Sociocultural dynamics that influence chagas disease health care in Colombia

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dc.contributor.authorMartínez-Parra, Adriana Gisela
dc.contributor.authorPinilla-Alfonso, Maria Yaneth
dc.contributor.authorAbadia, Cesar
dc.date.accessioned2020-06-16T17:30:21Z
dc.date.available2020-06-16T17:30:21Z
dc.description.abstractenglishChagas disease (CD) is a Latin America endemic and neglected tropical disease that affects primarily poor people living in rural areas. Its current low profile leads to many diagnostic, treatment, and control challenges. This study aimed to identify and characterize the sociocultural dynamics that influence CD health care in Colombia. Data for our ethnographic study was collected in 2013 and included participant observation in two main endemic areas in Colombia. In addition, 81 people belonging to four groups (patients and family members; health care workers; researchers; and officers) were recruited through snowball sampling technique and participated in informal and semi-structured interviews. People from the first two groups also participated in social cartography excercises. Data analysis resulted in the identification of three main sociocultural dynamics. Local Understandings: Patients reported confusions around disease transmission, treatment effectiveness and development of future complications. Providers' Knowledge and Training: Failures in professional's knowledge and training mostly affect the primary level of care in rural areas. Professionals undergo minimal training during medical school and lack access to continuous education. In contrast, clinicians working at tertiary university hospitals or at the CD unit of the Colombian National Institute of Health (NIH) exhibited great knowledge and competency. Health Care System Barriers: The Colombian market-based health care reform augmented access barriers, which impacted CD care greatly. We identified geographic and bureaucratic itineraries that depended on type of insurance plan, insurance contracts with service providing institutions, and levels of care. This study shows that people's experience of these sociocultural dynamics vary depending on their mobility from rural to urban contexts. It unveils the importance of analyzing the structure of the health care system. In the Colombian case, its for-profit orientation has become one of the most important obstacles for comprehensive, integrated, and timely health care responses.eng
dc.format.mimetypeapplication/pdf
dc.identifier.doihttps://doi.org/10.1016/j.socscimed.2018.09.012
dc.identifier.instnameinstname:Universidad El Bosquespa
dc.identifier.issn0277- 9536
dc.identifier.reponamereponame:Repositorio Institucional Universidad El Bosquespa
dc.identifier.repourlhttps://repositorio.unbosque.edu.co
dc.identifier.urihttps://hdl.handle.net/20.500.12495/3189
dc.language.isoeng
dc.publisherElsevierspa
dc.publisher.journalSocial science and medicinespa
dc.relation.ispartofseriesSocial science and medicine, 0277- 9536, Vol. 215, 2018, p. 142-150spa
dc.relation.urihttps://www.sciencedirect.com/science/article/abs/pii/S0277953618304957
dc.rights.accessrightshttps://purl.org/coar/access_right/c_abf2
dc.rights.accessrightsinfo:eu-repo/semantics/openAccess
dc.rights.accessrightsAcceso abierto
dc.rights.creativecommons2018-09-11
dc.rights.localAcceso abiertospa
dc.subject.decsEnfermedades transmitidas por vectoresspa
dc.subject.decsAntropología culturalspa
dc.subject.decsEducación médicaspa
dc.subject.keywordsHealth care reformspa
dc.subject.keywordsHealth care servicesspa
dc.subject.keywordsMedical anthropologyspa
dc.titleSociocultural dynamics that influence chagas disease health care in Colombiaspa
dc.title.translatedSociocultural dynamics that influence chagas disease health care in Colombiaspa
dc.type.coarhttps://purl.org/coar/resource_type/c_6501
dc.type.driverinfo:eu-repo/semantics/article
dc.type.hasversioninfo:eu-repo/semantics/publishedVersion
dc.type.localArtículo de revista

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