https://orcid.org/0000-0002-5422-6043
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ABSTRACT
How are indigenous public health policies implemented in contexts of diversity? The rural-urban migration processes that indigenous people have experienced since the mid-1990s in Latin American countries have affected the implementation of public policies, especially in the field of health. These processes have put pressure on ancestral practices of territorial representation, challenging traditional mechanisms that have supported western health policies. Based on a case study in urban Chile, this article examines the implementation processes of indigenous public policies in field of intercultural health. The analysis is informed by data collected from in-depth interviews with 35 key actors (Indigenous health practitioners, managers, health professionals, users, indigenous leaders), who have played a role in different stages in the implementation process of ‘Indigenous Peoples Special Health Program (PESPI)’. The data points to some challenges that persist with the implementation and adaption to this policy into a Western Health Model, where indigenous practices do not always find space to develop. The data collected reveals the efforts that indigenous people make in order to maintain their traditions and practices in different territorial contexts. The findings have the potential to enrich discussion and decision-making on intercultural and or indigenous health policies in other countries experiencing similar issues.
Acknowledgement
This work was supported by Ministry of Social Development ‘Fondo Chile de todas y todos: 2016’.
Disclosure statement
No potential conflict of interest was reported by the author(s).
Correction Statement
This article has been republished with minor changes. These changes do not impact the academic content of the article.
Notes
2 This Program depends of Ministry of Health. Seeks to improve indigenous health promoting a greater interaction between indigenous and western health systems.
3 This is a Nationwide survey conducted by Chilean government to measure socioeconomic conditions of households in the country, in terms of access to health, education, work, and housing conditions.
4 Ancestral authority responsible for the community wellbeing, western equivalent for physician. It is important to mention that in the Mapuche culture health is understood in a holistic way, what is known as Küme Mongen (or good life) is the result of the balance between the individual, the environment and the supernatural, including this perspective in the harmony-disharmony model, where health is maintained in an interdependence between the elements previously mentioned (Hassen Citation2012). The machi is who carries out the medical attention, diagnosis, and prescribes the herbs for treatment.
5 Person responsible for preparing the medical herbs the machi will prescribe.
6 Person responsible for translating the machi speech in Mapudungun during the trance when treating a patient.
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Notes on contributors
Verónica Figueroa Huencho
Verónica Figueroa Huencho Associate professor at the Institute of Public Affairs. Public administrator of the University of Chile (2001). Ph.D. in Management Sciences (ESADE-Universidad Ramón Lull) (2007). Postdoctoral candidate at the Center for Latin American Studies at Stanford University (2013). His main line of research is the process of formulation and implementation of indigenous public policies in contexts of diversity, where he has publications in ISI-indexed journals, as well as books and book chapters in national and international publishers. She has led and participated as a principal researcher and co-researcher in different FONDECYT projects as well as in others of the Inter-American Development Bank.
Cristian Lagos Fernández
Cristian Lagos Fernández Social anthropologist and Kinesiologist, Associate Professor of the Department of Linguistics of the University of Chile. Doctor in Hispanic Philology from the University of Valladolid, Spain (2011), Postdoctorate of the Center for Language, Interaction and Culture (CLIC), Department of Anthropology at the University of California, Los Angeles (2014). His main line of research is the language and culture of indigenous communities in Chile, including traditional systems around health and disease, with publications in ISI-indexed journals, as well as books and book chapters, both national and international. He has led and participated as a principal investigator and co-researcher in different internal projects of the University of Chile, FONDECYT projects, of the Ministry of Social Development and has been a consultant of the Inter-American Development Bank.
Mónica Manriquez Hizaut
Mónica Manriquez Hizaut Kinesiologist, Assistant Professor of the Department of Kinesiology at the University of Chile. Master in Public Health at the University of Chile (2016). His main line of research is studies in Intercultural Health and Disability. She has participated as an alternate researcher and co-researcher in Health Research projects (FONIS) funded by the State of Chile, through CONICYT and in another experience systematization project funded by the Ministry of Social Development.
Jame Rebolledo Sanhueza
Jame Rebolledo Sanhueza Kinesiologist. Assistant Professor of the Department of Kinesiology at the University of Chile. Master in Community Psychology at the University of Chile (2019). Her main line of research is qualitative studies in Public Health, and studies in disability and rights. She has participated as a co-researcher in Health Research projects (FONIS) funded by the State of Chile, through CONICYT and in another experience systematization project funded by the Ministry of Social Development, as well as internal funds of the Faculty of Medicine of the University of Chile.