BackgroundStructural and gender violence in Mexico take on various forms, obstetric violence among them. The objective of our study consisted in analyzing experiences of structural and gender discrimination against women during childbirth care at two public hospitals in Mexico.MethodsWe conducted a cross-sectional mixed methods study including a survey of closed questions administered to all women who received health care for vaginal or cesarean childbirth at two public hospitals from May 7 to June 7, 2012 (N = 512). Those who reported some form of abuse on the part of health-care professionals were then invited to complete a semi-structured interview (20 women agreed to participate). In addition, three focus groups were organized with health-care professionals from both institutions (31 participants): two were composed of nurses and one of obstetrician-gynecologists (OB-GYNs). This work deals with the qualitative component of the study.ResultsThe narratives of the health-care professionals interviewed contained expressions of health discrimination relating to certain characteristics of their clients, namely poverty, ignorance, failure to understand instructions and being women. The women, on the other hand, perceived themselves as belonging to a low social class and, as a result, behaved passively with staff throughout their hospital stay. They reported both physical and psychological abuse during care. The first included having their legs manipulated roughly, being strapped to the bed, and being subjected to multiple and careless pelvic examinations. Psychological abuse included reprimands, insults, disrespectful remarks, neglect and scowling gestures when requesting assistance.ConclusionsThe results of our study bear implications for the doctor-client relationship and for the health system in general. They suggest a need to dismantle medical practice – particularly with regard to obstetrics and gynecology - as it has been historically learned and internalized in Mexico. It is imperative to design public policies and strategies based on targeted interventions for dismantling the multiple forms of structural and gender violence replicated daily by actors in the health system.

Objetivo: Diseñar, implementar y evaluar una intervención educativa que contribuya al manejo adecuado de los residuos sólidos urbanos con participación de una comunidad semiurbana, al norte de Cuernavaca, Morelos, México. Material y métodos: Estudio con medición pre y post-intervención educativa, también llamado diseño pre-experimental, con aproximación cuanti-cualitativa. Cuestionario hecho en 27 hogares, 3 grupos focales, 8 entrevistas y creación de un registro etnográfico, de agosto 2010 a mayo 2011. Resultados: Participaron 23 niños/niñas y 14 mujeres de manera directa, en actividades de la intervención. Se incrementó 4,74% el conocimiento sobre manejo de los residuos ( p = 0,036), 4.5% la susceptibilidad percibida ( p = 0,041) y 3.39% los beneficios percibidos ( p = 0,032). La basura se percibe como problema asociado a daños a la salud y medio ambiente. Se identificó a la mujer como responsable del manejo de residuos sólidos. Se favoreció la relación vecinal e incorporación de acciones de separar residuos y barrer las calles con más frecuencia. Conclusiones: Reconocer a la población como guía de acciones en salud es fundamental para el éxito de intervenciones comunitarias. Se recomienda el uso de una metodología participativa en otras propuestas de intervención.