Abstract
This paper seeks to analyze the problems and barriers encountered when public policy health programs are implemented within indigenous communities. The initial stumbling block for such programs is precisely the idea of health as a universal right, around which emerges a characterization and stereotype of the indigenous population who are consequently addressed as a homogenized unit subsisting below the poverty line, and marginalized. A result of this is that the particular ethno-cultural register of such populations fails to be acknowledged and form part of a systematic public health policy. Consequently, health policies become generalized in character, unable to variate and differentiate according to the culturally specific contexts within which health outreach and access is needed. In this sense, based on the results of an ethnographic study carried out in two Mbya-Guaraní indigenous communities of Argentina, our study highlights as to how public policies of indigenous health are perceived, their impact value measured, and the meanings which emerge locally about the policy practices implemented.Lastly, our study identifies problems that can be avoided in fulfilling the goals of universal policies and certain questions to consider at the time of policy design and implementation.
Highlights
A great stock of research which was developed during the 1930s highlighted crucial differences between the ways in which health-illness processes are perceived by ethnic groups and the way biomedical knowledge is practiced and implemented
In contradisction to the rationale of bio-medicine, it was principally observed that certain ethnic groups did not, and still do not, consider disease as a suffering: diseases were, and are, recognized, yet not evaluated and categorized in the same way as natural scientific medicine (Menéndez, 1997)
What a morbid entity represents for the pathologist and medic, can be strikingly differently to what a disease represents for members of ethnic, indigenous communities. Does this mark a tension between different ways of seeing, and between the natural scientific and cosmological, between medical anthropology and cosmo-anthropology
Summary
A great stock of research which was developed during the 1930s highlighted crucial differences between the ways in which health-illness processes are perceived by ethnic groups and the way biomedical knowledge is practiced and implemented. Numerous national and international instruments emphasize health as a Human Right flagging the discrimination suffered by people who do not have territorial or social access to health services, owing to factors of geography, ethnicity, sex or socio-economic status In this sense, it is the concerted promotion of self- and comanagement of health programs, with culturally respectful actions and solutions which can mark the contemporary and ethical framework of policy, its design and practice. Based on the results of the present research, and the nature of the relationship between the Mbya Population and the body of Official Medicine, we were able to measure the reality of policy impact and how policy resonates in practice with the ethnic population This enabled us to highlight key issues that should be taken into account when health policies or programs are designed and implemented
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