Sexual and reproductive health and rights of Aymara women in the intercultural health system in Chile / Salud y derechos sexuales y reproductivos de las mujeres Aymara en el sistema de salud intercultural de Chile

Abstract

This investigation seeks to understand how Aymara women navigate their sexual and reproductive health and rights (SRHR) in Chile’s intercultural health care model. Indigenous communities have their own practices that complicate the provision of sexual and reproductive health by requiring health care providers to be aware of two different worldviews and how they may conflict, as well as what is necessary to provide respectful care. However, an ethnically and culturally pertinent framework is vital to actually assuring successful SRHR provision, whose tenants include autonomous choice and care free of discrimination, coercion or violence. These interactions were investigated through semi-structured interviews of 14 Aymara women from Putre, Chile and 3 of their health care professionals on various SRHR topics with a focus on birth and pregnancy. The women were aged 27-61 and had many different, unique experiences and relationships with their pregnancies. They used a wide range of contraceptive methods and many sought attention from both Aymara and Western doctors for prenatal exams. They had an average of 2.86 births(SD 1.5), with a range of 1-7 births. Of the participants, 50% had at least one of their births in a house either alone or with the help of a midwife and 85.8% had given birth at least once in a hospital. There was a 64%preference of home births to hospital births, although many also mentioned that the hospital offered safer and more hygienic care in case of complications. Women reported the need for more midwifery attention in hospitals and more respect and patience in the care they receive from doctors. They also conveyed that they would prefer to be able to give birth in their homes or at least at the consultorio in Putre. The results of this study suggest that while the infrastructure is present to provide ethnically competent SRHR to Aymara women in Putre, there are still gaps in its provision and execution, especially in regards to birth. The suggestions of the participants about how to improve their attention and birth care should be considered and listened to in order to improve the quality of intercultural care.