Traditional and biomedical maternal and neonatal care practices in a rural Indigenous population of the Bolivian Amazon

ABSTRACT

In recent decades, Bolivia has expanded maternal and child health insurance coverage to improve access to prenatal and early life health care. Nationally, however, maternal and child health disparities persist along a rural-urban divide. Research is needed among rural populations to better understand local barriers to health care access and usage. Particularly among Indigenous populations, disparities may be compounded by differences in preferences for and access to traditional versus biomedical health care. We examined prenatal care and birth practices among Tsimane forager-farmers of El Beni, Bolivia. From 2012-2013, we interviewed 151 Tsimane mothers (0-35 months postpartum) from nine villages about birth and neonatal care practices, prenatal care, and pharmaceutical usage during labour and postpartum recovery. Results demonstrate local disparities in biomedical care usage by ease of access (e.g. proximity to market town, Spanish fluency), and maternal experience (e.g. parity and prior offspring death or miscarriage). While 59% of interviewed mothers had received at least one prenatal screening, services performed in screenings were limited. Nearly all women continue to birth at home with family assistance. Inconsistent access to health care services may be exacerbated by regional, generational, and educational disparities within the population.

KEYWORDS:

• Indigenous health
• traditional medicine
• prenatal care
• birth practices
• health disparities

Acknowledgements

We would like to thank our host villages and families that participated in this study. Geni Garcia, Jaime Durbano, Bernabe Nate, Cody Elwell, and Tsimane Health and Life History Project staff and researchers provided invaluable assistance during field data collection. We are particularly grateful to the Estación Biological de Beni for their assistance during this study, and continued assistance and service to the Tsimane community. This research was funded by: Wenner-Gren Foundation, the National Science Foundation (DDIG 1232370), and National Institute of Health (NIH/NIA R01AG024119).

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

We would like to thank our host villages and families that participated in this study. Geni Garcia, Jaime Durbano, Bernabe Nate, Cody Elwell, and Tsimane Health and Life History Project staff and researchers provided invaluable assistance during field data collection. We are particularly grateful to the Estación Biological de Beni for their assistance during this study, and continued assistance and service to the Tsimane community. This research was funded by: Wenner-Gren Foundation, the National Science Foundation [grant number DDIG 1232370], and National Institute of Health [grant number NIH/NIA R01AG024119].