Objetivo: comprender los significados que tiene el personal asistencial sobre la influencia que ejerce el contexto de salud y las condiciones laborales en la atención a las madres durante el proceso de parto, en algunos servicios de salud de la ciudad de Medellín en los años 2015-2016. Metodología: estudio de naturaleza cualitativa, usando la metodología propuesta por la teoría fundamentada (TF) de Anselm Strauss y Julieth Corbin. Resultados y conclusión: las relaciones entre el personal asistencial y las gestantes en proceso de parto están enmarcadas en un macrocontexto, como lo es el Sistema de Salud de Colombia, y una perspectiva neoliberal que mercantiliza la vida. El cierre de muchos servicios de maternidad y algunas condiciones laborales difíciles han afectado las relaciones entre el personal de salud y las madres durante el proceso de parto.

Article linked to the research: Meanings of players involved at the moment of the delivery, on the relations established during care in some health services of the public network of the city of Medellín". Objective. This work sought to describe the meanings constructed in the experiences of women in relation to the care received by the healthcare staff at the moment of delivery. Methods. Qualitative study using the procedures proposed by the Grounded theory for data analysis. The sample comprised 18 women over 14 years of age, between 40 days and 6 months postpartum. Twelve of the participants were selected through convenience and to reach saturation of the categories, six more participants were included by using theoretical sampling. Semistructured interviews were conducted in three information collection phases, and said interviews were analyzed line by line by using coding and categorization techniques. Results. The mothers described the parturition experience negatively, perceiving it as the implicit imposition of stoicism to repress their emotions, pain, and discomfort Original article Conflicts ofand prefer an attitude of submission to the health staff. The participating mothers critically conjure up the care received, which translates into procedures performed and verbal and psychological abuse. Conclusion. The mothers assign meanings to their experiences of the delivery process not so much as a transcendent human experience, but rather as a super-experience to the dehumanization of giving birth within the biomedical context.Descriptors: dehumanization; humanizing delivery; parturition; health personnel; women; qualitative research.La deshumanización en el parto: significados y vivencias de las mujeres asistidas en la red pública de MedellínObjetivo. Describir los significados construidos a partir de la experiencia vivida por mujeres en relación con la atención recibida por parte del personal asistencial en el momento del parto. Métodos. Estudio cualitativo que utilizó los procedimientos propuestos por la Teoría Fundada para realizar el análisis de los datos. La muestra estuvo compuesta por 18 mujeres mayores de 14 años, entre 40 días y seis meses de postparto. Doce de las participantes se seleccionaron por conveniencia, y para llegar a la saturación de las categorías, se incluyeron otras seis participantes usando el muestreo teórico. Se realizaron entrevistas semiestructuradas durante tres fases de recolección de información, las cuales se analizaron línea por línea, utilizando técnicas de codificación y categorización. Resultados. Las madres describieron la experiencia del parto de forma negativa, pues la perciben como la imposición implícita del estoicismo para reprimir sus emociones, dolor e incomodidad y prefieren una actitud de sometimiento frente al personal de salud. Las madres evocan la asistencia recibida de manera crítica, la cual se traduce en procedimientos realizados sin consentimiento y maltrato verbal y psicológico. Conclusión. Las madres asignan significados a sus vivencias del proceso de...

Background Abusive and disrespectful treatment of women during childbirth is a critical global issue that threatens women’s sexual rights and reproductive rights and access to quality maternal care. This phenomenon has been documented in Colombia. However, little emphasis has been placed on identifying the drivers of and potential interventions against disrespect and abuse against particularly vulnerable populations in the country, including internally displaced indigenous women. Methods This report is a sub-analysis of a larger project. Semi-structured interviews were conducted with indigenous (Embera) women with childbirth experience (n = 10), maternal healthcare workers (n = 6), and community stakeholders (n = 5) in Medellín, Colombia. Qualitative analysis techniques, consisting of inductive and deductive approaches, were used to identify and characterize the drivers of disrespect and abuse against indigenous women during childbirth and points for intervention. Existing frameworks were adapted to thematically organize drivers and potential solutions into four interrelated subsystems: individual and community factors, clinician factors, facility factors, and national health system factors. Results Participants highlighted disrespect and abuse as stemming from (within the individual and community level) its normalization, lack of autonomy and empowerment among indigenous women, lacking antenatal care, (within the clinician level) prejudice, linguistic or cultural barriers to communication, lack of understanding of indigenous culture, medical culture and training, burnout and demoralization, (within the facility level) inadequate infrastructure, space, and human resources, and (within the national systems level) lack of clear policies and the devaluing of respectful maternity care. They called for interventions specific to these drivers, grounded in dignity and respect for indigenous culture. Conclusion This paper expands upon the growing literature on global mistreatment during childbirth by highlighting drivers of mistreatment and identifying points for intervention in a previously unstudied population. Our data show that indigenous women are especially vulnerable to mistreatment due to cultural and linguistic barriers and prejudice. Broad and meaningful action is urgently needed to realize these women’s rights to respectful maternity care. Interventions must be multifaceted and locally specific, taking into account the needs and wants of the women they serve.

La situación alimentaria de los desconectados de los servicios públicos domiciliarios en la parte alta de la comuna 3 de la ciudad de Medellín * The food situation of people without household utilities connection in the upper section of commune 3 in the city of Medellin A situação alimentar dos desligados dos serviços públicos domiciliares na parte alta da comuna 3 da cidade de Medellín

Los países de la subregión andina Bolivia, Chile, Colombia, Ecuador, Perú y Venezuela, integrados en el Organismo Andino de Salud – Convenio Hipólito Unanue (ORAS – CONHU) elaboraron y aprobaron mediante Resolución REMSAA XXXIII/474 del 23 de Noviembre de 2012, la Política Andina de Planificación y Gestión de Recursos Humanos en Salud y la implementación de su Plan de Acción 2013 – 2017.