Sandes Luiza Fernandes Fonseca, Freitas Daniel Antunes, de Souza Maria Fernanda Neves Silveira, Leite Kellen Bruna de Sousa
Universidade Estadual de Montes Claros (Unimontes), Faculdade de Medicina, Montes Claros (MG), Brasil.
Departamento de Saúde Mental e Saúde Coletiva, Universidade Estadual de Montes Claros (Unimontes), Montes Claros (MG), Brasil.
Rev Panam Salud Publica. 2018 Oct 4;42:e163. doi: 10.26633/RPSP.2018.163. eCollection 2018.
To review the literature regarding the access to primary health care (PHC) by indigenous communities in South America, identifying the main access barriers.
Integrative review of articles published from 2007 to 2017 in the LILACS, PubMed, and SciELO databases. The search terms "indigenous AND health AND Brazil" and "indigenous AND health NOT Brazil" were used in Portuguese and English. Articles published in English, Portuguese, or Spanish, focusing strictly on PHC and on South-American indigenous populations were included.
Forty articles describing aspects of PHC for indigenous populations in eight countries - Brazil, Peru, Colombia, Bolivia, Argentina, Chile, Paraguay, and Ecuador - were included. The main barriers to accessing PHC were the difficulty of reaching the health care facilities closest to villages; difficulty in communicating with health care professionals; inadequate transportation to the health care units; lack of epidemiological data on indigenous villages; lack of information regarding local indigenous cultures; and fear of discrimination or humiliation on the part of indigenous patients.
Studies regarding the health of indigenous populations in South America are scarce. It is evident that national health systems still need to advance towards an intercultural medicine that respects the social, cultural, and economic realities of all communities, with knowledge and consideration for different forms of care.
回顾有关南美洲原住民社区获得初级卫生保健(PHC)的文献,确定主要的获取障碍。
对2007年至2017年在LILACS、PubMed和SciELO数据库中发表的文章进行综合回顾。使用葡萄牙语和英语的搜索词“原住民与健康与巴西”以及“原住民与健康非巴西”。纳入严格聚焦于初级卫生保健和南美洲原住民人口的英语、葡萄牙语或西班牙语发表的文章。
纳入了40篇描述巴西、秘鲁、哥伦比亚、玻利维亚、阿根廷、智利、巴拉圭和厄瓜多尔八个国家原住民初级卫生保健方面的文章。获得初级卫生保健的主要障碍包括难以到达离村庄最近的卫生保健设施;与卫生保健专业人员沟通困难;前往卫生保健单位的交通不便;缺乏关于原住民村庄的流行病学数据;缺乏关于当地原住民文化的信息;以及原住民患者担心受到歧视或羞辱。
关于南美洲原住民健康的研究稀缺。显然,国家卫生系统仍需朝着一种跨文化医学发展,这种医学要尊重所有社区的社会、文化和经济现实,并具备对不同护理形式的了解和考虑。