Abstract
BackgroundPregnancy is an important life experience that requires uniquely tailored approach to health care. The socio-cultural care practices of indigenous pregnant women (IPW) are passed along the maternal line with respect to identity, worldview and nature. The cultural differences between non-indigenous healthcare professionals (HPs) and IPW could present a great challenge in women’s health care. This article presents an analysis from a human rights and gender perspective of this potential cultural divide that could affect the health of the IPW in an Andean region of Ecuador with the objective of describing the health challenges of IPWs as rights holders through the experiences and perceptions of HP as guarantors of rights.MethodsWe conducted 15 in-depth interviews with HPs who care for IPW in Chimborazo, Pichincha provinces of Ecuador. We utilized a semi-structured interview guide including questions about the experiences and perceptions of HPs in delivering health care to IPW. The interviews were recorded, transcribed and subjected to thematic analysis in Spanish and translated for reporting.ResultsWe found disagreements and discrepancies in the Ecuadorian health service that led to the ignorance of indigenous cultural values. Common characteristics among the indigenous population such as illiteracy, low income and the age of pregnancy are important challenges for the health system. The gender approach highlights the enormous challenges: machismo, gender stereotypes and communication problems that IPWs face in accessing quality healthcare.ConclusionsUnderstanding the diverse perspectives of IPW, acknowledging their human rights particularly those related to gender, has the potential to lead to more comprehensive and respectful health care delivery in Ecuador. Further, recognizing there is a gender and power differential between the provider and the IPW can lead to improvements in the quality of health care delivery and reproductive, maternal and child health outcomes.
Highlights
Pregnancy is an important life experience that requires uniquely tailored approach to health care
The human rights perspective interacts with the gender perspective, which is interested in how women individually make decisions related to their health in a limited range of options derived from gender relations [26]
From the information collected, four themes emerged on the perception and experiences of healthcare professionals (HPs) related to the values, practical behaviors or opinions of indigenous pregnant women: Home versus hospital and health care models The public health system in Ecuador includes home health care in rural areas, which are predominantly home to indigenous communities
Summary
Pregnancy is an important life experience that requires uniquely tailored approach to health care. Incorporating a human rights perspective into the analysis of reproductive and maternal care of IPW could be useful to avoid or reduce gender biases in health care and broaden the context of health to be one that is more holistic [25]. This human rights approach focuses on the fulfillment of health care, including the availability, accessibility, acceptability, quality and relevance of care [24]. This article aims to describe the health care challenges of IPWs as human rights holders through the experiences and perceptions of health professionals (HPs) as guarantors of rights
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