Madres indígenas enfrentan más de tres demoras: Los desafíos de la interculturalidad en salud
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J. Selva Andina Res. Soc.
Abstract
A pesar que la razón de la mortalidad materna en Bolivia descendió de 416 (1989) a 229 (ENDSA 2003) muertas por cada cien mil nacidos vivos, todavía es una de las más altas de la región. Al ser un promedio nacional, oculta diferencias rural-urbanas, socio-económicas y la realidad propia de las poblaciones indígenas. La mortalidad materna es todavía uno de los mayores desafíos a nivel nacional. La reducción de la mortalidad materna, además de las medidas técnicas-clínicas y la oferta de servicios, requiere prestar especial atención a los aspectos socio-culturales que obstaculizan el acceso a los servicios de salud. Este artículo examina los desafíos que las madres indígenas enfrentan para acceder a los servicios de salud. Además de las barreras geográficas, económicas y administrativas que generan demoras en el acceso a los servicios de salud, existen otras que se presenta en el contexto de la interculturalidad que resultan de actitudes discriminatorias ejercidas en los centros de salud. Los testimonios de las madres indígenas evidencian las demoras que se enfrentan en los centros de salud a raíz de prejuicios y discriminaciones sufridas, que ponen en riesgo la vida de las madres y sus bebés. El estudio propone además la necesidad de profundizar lo que significa la interculturalidad como una estrategia acertada en salud, a fin de promover la equidad y la justicia social en el horizonte de sociedades más inclusivas.
Although the maternal mortality ratio has descended in Bolivia from 416 (1989) to 229 deaths (DHS 2003) per one hundred thousand live births, it is one of the highest in the region. As a national average, the ratio conceals the rural-urban, socio-economics differences and the reality of the indigenous population. Maternal mortality is one of the major challenges at national level. Reduction of maternal mortality, in addition of technical-medical measures offering health services, requires to focus on socio-cultural aspects that hamper the access to health services. This article examines challenges faced by indigenous mothers accessing the health services. In addition to the geographic, economic and administrative barriers that generate delays in access to the health services, there are others that are presented in the context of multiculturalism resulting from discriminatory attitudes exercised in health centers. The testimonies of indigenous mothers show delays faced in health centers because of prejudice and discrimination suffered, threatening the lives of mothers and their babies. The study also suggests the need to deepen the concept of multiculturalism as a successful strategy in health, in order to promote equity and social justice on the horizon of more inclusive societies.
Although the maternal mortality ratio has descended in Bolivia from 416 (1989) to 229 deaths (DHS 2003) per one hundred thousand live births, it is one of the highest in the region. As a national average, the ratio conceals the rural-urban, socio-economics differences and the reality of the indigenous population. Maternal mortality is one of the major challenges at national level. Reduction of maternal mortality, in addition of technical-medical measures offering health services, requires to focus on socio-cultural aspects that hamper the access to health services. This article examines challenges faced by indigenous mothers accessing the health services. In addition to the geographic, economic and administrative barriers that generate delays in access to the health services, there are others that are presented in the context of multiculturalism resulting from discriminatory attitudes exercised in health centers. The testimonies of indigenous mothers show delays faced in health centers because of prejudice and discrimination suffered, threatening the lives of mothers and their babies. The study also suggests the need to deepen the concept of multiculturalism as a successful strategy in health, in order to promote equity and social justice on the horizon of more inclusive societies.
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Vol. 6, No. 2