Mapuche health experiences in Primary Health Care from health workers and users in urban Chile

This study describes experiences and perceptions on interculturality in Primary Health Care (PHC) from the perspective of health workers and Mapuche health users. For this purpose, a qualitative systematization of these experiences was carried out in a PHC Intercultural Health Program at an urban commune in Chile. Data were collected by means of individual and group interviews, respectively, with 19 users and 13 professionals. The semantic content analysis was performed. While service users perceive Mapuche health positively, assimilating it to the concept of interculturality, health workers reported that Mapuche health is respected but no integrated work is promoted. As barriers, participants cited administrative aspects, lack of integration, and scientific issues. In conclusion, recognition of indigenous health and greater occupational training on indigenous health and interculturality is necessary.Este estudio describe experiencias y percepciones sobre interculturalidad en Atención Primaria de Salud (APS) desde la perspectiva de trabajadores/as y usuarios/as de salud mapuche. Se realizó una sistematización cualitativa de experiencias de un Programa de Salud Intercultural en APS en una comuna urbana de Chile. Participaron 19 usuarios/as y 13 trabajadores/as en entrevistas individuales y tres entrevistas grupales, respectivamente. Se realizó un análisis de contenido semántico. Para los participantes, la salud mapuche es percibida positivamente, los/as usuarios/as la asimilan al concepto de interculturalidad, mientras que los/as trabajadores/as señalan que, si bien se respeta, no se promueve un trabajo integrado. Los/las participantes identifican como barreras aspectos administrativos, falta de integración y cuestionamientos científicos. Se requiere reconocimiento de la salud indígena y mayor formación de trabajadores/as sobre salud indígena e interculturalidad

Rehabilitación Basada en la Comunidad (RBC) en centros de atención primaria en Chil

OBJECTIVE: To describe the implementation status of the Community-Based Rehabilitation in Chile. METHODS: Quantitative, transversal and descriptive study. The scope was constituted by the 66 community-based rehabilitation centers in the Chilean Metropolitan Region that implemented Community-Based Rehabilitation until December 2016. The sampling was based on a census method, so all the community centers were contacted. A self-administered questionnaire designed based on the Community-Based Rehabilitation matrix defined by the World Health Organization was applied. The questionnaire was answered on-line by the coordinators of the strategy in their respective centers. The data analysis was performed using descriptive statistics. RESULTS: A heterogeneous level of implementation of Community-Based Rehabilitation was identified, specifically in terms of the components of the matrix described by the World Health Organization. The most implemented component was Health; the Social, Livelihood and Empowerment components were moderately implemented; and the Education component was the least implemented. CONCLUSION: The implementation of Community-Based Rehabilitation is mainly based on the Health component. The level implementation of the other components of the matrix needs to be increased, as well as interdisciplinary and intersectoral strategies to achieve greater social inclusion of people with disabilities.OBJETIVO: Describir el estado de implementación de la Rehabilitación Basada en la Comunidad en Chile. MÉTODOS: Estudio cuantitativo, transversal y descriptivo. El universo estuvo conformado por los 66 centros comunitarios de rehabilitación de la Región Metropolitana de Chile que implementaron la Rehabilitación Basada en la Comunidad hasta diciembre de 2016. El muestreo tuvo intención censal, por lo que se contactaron todos los centros comunitarios. Se aplicó un cuestionario autoadministrado diseñado con base a la matriz de Rehabilitación Basada en la Comunidad definida por la Organización Mundial de la Salud. El cuestionario fue respondido on-line por los coordinadores de la estrategia en sus respectivos centros. El análisis de datos se realizó utilizando estadígrafos descriptivos. RESULTADOS: Se identificó un nivel heterogéneo de implementación de la Rehabilitación Basada en la Comunidad, específicamente en cuanto a los componentes de la matriz descrita por la Organización Mundial de la Salud. El componente más implementado fue Salud; los componentes Social, Subsistencia y Fortalecimiento fueron medianamente implementados; y el componente Educación fue el menos implementado. CONCLUSIÓN: La implementación de la Rehabilitación Basada en la Comunidad se basa principalmente en el componente Salud. Se requiere aumentar el nivel de implementación de los otros componentes de la matriz, así como de estrategias interdisciplinarias e intersectoriales para lograr una mayor inclusión social de las personas con discapacidad

Experiencias de salud mapuche en Atención Primaria de Salud desde trabajadores sanitarios y usuarios/as en zona urbana de Chile

This study describes experiences and perceptions on interculturality in Primary Health Care (PHC) from the perspective of health workers and Mapuche health users. For this purpose, a qualitative systematization of these experiences was carried out in a PHC Intercultural Health Program at an urban commune in Chile. Data were collected by means of individual and group interviews, respectively, with 19 users and 13 professionals. The semantic content analysis was performed. While service users perceive Mapuche health positively, assimilating it to the concept of interculturality, health workers reported that Mapuche health is respected but no integrated work is promoted. As barriers, participants cited administrative aspects, lack of integration, and scientific issues. In conclusion, recognition of indigenous health and greater occupational training on indigenous health and interculturality is necessary.Este estudio describe experiencias y percepciones sobre interculturalidad en Atención Primaria de Salud (APS) desde la perspectiva de trabajadores/as y usuarios/as de salud mapuche. Se realizó una sistematización cualitativa de experiencias de un Programa de Salud Intercultural en APS en una comuna urbana de Chile. Participaron 19 usuarios/as y 13 trabajadores/as en entrevistas individuales y tres entrevistas grupales, respectivamente. Se realizó un análisis de contenido semántico. Para los participantes, la salud mapuche es percibida positivamente, los/as usuarios/as la asimilan al concepto de interculturalidad, mientras que los/as trabajadores/as señalan que, si bien se respeta, no se promueve un trabajo integrado. Los/las participantes identifican como barreras aspectos administrativos, falta de integración y cuestionamientos científicos. Se requiere reconocimiento de la salud indígena y mayor formación de trabajadores/as sobre salud indígena e interculturalidad

Ethnicity and health: experience with an urban mapuche health program from the perspective of key actors

This article explores the relationships and tensions between ethnicity and health, describing the perspectives of various social actors on a Mapuche clinic in the context of a national health program. A qualitative methodology was used to carry out this case study of the Mapuche clinic "La Ruka," located in an urban area of the Metropolitan Region of Chile. The study analyzes the narratives of traditional health practitioners (including a machi, lawentuchefe, lonko, and intercultural facilitator), consumers, conventional healthcare professionals, and local health authorities and community leaders who share a physical, political, and symbolic space around the Mapuche health experience. The systemization of experiences method was applied to the data, acquired through nonparticipant observation, individual interviews, and focus groups. The results suggest that this healthcare experience is highly valued by its protagonists. However, there is a tension surrounding cultural diversity programs that recognize non-Western approaches to healing, such as indigenous practices. This study examines the health-related, cultural, and political tensions involved in projecting indigenous traditions into a homogenizing space such as healthcare in a multicultural neoliberalism system

Community-based rehabilitation (CBR) in primary care centers in Chile

OBJECTIVE: To describe the implementation status of the Community-Based Rehabilitation in Chile. METHODS: Quantitative, transversal and descriptive study. The scope was constituted by the 66 community-based rehabilitation centers in the Chilean Metropolitan Region that implemented Community-Based Rehabilitation until December 2016. The sampling was based on a census method, so all the community centers were contacted. A self-administered questionnaire designed based on the Community-Based Rehabilitation matrix defined by the World Health Organization was applied. The questionnaire was answered on-line by the coordinators of the strategy in their respective centers. The data analysis was performed using descriptive statistics. RESULTS: A heterogeneous level of implementation of Community-Based Rehabilitation was identified, specifically in terms of the components of the matrix described by the World Health Organization. The most implemented component was Health; the Social, Livelihood and Empowerment components were moderately implemented; and the Education component was the least implemented. CONCLUSION: The implementation of Community-Based Rehabilitation is mainly based on the Health component. The level implementation of the other components of the matrix needs to be increased, as well as interdisciplinary and intersectoral strategies to achieve greater social inclusion of people with disabilities.Fondo Nacional de Investigacion y Desarrollo en Salud (FONIS) Comision Nacional de Investigacion Cientifica y Tecnologica (CONICYT) SA15I2012