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      Salud intercultural y el modelo de salud propio indígena Translated title: Intercultural health and the indigenous health model

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          Abstract

          RESUMEN La población indígena tiene condiciones de vida inferiores al resto, reflejadas en mayor morbilidad y mortalidad a pesar de la cobertura del Sistema de Salud. Por ello, es importante conocer las causas de estas diferencias. Para esto, se hace uso de la interculturalidad como puente entre la cultura occidental y la cultura indígena. En este encuentro de saberes se identifica el modelo de salud indígena como respuesta cultural a la necesidad de mantener la salud y tratar la enfermedad, un modelo organizado jerárquicamente en el que la salud del individuo depende además de sus hábitos, de la armonía con la naturaleza, el espíritu, los dioses y su comunidad. Este modelo había sido menospreciado hasta hace poco tiempo por la comunidad científica; pero, gracias a los estudios en interculturalidad, se sabe que la salud también debe ser intercultural y que las políticas públicas deben incluirla para poder obtener los resultados esperados en la comunidad objetivo. Para hacer realidad estas políticas públicas debe haber voluntad y agenda política, una adecuada estructura en los servicios de salud y formación de los profesionales de la salud en interculturalidad desde sus estudios técnicos, tecnológicos, profesionales y de posgrado. Esas políticas públicas deben contener: capacitación, empleo de la lengua indígena local, alimentación y equipamiento con elementos tradicionales, diálogo respetuoso con los médicos tradicionales, atención humanizada, entre otros. Así se brinda una atención en salud de calidad que respeta las diferencias culturales de toda la población.

          Translated abstract

          ABSTRACT The indigenous population has lower living conditions reflected in higher morbidity and mortality despite the coverage of the Health System, so it is important to know the causes of these differences. For this, Interculturality is used as a bridge between western culture and indigenous culture. In this meeting of knowledge, the indigenous health model is identified as a cultural response to the need to maintain health and treat disease, a hierarchically organized model in which the health of the individual also depends on their habits, on harmony with nature, the spirit, the gods and their community. Until recently, this model had been undervalued by the scientific community, but thanks to studies in Interculturality, it is known that health must also be intercultural and that public policies must include it in order to obtain the expected results in the target community. To make these public policies a reality, there must be a will and a political agenda, an adequate structure in the health services and training of health professionals in interculturality from their technical, technological, professional and postgraduate studies. These public policies must contain training, use of the local indigenous language, food and equipment with traditional elements, respectful dialogue with traditional doctors, humanized care, among others. This provides quality health care that is respectful of cultural differences to the entire population.

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          Etnogubernamentalidad: La formación del campo de la salud intercultural en Chile

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            O desafio da atenção primária na saúde indígena no Brasil

            RESUMO No Brasil, o direito à saúde pleiteado pelos povos indígenas dialoga com diferentes marcos regulatórios, incluindo a Declaração de Alma-Ata, a qual propõe e valoriza a atenção primária à saúde (APS) como promotora de maior acesso e forma de minimizar as desigualdades em saúde. No âmbito do Sistema Único de Saúde (SUS), o subsistema de atenção à saúde indígena (SASI) e a Política de Atenção à Saúde dos Povos Indígenas (PNASPI) foram criados como estratégia para garantir o acesso à saúde aos povos indígenas. A PNASPI prevê atenção diferenciada às populações indígenas com base na diversidade sociocultural e nas particularidades epidemiológicas e logísticas desses povos e focando no desenvolvimento da APS com garantia de integralidade da assistência. O presente artigo traz reflexões acerca da implementação da PNASPI, destacando os avanços e desafios apresentados durante esse percurso. Apesar dos crescentes recursos financeiros disponibilizados para implementar o subsistema de saúde indígena, as ações têm apresentado poucos resultados nos indicadores de saúde, que refletem desigualdades historicamente descritas entre esses povos e os demais segmentos. A participação social ainda se mantém frágil, e suas discussões refletem a insatisfação dos usuários. A descontinuidade do cuidado somada à carência e alta rotatividade de profissionais, assim como a necessidade de estabelecer diálogos interculturais que promovam a articulação com saberes tradicionais, são fatores que desafiam a efetividade da PNASPI. O cuidado ainda é centrado em práticas paliativas e emergenciais, geralmente baseado na remoção de pacientes, gerando altos custos. A superação desses desafios depende do fortalecimento da APS e de seu reconhecimento enquanto importante marco regulador do modelo organizacional da PNASPI.
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              Intercultural health and ethnobotany: how to improve healthcare for underserved and minority communities?

              The present conceptual review explores intercultural healthcare--defined as the integration of traditional medicine and biomedicine as complementary healthcare systems--in minority and underserved communities. This integration can take place at different levels: individuals (patients, healers, biomedical healthcare providers), institutions (health centers, hospitals) or society (government policy). Contemporary ethnobotany research of traditional medicine has primarily dealt with the botanical identification of plants commonly used by local communities, and the identification of health conditions treated with these plants, whereas ethnopharmacology has focused on the bioactivity of traditional remedies. On the other hand, medical anthropology seems to be the scholarship more involved with research into patients' healthcare-seeking itineraries and their interaction with traditional versus biomedical healthcare systems. The direct impact of these studies on public health of local communities can be contested. To compare and discuss the body of scholarly work that deals with different aspects of traditional medicine in underserved and minority communities, and to reflect on how gaps identified in research can be bridged to help improve healthcare in these communities. The literature covers a broad range of information of relevance to intercultural healthcare. This information is fragmented across different scientific and clinical disciplines. A conceptual review of these studies identifies a clear need to devote more attention to ways in which research on traditional medicine can be more effectively applied to improve local public health in biomedical resource-poor settings, or in geographic areas that have disparities in access to healthcare. Scholars studying traditional medicine should prioritize a more interdisciplinary and applied perspective to their work in order to forge a more direct social impact on public health in local communities most in need of healthcare. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.
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                Author and article information

                Journal
                rsap
                Revista de Salud Pública
                Rev. salud pública
                Instituto de Salud Publica, Facultad de Medicina - Universidad Nacional de Colombia (Bogotá, DF, Colombia )
                0124-0064
                August 2020
                : 22
                : 4
                : e187320
                Affiliations
                [1] Cali Valle del Cauca orgnameUniversidad del Valle Colombia mirlelly.aguilar@ 123456correounivalle.edu.co
                [3] Cali Valle del Cauca orgnameUniversidad del Valle orgdiv1Escuela de Medicina orgdiv2Departamento de Cirugía/Urología Colombia herney.garcia@ 123456correounivalle.edu.co
                [2] Cali orgnameEscuela de Salud Pública Colombia maria.f.tobar@ 123456correounivalle.edu.co
                Article
                S0124-00642020000401104 S0124-0064(20)02200401104
                10.15446/rsap.v22n4.87320
                5fe64fb9-cbf7-4ae0-9f9a-2e7c82ab22fc

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 30 June 2020
                : 15 May 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 24, Pages: 0
                Product

                SciELO Colombia

                Categories
                Revisión

                Latin America,política pública (fuente: DeCS, BIREME),medicine, traditional,Asistencia sanitaria culturalmente competente,public policy (source: MeSH, NLM),América Latina,servicios de salud del indígena,medicina tradicional,Culturally competent care,health services, indigenous

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