding in Rural Guatemala and Implications for Child Nutrition Interventions. Breastfeeding Medicine 6:227-31.

Rohloff P, Kraemer Diaz A, Dasgupta S.(2011). “Beyond development “– A critical appraisal of the emergence of small health care non-governmental organizations in rural Guatemala. Human Organization 70:427-437.

Chary, A., Dasgupta, S., & Rohloff, P. (2011). Breastfeeding, subjugation, and empowement in rural Guatemala. In An Anthropology of Mothering (M Walks & N McPherson, Eds.). Toronto: Demeter Press.

Rohloff P and Sotz Mux M (2008). Tiqaq’omaj qi’. Bethel, VT: Wuqu’ Kawoq.