A participatory action research approach to assess, improve and monitor SDGs for equitable urban health in Guatemala

This project will utilise a participatory action research approach with stakeholders in Guatemala to assess, improve and monitor urban health inequities in relation to SDG goals using both qualitative and quantitative data. 

Quantitative data methods will include the use of health systems data to identify health inequities within urban centres through application of tools such as the WHO Urban Health Equity Assessment and Response Tool (Urban HEART).  Recent advancements in information and communication technologies (ICTs) should be considered to develop synergies between SDG monitoring and Urban HEART. It is likely that data gaps will exist and alternative proxy measures to analyse inequities should be identified. Results will inform GIS maps that reflect priority areas for action. Qualitative data methods will include participatory workshops with key health systems actors and policy analysis to explore identified health inequities and how policies shape these. Engaging in equitable partnerships with health systems actors, the research will co-lead the development of sustainable actions to improve and monitor health inequities in identified priority areas and in relation to SDGs for health and the determinants of health. It is anticipated that this will lead to; an increased awareness of the need to improve health equity; the adoption of participatory evidence-based approaches to deliver appropriate prevention and promotion strategies,  support health service delivery and assist with identification of necessary structural changes in urban Guatemala. The research will also explore the interlinkages between inequities, policy, governance and accountability including the political dimensions of assessing, highlighting and tracking health inequities in urban centres.

Where does the project lie on the Translational Pathway?

T3 (Evidence into Practice) – T4 (Practice to Policy/Population)

Expected Outputs

This study will assess the feasibility of using a participatory problem-solving process with urban municipal actors to assess, improve and monitor urban inequities within Guatemala. This research proposal will be co-developed and implemented with municipal actors. Results will be embedded within regional and national municipal governance systems and used by municipal actors to systematically measure and improve health inequities using a people centered, participatory approach. The project will have direct impact on local municipal actors who could increase the equity of public health services and policy for the populations they serve.  These impacts will benefit more stakeholders in urban areas across Guatemala and other urban health systems in LMICs. The findings from this research will also have an impact for the global community that is currently involved in tackling the challenges of urban health inequities and will contribute to the theoretical and practical knowledge to improve them in cities globally.


Outputs will include:

  • a web-based tool to assess, improve and monitor health inequities in relation to SDGs.
  • at least three publications related to; (a) using the Urban Heart tool for assessing and monitoring SDGs (b) using Participatory action research to improve urban health inequities and (c) using GIS maps to track changes in health inequities over time

Policy briefs for urban municipal health actors


Training Opportunities

Experience and understanding of implementation research, participatory action research, associated principles and procedures of programme monitoring and evaluation; health systems research, well-developed communication and inter-personal skills; developing and sustaining equitable research partnerships.

Skills Required

Background and understanding of urban health inequities, urban health systems, Guatemalan health inequities action research and employing participatory methodologies for equitable research partnerships. Spanish speaking is an asset.

Key Publications associated with this project

Prasad, A., Borrell, C., Mehdipanah, R. & Chatterji, S. 2018. Tackling Health Inequalities Using Urban HEART in the Sustainable Development Goals Era. Journal of Urban Health, 95, 610-612.

Abimbola, S., Negin, J., Jan, S. & Martiniuk, A. 2014. Towards people-centred health systems: a multi-level framework for analysing primary health care governance in low-and middle-income countries. Health Policy and Planning, 29, ii29-ii39.

Cross, H. E., De La Cruz, M. & Dent, J. 2019. Government stewardship and primary health care in Guatemala since 1996. Public Administration and Development, 39, 11-22.

Hegel, G., Lopez, Y. & Ozano, K. 2020. Recommendations from Guatemala to urban municipalities responding to COVID-19 in low- and middle-income countries. Available from: http://www.ariseconsortium.org/recommendations-from-guatemala-to-urban-municipalities-responding-to-covid-19-in-low-and-middle-income-countries/ [Accessed May 15th 2020].

Pan American Health Organisation (PAHO). 2019. Health in the Americas: Guatemala [Online]. Pan American Health Organisation (PAHO). Available: https://www.paho.org/salud-en-las-americas-2017/?p=3338 [Accessed 5th April 2020].

Deadline: Thursday 11th February 2021; 12:00 noon GMT

Further details on the MRC/DTP and CASE programmes and application guidance and process can be found here