There is no free chronic healthcare in Guatemala. There are free public hospitals but these only are available to essentially treat crises or exacerbatations of chronic conditions. So the system of chronic healthcare is fairly broken, and the clinic where we work plays a small role by providing some free chronic care to residents of Xela and surrounding communities.
There are 4 main levels of care available in Guatemala. The first most local level of care are the “puestos de salud” or health “posts”. These provide very basic services and have two nurses available for nutrition and vaccinations. The second level of care is the “centros de salud”, which provide slightly more comprehensive services including 24 attention for births (I don’t think this is medical attention but care by a midwife or a nurse), as well as vaccinations and a more extensive nutrition program.
The tertiary and quarternary levels of care are the hospitals. The 3rd level includes regional and national public and private (I think?) hospitals that are more generalized. The 4th level is specialty hospitals including hospitals that treat patients with only HIV and tuberculosis, for example.