Indigenous mothers face more than three delays: The challenges of multiculturalism in health

Abstract

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.