A Qualitative Study on the Work and Challenges Faced by Non-Governmental Organizations Providing Sexual and Reproductive Health Services to Vulnerable Populations in Guatemala

Introduction
Non-governmental organizations (NGOs) are key actors in the provision of sexual and reproductive health (SRH) services to vulnerable populations in Guatemala. We conducted an exploratory qualitative study to shed light on the work and challenges faced by these NGOs, which are underrepresented in the scientific literature.

Methods
We selected 16 representatives from four SRH-providing NGOs who participated in two semi-structured interviews and four focus group discussions in May–June 2022. The data were analyzed using thematic analysis.

Results
All participating NGOs prioritized indigenous women with low socioeconomic backgrounds in rural areas. Participants shared several challenges they face, including the taboo around sexuality, exposure to violence, limitations to their activities caused by the COVID-19 pandemic, unfavorable policy and legal frameworks for SRH service delivery, and limited inter-institutional collaboration on SRH issues.

Conclusions
Our results highlight the importance of involving communities and tailoring interventions to the context to ensure successful implementation. Also, an urgent need for changes in the country’s political management and regulations to guarantee the full exercise of the sexual and reproductive rights (SRR) of the population, as well as greater inter-institutional collaboration to improve the quality and efficiency of SRH services in Guatemala.

Policy Implications
Guatemala needs to develop a national SRH policy to guide and align the work of the different actors providing SRH services and facilitate their accountability. Also, Guatemalan politicians representing the citizenry should continue to promote reforms to the legal framework to facilitate effective fulfillment of the SRR of the Guatemalan population.