Reproductive medicine in northwest Argentina: traditional and institutional systems

<p>Abstract</p> <p>Background</p> <p>The state of conservation of the traditional cultures of Northwest Argentina is variable and somewhat problematic but to a lesser or a greater extent all the peoples are related to an hegemonic culture. We present a case study carried out in the rural communities of the Yungas biome (Salta) where the extent of isolation varies as does the type of access to public health services. The use of medicinal plants in the area is ordinary and widely spread.</p> <p>Methods</p> <p>The data can be organized in two categories, as medical systems public records (for the regional hospital at Los Toldos), and as ethnobotanical sets. A total of 59 surveys to 40 interviewees were undertaken using a semi structured questionnaire. We present an analysis of the relative importance of the medicinal herbs used in reproductive medicine considering the plants used in the traditional medical system and the factors that can affect the relationship between formal medicine and patients. We further analized how the degree of accessibility to the local hospital influences the diversity of use of plant species used to assist deliveries and to decrease infant mortality in children minor than one year of age.</p> <p>Results</p> <p>In reproductive medicine, 13 ailments and/or different physiological states are locally identified and treated. Local population uses 108 ethnospecies for this kind of illnesses. According to the local conception the hot/cold imbalance could be the principal cause for reproductive illnesses; pregnancy may have natural or supernatural origin, post partum and menstruation involve similar sanitary risks, and neonatal care has a strong magic connotation. In relation with the formal medicine, the more accessible is the health center the more women assist to it. We have not found a relation between accessibility and infant mortality.</p> <p>Conclusion</p> <p>In the local reproductive medicine, most of the practices are concerned with the hot/cold balance. According to their importance the factors involved are: the family medicine, the midwife, and the formal doctors. Plants have an important role; however there is a lack of total agreement among the families who use them. Reluctance to institutional deliveries may be due to the weak relationship between patients and doctors, and the lack of logistic assistance to delivering mothers coming from far away locations.</p

The Freelisting Method

A freelist is a mental inventory of items an individual thinks of within a given category. Freelists reveal cultural " salience " of particular notions within groups, and variation in individuals' topical knowledge across groups. The ease and accuracy of freelist interviewing, or freelisting, makes it ideal for collecting data on health knowledge and beliefs from relatively large samples. Successful freelisting requires researchers to break the research topic into honed categories. Research participants presented with broad prompts tend to " unpack " mental subcategories and may omit (forget) common items or categories. Researchers should find subdomains to present individually for participants to unpack in separate smaller freelists. Researchers may focus the freelist prompts through successive freelisting, pile sorts, or focus group-interviews. Written freelisting among literate populations allows for rapid data collection, possibly from multiple individuals simultaneously. Among nonliterate peoples, using oral freelists remains a relatively rapid method; however, interviewers must prevent bystanders from " contaminating " individual interviewees' lists. Researchers should cross-check freelist responses with informal methods as much as practicable to contextualize and understand the references therein. With proper attention to detail, freelisting can amass high quality data on people's medical understanding, attitudes, and behaviors