Healthcare professionals’ experiences and perceptions regarding health care of indigenous pregnant women in Ecuador

Abstract

Background 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. Methods 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. Results 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. Conclusions 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.

Adherencia a la atención prenatal en el contexto sociocultural de países subdesarrollados: una revisión narrativa

“…La presente revisión nos permite evidenciar que, a la Adherencia a la atención prenatal en el contexto sociocultural de países subdesarrollados: una revisión narrativa Horiz Med (Lima) 2023; 23(4): e2252 fecha, existen brechas socioculturales que se arrastran de siglos atrás y no han podido erradicarse, especialmente en países en vías de desarrollo, como el machismo, problema que ocasiona en la mujer estados de depresión y un déficit de empoderamiento, y genera una disminución en la toma de las propias decisiones; por otra parte, en las familias repercute directamente sobre el bebé, dado que se forma un rechazo afectivo hacia él (46) ; mientras que, en lo concerniente a la sociedad, genera que las mujeres busquen ayuda para su supervivencia, sin encontrar respuesta alguna (47)(48)(49)(50) . Asimismo, las brechas educativas en la mujer, como el bajo nivel de instrucción, el desconocimiento de la atención prenatal y la falta de conocimiento sobre salud sexual y reproductiva, la sitúan en un nivel bajo de empoderamiento en la sociedad, tanto desde el punto de vista económico como en la toma de decisiones dentro de la familia y la comunidad (1,51,52) .…”