Women's health disparities in Honduras: indicators and determinants

Disparities in women's health indicators exist throughout the Americas. Health data about indigenous women in the remote highland communities of Honduras are lacking. Our objective was to assess women's health indicators and to suggest potential interventions.

An anonymous questionnaire was administered to women ≥age 18 in the Yamaranguila municipality. We assessed rates of Pap smear, breastfeeding, family planning (FP), and prenatal care (PNC); childbirth setting; access issues; and self-health perceptions.

Of the 134 participants, 30% were aged < 25 and 10% were ≥ 45. Most attended some primary school, and 11% had no education; 56% reported fair or poor self-health, and 90% had heard of the Pap smear, but only 20% had one within 1 year. Despite knowledge of various FP methods, only 42% in a union were using FP, which is significantly lower than national rates (p<0.01). Thirty-six percent of the respondents' most recent childbirths took place outside a health center. Seventy-six percent exclusively breastfed their youngest child for 6 months, higher than the national rate of 30% (p<0.01). Distance from the municipal center, reflecting more traditional indigenous identity, predicted lower rates of FP use (p<0.05), Pap smear (p<0.01), and prenatal care (PNC) (p<0.05), but age and education level did not.

In Honduras, the rural indigenous people have some of the worst health indicators compared to urban and nonindigenous people. Women's health status might be improved by implementing mobile care teams, training indigenous women as community health workers, and employing alternate modalities of cervical screening. Fundamental socioeconomic causes of poor health, such as remote residence, indigenous identity, and gender inequality, should be considered in future interventions to alleviate disparities in health status.