Research Group on Food and Human Nutrition (GIANH), Faculty of Public Health, Higher Polytechnic School of Chimborazo, Pan-American Sur Km 1 1/2, Riobamba, Ecuador.
School of Computer Science and Informatics, Human-centered Computing Group, Cardiff University, Cardiff, UK.
BMC Pregnancy Childbirth. 2022 Feb 4;22(1):101. doi: 10.1186/s12884-022-04432-5.
Pregnancy is an important life experience that requires uniquely tailored approach to health care. The socio-cultural care practices of indigenous pregnant women (IPW) are passed along the maternal line with respect to identity, worldview and nature. The cultural differences between non-indigenous healthcare professionals (HPs) and IPW could present a great challenge in women's health care. This article presents an analysis from a human rights and gender perspective of this potential cultural divide that could affect the health of the IPW in an Andean region of Ecuador with the objective of describing the health challenges of IPWs as rights holders through the experiences and perceptions of HP as guarantors of rights.
We conducted 15 in-depth interviews with HPs who care for IPW in Chimborazo, Pichincha provinces of Ecuador. We utilized a semi-structured interview guide including questions about the experiences and perceptions of HPs in delivering health care to IPW. The interviews were recorded, transcribed and subjected to thematic analysis in Spanish and translated for reporting.
We found disagreements and discrepancies in the Ecuadorian health service that led to the ignorance of indigenous cultural values. Common characteristics among the indigenous population such as illiteracy, low income and the age of pregnancy are important challenges for the health system. The gender approach highlights the enormous challenges: machismo, gender stereotypes and communication problems that IPWs face in accessing quality healthcare.
Understanding the diverse perspectives of IPW, acknowledging their human rights particularly those related to gender, has the potential to lead to more comprehensive and respectful health care delivery in Ecuador. Further, recognizing there is a gender and power differential between the provider and the IPW can lead to improvements in the quality of health care delivery and reproductive, maternal and child health outcomes.
怀孕是一项重要的人生经历，需要针对其健康护理提供独特的方法。土著孕妇（IPW）的社会文化护理实践是通过身份、世界观和自然沿着母系传承的。非土著医疗保健专业人员（HPs）与 IPW 之间的文化差异可能会对妇女的医疗保健带来巨大挑战。本文从人权和性别角度分析了这种潜在的文化鸿沟，这种文化鸿沟可能会影响厄瓜多尔安第斯地区的 IPW 的健康，旨在通过 HP 作为权利保障者的经验和看法来描述 IPW 作为权利持有者的健康挑战。
我们在厄瓜多尔钦博拉索省和皮钦查省对为 IPW 提供护理的 HPs 进行了 15 次深入访谈。我们使用了半结构化访谈指南，其中包括有关 HPs 为 IPW 提供医疗保健的经验和看法的问题。访谈以西班牙语进行了记录、转录，并进行了主题分析，并翻译成英文进行报告。
我们发现厄瓜多尔卫生服务存在分歧和差异，导致忽视了土著文化价值观。土著人口的共同特征，如文盲、低收入和怀孕年龄，是卫生系统面临的重要挑战。性别方法强调了巨大的挑战：大男子主义、性别刻板印象和 IPW 在获得优质医疗保健方面面临的沟通问题。
了解 IPW 的不同观点，承认他们的人权，特别是与性别有关的人权，有可能导致在厄瓜多尔提供更全面和尊重的医疗保健。此外，认识到提供者和 IPW 之间存在性别和权力差异，可以改善医疗保健的提供质量和生殖、孕产妇和儿童健康结果。
