Water supply and sanitation in Guatemala


Water supply and sanitation in Guatemala

The water supply and sanitation sector in Guatemala is characterized by low and inconsistent service coverage, especially in rural areas; unclear allocation of management responsibilities; and little or no regulation and monitoring of service provision.

Access

According to the WHO/UNICEF Joint Monitoring Programme for Water Supply and Sanitation, access to water and sanitation services has slowly risen over the years in Guatemala. In 1990, 79% of the total population had access to improved water sources, while in 2004, 95% of the population had access. Sanitation coverage has also risen, from 58% of the total population having access to adequate sanitation in 1990, to 86% with access in 2004. The government of Guatemala estimates that the population without access to water services is growing at a rate of at least 100,000 people every year. [ Inter-American Development Bank. 2003. Guatemala Rural Water and Sanitation Program (GU-0150) Loan Proposal. [http://www.iadb.org/exr/doc98/apr/gu1469e.pdf] ]

"Source": Joint Monitoring Program for Water Supply and Sanitation WHO/UNICEF ( [http://www.wssinfo.org/en/welcome.html JMP] /2006).Data for [http://www.wssinfo.org/pdf/country/GTM_wat.pdf water] and [http://www.wssinfo.org/pdf/country/GTM_san.pdf sanitation] based on surveys including the Guatemalan Demographic Census (1994), the World Health Survey, WHO (2003), and the National Maternal and Infant Health Survey (Encuesta Nacional de Salud Materno Infantil) (2002).

Accurate and reliable data regarding coverage in rural areas is unavailable. Conflicting statistics as to the percentages of the population using improved drinking water sources present difficulties in assessing the seriousness of the problem. Although the data above shows that water and sanitation coverage in both rural and urban areas is fairly high in Guatemala, the National Water and Sanitation Information System (Sistema Nacional de Informacion de Agua y Saneamiento) (SAS), which collects and maintains information regarding water and sanitation in rural communities, released information in 2002 indicating that only 53% of homes (it is assumed that this statistic refers to households in rural areas due to the rural focus of SAS) had access to water services. [ United Nations Development Program. 2002. “Metas del Milenio: Informe de Avance de Guatemala”. Guatemala. [http://www.lib.utexas.edu/benson/lagovdocs/guatemala/federal/presidente/metas/metas-2002.pdf] ] The SAS considers accessible services to be less than 1 kilometer from a home and that at least 20 liters of water is available to each person every day. [ United Nations Development Program. 2002. “Metas del Milenio: Informe de Avance de Guatemala”. Guatemala. [http://www.lib.utexas.edu/benson/lagovdocs/guatemala/federal/presidente/metas/metas-2002.pdf] ] While 24,000 rural communities exist in Guatemala, SAS has only collected data from 36% of these, making it difficult to determine the actual number of individuals lacking services. [ Inter-American Development Bank. 2003. Guatemala Rural Water and Sanitation Program (GU-0150) Loan Proposal. [http://www.iadb.org/exr/doc98/apr/gu1469e.pdf] ] Access to water in urban areas is irregular, as 80% of urban water systems function for an average of 12 hours every day. [ Organización Panamericana de la Salud (OPS), OMS. 2000. “Evaluación de los Servicios de Agua Potable y Saneamiento 2000 en las Américas.” [http://www.bvsde.paho.org/eswww/eva2000/guatemala/caliserv/calidad.html] ] As of the year 2000, 25% of water in urban systems was disinfected and only 1% of all collected sewage water has been treated. [ Organización Panamericana de la Salud (OPS), OMS. 2000. “Evaluación de los Servicios de Agua Potable y Saneamiento 2000 en las Américas.” [http://www.bvsde.paho.org/eswww/eva2000/guatemala/caliserv/calidad.html] ]

Quality of service

The water and sanitation sector in Guatemala is characterized by “low coverage, poor quality services, and deteriorating physical assets,” [ Inter-American Development Bank. 2003. Guatemala Rural Water and Sanitation Program (GU-0150) Loan Proposal. [http://www.iadb.org/exr/doc98/apr/gu1469e.pdf] ] related to a need for increased investments in basic infrastructures. Population growth, agricultural expansion, unevenly distributed services, and polluted sources have contributed to the inability of citizens to access adequate amounts of clean water.

History and recent events

See also:Guatemalan civil war

In 1996 the government of Guatemala and the Guatemalan National Revolutionary Unity, the guerilla movement, signed a peace accord which ended 36 years of a civil, guerilla war. [ United Nations Development Program. 2002. “Metas del Milenio: Informe de Avance de Guatemala”. Guatemala. [http://www.lib.utexas.edu/benson/lagovdocs/guatemala/federal/presidente/metas/metas-2002.pdf] ] This conflict left over 100,000 Guatemalans dead and created over 1 million internally displaced refugees. [ Central Intelligence Agency. 2006. The World Factbook. Guatemala. [https://www.cia.gov/cia/publications/factbook/geos/gt.html] ] This recent tumultuous history, along with a fairly new constitution written in 1985 and then again amended in 1993, can explain a lack of information regarding water and sanitation, as well as low service coverage.

While many improvements have been made since the end of the war, Guatemala continually suffers from political violence and corruption, drug trafficking, and a large trade deficit. [ Central Intelligence Agency. 2006. The World Factbook. Guatemala. [https://www.cia.gov/cia/publications/factbook/geos/gt.html] ] In light of these problems, it has been difficult for the national government to raise funds internally, or to attract assistance and investment from international donors and financial institutions. [ Water for People. 2005. “Strategy Paper-Guatemala.” [http://www.waterforpeople.org/downloads/plans/Guatemala%20Strategy%20Paper.pdf] ] These financial set-backs prevent needed improvements in the countries’ general infrastructure, such as education, public health, and water and sanitation systems.

From 1991 to 1998 the President of the Republic created a Secretary of Hydrological Resources whose mission was to order and plan the water sector and to make a Water Law. [ Cobos, Carlos Roberto. 2002. “El Agua: Situación Actual y Necesidades de Gestión.” Universidad de Rafael Landivar: Guatemala. [http://www.marn.gob.gt/remodelmarn/index.htm] ] Several proposals for the law were turned down, largely due to the lack of a legal and institutional framework for managing water resources in Guatemala. [ Cobos, Carlos Roberto. 2002. “El Agua: Situación Actual y Necesidades de Gestión.” Universidad de Rafael Landivar: Guatemala. [http://www.marn.gob.gt/remodelmarn/index.htm] ]

In 1995 COPECAS, in collaboration with other principal institutions, conducted a country-wide analysis of water and sanitation to address disorganization, contradictions and discrepancies in the sector. [ Organización Panamericana de la Salud (OPS), OMS. 2000. “Evaluación de los Servicios de Agua Potable y Saneamiento 2000 en las Américas.” [http://www.bvsde.paho.org/eswww/eva2000/guatemala/caliserv/calidad.html] ] This study led to changes in the coordination and management of the sector, such as giving INFOM the responsibility to manage the sector.

In 1999 the Ministry of Agriculture, Livestock and Food (MAGA) was given responsibility for creating an Integrated Management Plan for Hydrological Resources, which will focus on water resources in terms of a political, legal and institutional framework, information and sustainability, and education. [ Organización Panamericana de la Salud (OPS), OMS. 2000. “Evaluación de los Servicios de Agua Potable y Saneamiento 2000 en las Américas.” [http://www.bvsde.paho.org/eswww/eva2000/guatemala/caliserv/calidad.html] ]

In 2002 the Inter-American Development Bank gave Guatemala support for the reform and reorganization of INFOM in order to better serve and assist municipalities. [ Inter-American Development Bank. 2003. Guatemala Rural Water and Sanitation Program (GU-0150) Loan Proposal. [http://www.iadb.org/exr/doc98/apr/gu1469e.pdf] ]

Responsibilities for water and sanitation

Policy

There are a multitude of government entities involved in water and sanitation and none of them has been assigned a clear leadership role in the sector. The [http://www.mspas.gob.gt/ Ministry of Health] , the Municipal Development Agency (Instituto de Fomento Municipal)( [http://www.infom.org.gt/ INFOM] ), the [http://www.marn.gob.gt/remodelmarn/index.htm Ministry of Environment] and the [http://www.segeplan.gob.gt/index.php?option=com_content&task=view&id=70&Itemid=108 Planning Secretariat] in the President's Office and all have a role, albeit ill-defined, in determining policies and strategies for water and sanitation, as well as for water resources management. [ Latinosan 2007 - Conferencia Latinoamericana de Saneamiento: Informe de Guatemala, p. 3-4 ]

INFOM, created in 1957, is a decentralized public institution whose mission is to support municipalities through the provision of administrative, financial, and technical assistance. [ Instituto de Fomento Municipal (INFOM). 2006. Gobierno de Guatemala. [http://www.infom.org.gt/index.php?option=com_frontpage&Itemid=1] ] In 1997 the Government Decree 376-97 gave INFOM the responsibility to manage the political and strategic aspects of the water and sanitation sector in Guatemala. [ Inter-American Development Bank. 2003. Guatemala Rural Water and Sanitation Program (GU-0150) Loan Proposal. [http://www.iadb.org/exr/doc98/apr/gu1469e.pdf] ]

In the same year, the Executive Unit of the Rural Aqueduct Program (Unidad Ejectora del Programa de Acueductos Rurales) (UNEPAR) and the Highlands Drinking Water and Sanitation Project (Proyecto de Agua Potable y Saneamiento del Altiplano) (PAYSA), programs for rural water and sanitation that had formerly been under the Ministry of Health, were placed under the management of INFOM. Although UNEPAR is placed under INFOM it continues to have separate financing from the national budget as well as the German Development Bank KfW. [ Inter-American Development Bank. 2003. Guatemala Rural Water and Sanitation Program (GU-0150) Loan Proposal. [http://www.iadb.org/exr/doc98/apr/gu1469e.pdf] ] UNEPAR also manages the data base of SAS.

A Permanent Coordinating Committee for Water and Sanitation (Comité Permanente de Coordinación de Agua y Saneamiento) (COPECAS) was created in 1985 by the Government Decree (Acuerdo Gubernativo) 10036-85 to coordinate the work of all public agencies in the water and sanitation sector, [ Centro Panamericano de Ingeniería Sanitaria y Ciencias del Ambiente (CEPIS). 1997. “Progress in the Privatization of Water-Related Public Services: Country-by-Country Review for Mexico, Central America and the Caribbean.” Guatemala. [http://www.bvsde.paho.org/muwww/fulltext/ppm/ppmguat.html] ] but it is inactive. The committee is supported by the Pan–American Health Organization (PAHO). [ Colom de Moran, Elisa. 2005. “Estudio de los Cambios Legales en el Marco de la Privatizacion del Agua en Guatemala.” Menschenrecht Wasser, Brot fur die Welt: Germany. [http://www.menschen-recht-wasser.de/downloads/Situacion_Legal_del_Agua_en_Guatemala.pdf] ]

There is no law granting all people the right to clean drinking water in Guatemala. [ Water for People. 2005. “Strategy Paper-Guatemala.” [http://www.waterforpeople.org/downloads/plans/Guatemala%20Strategy%20Paper.pdf] ]

Regulation

The Ministry of Public Health and Social Assistance (MSPASA) is legally responsible for monitoring drinking water quality at a national level. [ Centro Panamericano de Ingeniería Sanitaria y Ciencias del Ambiente (CEPIS). 1997. “Progress in the Privatization of Water-Related Public Services: Country-by-Country Review for Mexico, Central America and the Caribbean.” Guatemala. [htp://www.bvsde.paho.org/muwww/fulltext/ppm/ppmguat.html] ] They provide water quality testing services for private and public operators.

The Ministry of the Environment and Natural Resources, along with INFOM, is officially responsible for environmental regulation in the water and sanitation sector. [ Colom de Moran, Elisa. 2005. “Estudio de los Cambios Legales en el Marco de la Privatizacion del Agua en Guatemala.” MenshenRecht Wasser, Brot fur die Welt: Germany. [http://www.menschen-recht-wasser.de/downloads/Situacion_Legal_del_Agua_en_Guatemala.pdf] ] However, there is no real effective environmental management in the sector. [ Organización Panamericana de la Salud (OPS), OMS. 2000. “Evaluación de los Servicios de Agua Potable y Saneamiento 2000 en las Américas.” [http://www.bvsde.paho.org/eswww/eva2000/guatemala/caliserv/calidad.html] ]

Economic regulation in the sector is practically non-existent. Tariffs for service provision are determined by politics, and there are no organizations which monitor providers in order to detect abuses of the system. [ Centro Panamericano de Ingeniería Sanitaria y Ciencias del Ambiente (CEPIS). 2000. “Evaluación de los Servicios de Agua Potable y Saneamiento 2000 en las Américas”. Guatemala. [http://www.bvsde.paho.org/eswww/eva2000/guatemala/informe.html] ]

Provision of services

According to the law the provision of services is a responsibility of municipalities. Article 253 of the Constitution of the Republic of Guatemala gives the country's 332 municipalities the responsibility to use their resources to provide public services. [ Republic of Guatemala. “1985 Constitution with 1993 Reforms.” [http://pdba.georgetown.edu/Constitutions/Guate/guate93.html] ] In 2002 the Municipal Code published as Government Decree 12-2002 confirmed the legal responsibility of municipalities to deliver public services, including water and sanitation, to all those living in urban and rural areas. [ Inter-American Development Bank. 2003. Guatemala Rural Water and Sanitation Program (GU-0150) Loan Proposal. [http://www.iadb.org/exr/doc98/apr/gu1469e.pdf] ]

Municipalities have a difficult time serving urban and especially rural areas due to a lack of resources. In reality, therefore, a variety of public, communal and private entities provide services alongside the municipalities.

Direct municipal service provision

Water and sanitation services can be provided directly by a single municipality or through a group of municipalities who are organized to provide services together (“mancomunidades”). [ Inter-American Development Bank. 2003. Guatemala Rural Water and Sanitation Program (GU-0150) Loan Proposal. [http://www.iadb.org/exr/doc98/apr/gu1469e.pdf] ]

Municipal companies

The Municipality of Guatemala City created the Municipal Water Company (Empresa Municipal de Agua) (EMPAGUA) in 1972 to manage Guatemala City’s sewage and water services. Today it is the largest municipal water provider in the country. [ Centro Panamericano de Ingeniería Sanitaria y Ciencias del Ambiente (CEPIS). 1997. “Progress in the Privatization of Water-Related Public Services: Country-by-Country Review for Mexico, Central America and the Caribbean.” Guatemala. [htp://www.bvsde.paho.org/muwww/fulltext/ppm/ppmguat.html] ] XELAGUA manages the water supplies in Quetzaltenango, Guatemala’s second largest city. [ Organización Panamericana de la Salud (OPS), OMS. 2000. “Evaluación de los Servicios de Agua Potable y Saneamiento 2000 en las Américas.” [http://www.bvsde.paho.org/eswww/eva2000/guatemala/caliserv/calidad.html] ]

Bulk water provision to Guatemala City

The Executive Unit of the National Xayá-Pixcayá Aqueduct (Unidad Ejecutora del Acueducto Nacional Xayá-Pixcayá), managed under the Ministry of Public Communications, Transportation and Labor, administers, operates, and maintains the National Aqueduct which supplies bulk water to Guatemala City. [ Centro Panamericano de Ingeniería Sanitaria y Ciencias del Ambiente (CEPIS). 1997. “Progress in the Privatization of Water-Related Public Services: Country-by-Country Review for Mexico, Central America and the Caribbean.” Guatemala. [htp://www.bvsde.paho.org/muwww/fulltext/ppm/ppmguat.html] ]

Local private operators in Guatemala City

Several independent companies distribute potable water by tanker trucks and through private networks to rural and urban communities, serving at least 32% of Guatemala City alone. [ Solo, Tova Maria. 2003 . “Independent Water Entrepreneurs in Latin America: The other private sector in water services.” Washington, D.C.: World Bank. ] The National Mariscal Water Company (Compañía Nacional de Agua de Mariscal) is the largest and oldest of these companies, providing services to approximately 14% of the population of Guatemala City. [ Centro Panamericano de Ingeniería Sanitaria y Ciencias del Ambiente (CEPIS). 1997. “Progress in the Privatization of Water-Related Public Services: Country-by-Country Review for Mexico, Central America and the Caribbean.” Guatemala. [htp://www.bvsde.paho.org/muwww/fulltext/ppm/ppmguat.html] ]

Community-based organizations

Communities themselves, through water committees (Comités administradores de agua potable, or CAAP), provide services in rural areas. Water committees are considered to be private operators and are regulated by the Civil Code. Committees are elected by community members and are responsible for the collection of tariffs and the operation and maintenance of the system. [ Inter-American Development Bank. 2003. Guatemala Rural Water and Sanitation Program (GU-0150) Loan Proposal. [http://www.iadb.org/exr/doc98/apr/gu1469e.pdf] ]

It is written in Article 122 of the Constitution that all land within a 50 meter radius of a source of water is owned by the government of Guatemala. [ Republic of Guatemala. “1985 Constitution with 1993 Reforms.” [http://pdba.georgetown.edu/Constitutions/Guate/guate93.html] ] Communities and other private operators must purchase the land and water rights for a water source before developing a new system.

Assistance to community-based organizations

Assistance to community-based service providers is a key function in the water and sanitation sector. In Guatemala this function is not clearly assigned to a government institution. INFOM, through UNEPAR (see above under policy), does provide this function. In addition, many NGOs also support community-based organizations.

One of them is Servicios para el Desarrollo (SER), a local NGO dedicated entirely to water and sanitation through its program "Agua para todos". Created in 1996, SER counts among its ranks 14 professionals from various disciplines dedicated to support communities in finding sustainable integrated, sustainable and affordable water and sanitation solutions. It also tries to raise the awareness of civil society and the state concerning water and sanitation, and undertakes research and documentation to systematically assess experiences in the sector.

Financial aspects

Tariffs and cost recovery

Water tariffs for municipally-managed systems are set by municipal councils for urban areas and by water users, through general meetings of users, for rural areas. In the case of privately owned small networks, which exist mainly in Guatemala City, and private water tankers, tariffs and prices are set by the private service providers. Since metering is not common, tariffs usually take the form of a monthly flat fee. Tariffs vary greatly from one locality to the other. In Guatemala city it stood at US$ 2.1 per month for 15 cubic meters, while in other towns it was as low as US$ 0.5 per month for 7.5 cubic meters. [ [http://www.iadb.org/sds/conferences/waterconference/Sesion4-Garcia-Guatemala.pdf Nuevas opciones publicas-privadas para el financiamiento de sistemas rurales/aislados INFOM 2003 Carlos García Bickford] p. 2 ]

Cost recovery in municipal and communal systems is generally low and usually revenues are barely sufficient to cover operating costs and routine maintenance. However, there are exceptions. For example, a program supported by USAID since 1992 in the Altiplano required communities to repay 50% of investment costs, which they did with only very limited payment arrears, showing the willingness of communities to pay for water supply. [ [http://www.iadb.org/sds/conferences/waterconference/Sesion4-Garcia-Guatemala.pdf Nuevas opciones publicas-privadas para el financiamiento de sistemas rurales/aislados INFOM 2003 Carlos García Bickford] p. 3 ]

Investment

In 2005 investments in water and sanitation stood at only US$ 14 million or about US$ 1/capita, one of the lowest levels in Latin America. [ Latinosan 2007 - Conferencia Latinoamericana de Saneamiento: Informe de Guatemala, p. 1 ]

In 1999 investments had been much higher. The WHO estimated them at Quetzales 285.8 million (US$ 37.1). [ Organización Panamericana de la Salud (OPS), OMS. 2000. “Evaluación de los Servicios de Agua Potable y Saneamiento 2000 en las Américas.” Quoted from public investment Branco of the Secretaría de Planificación y Programación de la Presidencia (SEGEPLAN). [http://www.bvsde.paho.org/eswww/eva2000/guatemala/caliserv/calidad.html] ] This represented approximately 0.2% of the Gross Domestic Product and 1.5% of total government expenditures for 1999. [ Organización Panamericana de la Salud (OPS), OMS. 2000. “Evaluación de los Servicios de Agua Potable y Saneamiento 2000 en las Américas.” Quoted from public investment Branco of the Secretaría de Planificación y Programación de la Presidencia (SEGEPLAN). [http://www.bvsde.paho.org/eswww/eva2000/guatemala/caliserv/calidad.html] ] Spending by the central government increased dramatically in the sector, with only US$ 6.07 million spent in 1995 to US$ 56.13 million spent in 1998. [ Organización Panamericana de la Salud (OPS), OMS. 2000. “Evaluación de los Servicios de Agua Potable y Saneamiento 2000 en las Américas.” [http://www.bvsde.paho.org/eswww/eva2000/guatemala/caliserv/calidad.html] ] Investments in the sector lagged far behind other sectors in 1998, especially when taking into consideration the previously small investments made in water and sanitation. For example, spending in each of the sectors of Education, Culture and Sports; Transportation; Defense and Security; and Work and Social Provision, exceeded that of the sector for Water and Sanitation by an average of 900%. [ Organización Panamericana de la Salud (OPS), OMS. 2000. “Evaluación de los Servicios de Agua Potable y Saneamiento 2000 en las Américas.” [http://www.bvsde.paho.org/eswww/eva2000/guatemala/caliserv/calidad.html] ]

Government sponsored investment is channeled through various organizations, including INFOM and UNEPAR, the Ministry of Health, the Social Investment Fund (Fondo de Inversión Social) (FIS), and the National Fund for Peace (Fondo Nacional para la Paz) (FONAPAZ). [ Organización Panamericana de la Salud (OPS), OMS. 2000. “Evaluación de los Servicios de Agua Potable y Saneamiento 2000 en las Américas.” [http://www.bvsde.paho.org/eswww/eva2000/guatemala/caliserv/calidad.html] ] The lack of cohesion amongst these organizations prohibits the coordinated growth and advancement of the water and sanitation sector. Various NGOs directly assist communities, especially in rural areas.

Financing

A large share of the financing for water and sanitation comes from foreign donors. Communities and local governments, however, also make significant contributions in the form of unqualified labor, local materials and cash contributions. For example, under the program "Agua, fuente de paz" initiated in 1992, communities contributed 35% and local governments and other local stakeholders 25% of project costs, with only 40% financed by donors. The program supported 800 rural communities, focusing on those in extreme poverty. [ Latinosan 2007 - Conferencia Latinoamericana de Saneamiento: Informe de Guatemala, p. 6 ]

External support

The main donors currently active in the sector are the Inter-American Development Bank, the German Development Bank (KfW) and NGOs such as CARE (relief) and Agua del Pueblo. Since 1994, the FIS has invested US$ 160 million in water and sanitation projects. [ Inter-American Development Bank. 2003. Guatemala Rural Water and Sanitation Program (GU-0150) Loan Proposal. [http://www.iadb.org/exr/doc98/apr/gu1469e.pdf] ]

Interamerican Development Bank

A US$100,000 technical assistance grant for the [http://www.iadb.org/projects/Project.cfm?project=GU-T1034&Language=English GU-T1034 : Strengthening Office of the Presidential Commissioner for Water] was approved on September 2005.

A loan of $50 million for a [http://www.iadb.org/projects/Project.cfm?project=GU0150&Language=English GU0150 : Rural Water Investment Program] was approved in 2003 for the construction of potable water and sanitation projects to benefit a minimum of 500,000 new rural consumers. Loan components also include institutional strengthening of INFOM and community strengthening.

KfW

KFW supported rural water and sanitation through a series of four projects implemented by UNEPAR and INFOM. The first three projects, executed between 1987 and 1998, benefitted 165 communities in the western and eastern departments at a cost of 28 million Euros. A 2005 evaluation found that about 90% of the water systems were "properly operated and maintained", although only very few water committees disinfected water. The report also states that latrines built with support of the project were in good conditions. [ [http://www.kfw-entwicklungsbank.de/DE_Home/Evaluierung/Weitere_Informationen/Schlussprf90/PDF-Dokumente/guatemala_ldl_wv_sanitaerI.pdf KfW Rural Water and Sanitation Projects 2005 Closing Report] ]

World Bank

The World Bank financed a US$50 million [http://projportal.worldbank.org/servlet/secmain?menuPK=109012&theSitePK=213348&pagePK=112935&piPK=69345&PSPID=P040198 Guatemalan Second Social Investment Fund] loan for community based projects implemented by the Social Fund FIS. The project was approved in 1998 and closed in 2003. It included 14% (US$7 million) dedicated to water and sanitation.

External links

* [http://www.infom.org.gt/ Instituto de Fomento Municipal INFOM]
* [http://www.mspas.gob.gt/ Ministerio de Salud Pública y Asistencia Social]
* [http://www.marn.gob.gt/remodelmarn/index.htm Ministerio de Ambiente y Recursos Naturales]
* [http://www.segeplan.gob.gt/index.php?option=com_content&task=view&id=70&Itemid=108 Secretaria de Planificación y Programación de la Presidencia de la República SEGEPLAN]

Sources

* [http://www.iadb.org/exr/doc98/apr/gu1469e.pdf Inter-American Development Bank 2003]
* [http://www.bvsde.paho.org/eswww/eva2000/guatemala/caliserv/calidad.html Organización Panamericana de la Salud (OPS) 2000]
* [http://www.lib.utexas.edu/benson/lagovdocs/guatemala/federal/presidente/metas/metas-2002.pdf United Nations Development Program 2002]
* [http://www.bvsde.paho.org/muwww/fulltext/ppm/ppmguat.html Centro Panamericano de Ingeniería Sanitaria y Ciencias del Ambiente (CEPIS) 1997]

References


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