Social representations of the health care of the Mbyá-Guarani indigenous population by health workers.

Mirian Benites Falkenberg,Helena Eri Shimizu,Ximena Pamela Díaz Bermudez

doi:10.1590/1518-8345.1505.2846

Mirian Benites Falkenberg, Helena Eri Shimizu + Show 1 more

Open Access

https://doi.org/10.1590/1518-8345.1505.2846

Copy DOI

Abstract

ABSTRACTObjective:to analyze the social representations of health care of the Mbyá-Guarani ethnic group by multidisciplinary teams from the Special Indigenous Health District in the south coast of Rio Grande do Sul state (Distrito Sanitário Especial Indígena Litoral Sul do Rio Grande do Sul), Brazil. Method:a qualitative method based on the theory of social representations was used. Data were collected via semi-structured interviews with 20 health workers and by participant observation. The interviews were analyzed with ALCESTE software, which conducts a lexical content analysis using quantitative techniques for the treatment of textual data. Results:there were disagreements in the health care concepts and practices between traditional medicine and biomedicine; however, some progress has been achieved in the area of intermedicality. The ethnic boundaries established between health workers and indigenous peoples based on their representations of culture and family, together with the lack of infrastructure and organization of health actions, are perceived as factors that hinder health care in an intercultural context. Conclusion:a new basis for the process of indigenous health care needs to be established by understanding the needs identified and by agreement among individuals, groups, and health professionals via intercultural exchange.

Highlights

Indigenous health care in Brazil is conducted within the framework of the indigenous health care subsystem created by Law No 9,836/1999 in partnership with the Unified Health System (Sistema Único de Saúde – SUS)
This study addresses various concepts of health, disease, and indigenous health care by evaluating how health workers who are trained in biomedicine, who have disease as a guiding principle of their practices, and who are aided by indigenous workers represent health care at the intersection between two distinct medical systems, biomedicine and the Mbyá-Guarani traditional indigenous medicine
This study focused on the analysis of the contents of social representations brought by health workers and attempted to identify, whenever possible, the anchoring and objectification processes that are considered fundamental in the formation of social representations

Summary

Introduction

Indigenous health care in Brazil is conducted within the framework of the indigenous health care subsystem created by Law No 9,836/1999 in partnership with the Unified Health System (Sistema Único de Saúde – SUS). The subsystem is structured to include 34 Special Indigenous Health Districts (SIHDs). Indigenous health care at the primary care level is practiced by members of indigenous health multidisciplinary teams (IHMTs). These teams consist of non-indigenous health professionals, physicians, nurses, dentists, dietitians, and nursing technicians, among others. The teams include workers known as Indigenous Health Agents (IHAs) and Indigenous Sanitation Agents (ISAs) who are selected or nominated by their communities and trained to work to support health activities. One of the main tasks of these workers is the translation and interpretation of traditional language and knowledge among non-indigenous professionals. IHAs have been the main link between scientific knowledge and the popular knowledge of indigenous communities

Objectives

Methods

Results

Conclusion