Childhood primary health care in the Araucania region: Mothers' and providers' concerns

Date of Completion

January 2004

Keywords

Anthropology, Cultural|Health Sciences, Public Health

Degree

Ph.D.

Abstract

This is an ethnographic needs assessment for culturally competent primary health care for Chilean and Mapuche children in the Araucania region. This region lies 700 kilometers south from Chile's capitol city, Santiago, and its population consists of 800,000 inhabitants, 200,000 of which are Mapuche people who live mainly in rural communities. ^ The research methodology combines qualitative and quantitative methods of data collection and analysis. A sample of 137 mothers and health care givers provide information regarding children's health problems, the process of providing and obtaining health care delivery, and their suggestions for improving children's health care delivery in the Araucania region. ^ By using consensus analysis procedure, the results reveal that mothers and health providers share a common pattern of cognition and behavior regarding the assessment of primary health care in the region. Mothers and providers agree that respiratory diseases are the main health problems among children and that the first therapeutic resource in dealing with children's diseases is the mothers' empirical knowledge. Another source of agreement among participants is the perception that health care delivery is not culturally appropriate to the mothers' ethnicity, culture, and geographic origin. However, despite these weaknesses, participants recognize the existence of an acceptable human and professional interaction between mothers and health providers. The main concern of all participants is the lack of human and financial resources of the primary health care system in the region, especially in the rural areas. ^ The presence of intracultural variation within this general consensus, detected through factor analysis, shows that some participants emphasize the strengths of the health care system, while others, emphasize its weaknesses. Regression models detected that participants who hold positive opinions of the healthcare system tend to be young urban mothers, while those who report weaknesses tend to be participants with more educational attainment. ^ The results of this study provide important insights into improvements in the primary health care system. For example, the necessity of improving the intercultural communication skills of health care providers, tackling rural poverty through health development projects, and increasing the effectiveness of healthcare delivery in the rural areas of the Araucania region. ^

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