Indigenous Women Managing Pregnancy Complications in Rural Ecuador

Abstract

Previous research has explored the potential use of digital health to support maternal health in the Global South highlighting the importance of understanding the socio-cultural context to inform system design. However, the experiences of indigenous women managing pregnancy complications in Latin America remain underexplored in HCI. We present a qualitative study with 25 indigenous pregnant women in an Ecuadorian rural community looking at their experiences during complications, their antenatal care visits and their access and use of technologies. Our findings highlight key barriers that hinder the use of antenatal care services and influence women's experiences managing complications. Based on the findings, we present opportunities for digital health centered on indigenous women to enhance antenatal care in rural Ecuador.

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

“…In other cases, when the woman's health decisions depended on the husband e.g., family planning methods, delays or refusal by the husband was reported. Machismo and gender stereotypes have been documented as strongly ingrained characteristics of Ecuadorian indigenous culture [21,48]. And it has also been observed that women are more accepting of contraceptive methods than men [49] so empowering women can be the key to avoid unwanted pregnancies [21].…”

“…Machismo and gender stereotypes have been documented as strongly ingrained characteristics of Ecuadorian indigenous culture [21,48]. And it has also been observed that women are more accepting of contraceptive methods than men [49] so empowering women can be the key to avoid unwanted pregnancies [21].…”

“…Additionally the paucity of data for indigenous groups shows that comparisons by ethnic groups can be problematic [5,10]. Health services in Ecuador have not yet properly adapted an intercultural approach despite an improvement in the provision of services in the last few decades [20,21]. The western health care system tends to ignore the need for alternative and indigenous care and prevents women from putting into practice the rituals and practices that are needed for help define own identity [20][21][22].…”

“…Health services in Ecuador have not yet properly adapted an intercultural approach despite an improvement in the provision of services in the last few decades [20,21]. The western health care system tends to ignore the need for alternative and indigenous care and prevents women from putting into practice the rituals and practices that are needed for help define own identity [20][21][22]. The World Health Organization (WHO) recognizes lack of access, delayed used and poor quality of care as determinants of inequalities in health [23,24].…”

“…In addition, IPW should be considered as an autonomous actor with the agency to make decisions based on her own culture and preferences [3]. Discrepancies have been observed between the support that IPWs want and the support that the health system can provide [27] framed as predominantly mestizo healthcare [21].…”