Objectives. Identify the barriers that cause delays in the route of obstetric care in pregnant women of Yaxkukul, Yucatán, from January 2016 to May 2018. Methodology. Observational, descriptive, cross-sectional and retrospective study. Pregnant women who attended prenatal control at the rural health center of Yaxkukul were interviewed and reviewed their clinical record. Sociodemographic characteristics, prenatal control were studied and the critical route of obstetric care was described, under the model of the three delays. Percentages, measures of central tendency and dispersion were calculated; as well as square chi to look for association between delays and maternal morbidity. A 95% confidence level and a value of p <0.05 were used. Contribution. The present study contributes to the prevention of maternal and perinatal mortality. Knowing the barriers that cause delays in care can identify deficiencies in the obstetric emergency protocol established in rural health units, to improve the quality of obstetric care.

Las inequidades de género y de salud, como la violencia en el embarazo y la falta de acceso a cuidados médicos, ponen en riesgo a las mujeres cuando buscan ayuda en sus comunidades y tienen que ser trasladadas hasta llegar al hospital. Los motivos por los que esto sucede pueden ser estudiados bajo el modelo de las tres demoras, que implican el tiempo requerido para, a) tomar una decisión de búsqueda de atención, b) acceder a un sitio donde obtenerla, y c) conseguir la asistencia médica requerida. El objetivo de este trabajo fue describir inequidades de género y de acceso a la atención de la salud de las mujeres embarazadas de comunidades rurales de Yucatán, México. Se realizó un estudio descriptivo, retrospectivo, transversal. Se entrevistaron 247 embarazadas, de las cuales, 29.2 % presentaron la primera demora, 17.8 % la segunda y 53.0 % la tercera. Se refirieron 421 obstáculos como barreras que llevaron a demoras. El mayor número de obstáculos (253) correspondieron a la tercera demora, donde destacaron el tratamiento médico inadecuado e inoportuno y la falta de criterios médicos para ingreso (52.7 % y 43.5 %, respectivamente). La primera y segunda demora registraron incidencias de morbilidad de 61.1 % y 59.1 %, respectivamente. La incidencia de la tercera fue de 76.3 % y fue significativamente (P < 0.05) superior a las otras dos. La violencia económica estuvo presente en 53 % de los casos. Es fundamental reorganizar el sistema de salud materna para reducir las barreras que causan demoras en la atención, sobre todo en la tercera demora, que está relacionada con la calidad del servicio.

Community perceptions and practices towards the disease are mainly influenced by traditional medicine. The intercultural perspective in health allows building symmetrical relationships between medical and traditional knowledge. One of the most vulnerable group is under five years age. Exploring the perceptions and practices of mothers and caregivers on the disease and care of children can guide towards better health practices. Objective. Describe the perceptions and practices of mothers about the main health problems of their children during an emergency. Methodology. Quantitative-qualitative study, participatory action-research type with an intercultural perspective. Question guide was prepared for the exchange of knowledge with the focus group technique. Through inductive analysis of the transcripts, themes emerged. Results. Thirty-one mothers and caregivers attended the workshops. There were 48.6% emergencies due to diarrhea, fever and accidents. Home remedies, lack of hygiene in homes and lack of doctors on weekends were noted. Conclusions. Emergencies in children occured in almost half of the morbidity cases in the community studied. A new regionalization is necessary to reduce health gaps for children under five years of age.

Objective. To identify main environmental hazards to which pregnant women in Kinil, Yucatan are exposed. Methodology. Cross-sectional study consisting of two parts: 1) review of clinical archieves of women who received prenatal care from 2015 to 2017, registered in the Pregnancy Census of the Kinil Health Center, to obtain prenatal medical records, data on babies and perinatal conditions of their births; 2) the patients were visited in their homes to explain the objective of the study and request the pertinent permits with informed consent, as well as the caregivers in the case of minors. The frequency of major diseases during pregnancy was determined, as well as the prevalence of adverse perinatal outcomes. Contribution. Approach to environmental diagnosis, identify potential sources of risks of disease, characterize positive or negative situations to detect groups in vulnerable situations.