Search Results (23)

This article examines the maternal healthcare experiences of ten Brazilian women during Portugal’s obstetric crisis, focusing on access, use, and quality of care throughout the perinatal and childbirth periods. Using a qualitative approach based on semi-structured interviews, this study explores women’s perceptions of the adequacy and quality of maternal healthcare, contributing to a deeper understanding of their experiences within the Portuguese health system. Thematic analysis revealed persistent barriers to accessing services, linked to limited knowledge of the healthcare system, lack of awareness of legal rights, discrimination, and other structural obstacles. Participants expressed dissatisfaction with the clarity and quality of information provided by healthcare professionals, their communication skills, and the limited access to specialized care. They also described feeling undervalued by healthcare providers and reported an absence of emotional and psychosocial support during pregnancy, childbirth, and the postpartum period. Accounts of disrespectful and abusive practices highlight the vulnerability of migrant women. This study underscores the urgent need to recognize and address migrant women’s needs. Beyond access, policies should promote equity, cultural responsiveness, and intercultural dialogue to ensure respectful, person-centered maternal care. Full article

Amidst deepening ecological disruption and widespread disconnection from nature, this study explores the emerging field of Earth Awareness (EA) as a relational and experiential aspect of advancing planetary health. EA practices—rooted in Buddhist, Indigenous, mindfulness, and nature-based traditions—support direct experiences of interconnectedness with Earth, ecological awareness and consciousness, and opportunities to transform underlying patterns and systems. Through 45 reflective dialogues with teachers and practitioners across traditions, this participatory research identifies common inspirations, intentions, and challenges that shape the emerging EA field. Findings reveal that EA is characterized by contemplative practices, rituals, and ceremonies that bridge inner transformation and outer action in the world. Central intentions such as healing, interconnectedness, and justice align closely with planetary health priorities, including mental well-being, equity, and stewardship of the living world. Although the field faces challenges related to access, risk of cultural appropriation, and systemic separation, participants identified opportunities for community building, intercultural exchange, and centering Earth as teacher and co-participant. By mapping coherence in this diverse field, this study highlights EA’s potential to contribute to planetary health by reconnecting people with place, fostering a more ecological consciousness, and supporting culturally grounded pathways for collective action and care for Earth. Full article

Background: Indigenous populations worldwide face a disproportionate burden of HIV due to structural inequities, cultural marginalization, and limited access to health services. Despite growing recognition of the need for culturally adapted responses, the effectiveness of combination HIV prevention strategies in these communities remains underexplored. Objectives: This study aimed to evaluate and compare the effectiveness of multiple HIV prevention strategies among Indigenous populations using a systematic review and network meta-analysis (NMA), to inform equity-oriented public health interventions. Methods: Following PRISMA-NMA 2020 guidelines, a comprehensive literature search was conducted across four databases (PubMed, SciELO, LILACS, Science Direct) for quantitative studies published between January 2000 and June 2025. Eligible studies evaluated HIV prevention interventions among Indigenous populations and reported risk or odds ratios. A frequentist NMA model was used to calculate effect estimates (OR, 95% CI) and SUCRA rankings for seven types of interventions, combining biomedical, behavioral, and structural approaches. Results: Four high-to-moderate quality studies enclosing 4523 participants were included. The most effective intervention was home-based counseling and testing for HIV, followed by medical consultation combined with HIV testing. Standalone testing, while effective, was significantly less impactful than when combined with culturally sensitive educational strategies. Information-only strategies showed the least efficacy. The SUCRA analysis ranked home-based testing highest (45.17%), highlighting the importance of decentralization, community participation, and intercultural mediation. Conclusions: Culturally adapted combination prevention strategies—especially those integrating home-based testing and counseling—are more effective than isolated biomedical interventions in Indigenous populations. These findings reinforce the urgent need for participatory, context-driven public health responses that center Indigenous knowledge, reduce stigma, and expand equitable access to HIV care and prevention. Full article

Animal health strategies in rural Colombia face significant challenges due to a gap between institutional technical approaches and the sociocultural contexts of local communities. This study examines the social representations of animal health and welfare among small- and medium-scale livestock producers in rural Huila. Through a qualitative methodology, semi-structured interviews were applied and focus groups were conducted in different municipalities with the objective of contrasting and enriching the findings obtained in the interviews. In total, the perceptions, knowledge, and practices of 263 small and medium livestock producers from 23 municipalities in Huila were explored with respect to animal vaccination campaigns and healthcare in rural settings. Findings indicate that health management is shaped not only by technical protocols but also by cultural values, collective imaginaries, and symbolic relationships with animals. Representations of animal welfare are diverse—ranging from emotional and economic to preventive and communal perspectives—and often diverge from scientific–technological frameworks. These differences influence the level of community adherence to national animal health programs. The study highlights the limitations of top–down approaches and underscores the need to incorporate local knowledge and practices into policy design. It concludes that promoting sustainable livestock farming requires acknowledging these varied representations, fostering intercultural dialogue, and adopting a territorial approach to integrated health. Recognising the sociocultural dimensions of animal care is essential for developing effective, inclusive, and context-sensitive animal health strategies. Full article

One of the great threats to health in the 21st century is the relationship between health and environmental issues, as there is an inevitable relationship between the planet’s degradation and health problems. In this sense, health is also seen as a problem of public order, and more precisely of political order, to the extent that such an environmental issue implies public health as a social value that affects the spaces of political decision making; moreover, to the extent that the environmental issue also intersects with the religious issue, namely with the 2030 Agenda in the 21st century. This article intends to think about how such a confluence occurs regarding religion, public health, and the environment, considering how spiritual care provided in the healthcare domain is related to care in the common home (Cf. CITER, Project «Common home and new ways of living interculturally: Public theology and ecology of culture in pandemic times»). In particular, this article intends to analyse such issues in Brazilian and Portuguese contexts. Full article

Childbirth is a biological process and how it is experienced and managed is influenced by numerous factors, among them, socio-cultural or health care received. Objective: The objective of this study is to ascertain whether cultural factors influence the way in which women deal with childbirth through the treatment of pain, companionship and maternal satisfaction. Methods: This study is a non-experimental, quantitative, ex post facto, cross-sectional study of women who gave birth in a border town in southern Spain. The sample consisted of 249 women. Results: No relationship was found between cultural factors and the choice of epidural analgesia, alternative methods to alleviate pain, being accompanied nor maternal satisfaction. There was a significant relationship between the type of companionship and with maternal satisfaction. Conclusions: Cultural factors did not influence how women dealt with dilation and childbirth. Results found that the person accompanying the mother was important for increasing maternal satisfaction. The intercultural training of healthcare professionals is necessary. Full article

In the Brazilian Amazon, deaths and disabilities from snakebite envenomations (SBEs) are a major and neglected problem for the indigenous population. However, minimal research has been conducted on how indigenous peoples access and utilize the health system for snakebite treatment. A qualitative study was conducted to understand the experiences of health care professionals (HCPs) who provide biomedical care to indigenous peoples with SBEs in the Brazilian Amazon. Focus group discussions (FGDs) were carried out in the context of a three-day training session for HCPs who work for the Indigenous Health Care Subsystem. A total of 56 HCPs participated, 27 in Boa Vista and 29 in Manaus. Thematic analysis resulted in three key findings: Indigenous peoples are amenable to receiving antivenom but not to leaving their villages for hospitals; HCPs require antivenom and additional resources to improve patient care; and HCPs strongly recommend a joint, bicultural approach to SBE treatment. Decentralizing antivenom to local health units addresses the central barriers identified in this study (e.g., resistance to hospitals, transportation). The vast diversity of ethnicities in the Brazilian Amazon will be a challenge, and additional studies should be conducted regarding preparing HCPs to work in intercultural contexts. Full article

Nurses have faced during the COVID-19 pandemic a tough professional situation in which they have had to work in a resource-limited context and with a high probability of COVID-19 transmission. In today’s multicultural societies, care for immigrant patients is also included. In our study, we have delved into the perception of hospital nurses towards migrant people in the context of the COVID-19 pandemic. We used a qualitative methodology with a phenomenological approach. Semi-structured interviews were conducted with 16 nurses. Seven categories emerged and were distributed in the three blocks of the interviews: (a) perception before the pandemic: prejudices make a mark and communication problems; (b) perception after the pandemic: prejudices weaken and communication worsens; and (c) how to improve care: improve communication, more nurses, and no need for training. The approach in the interpersonal relationship between nurses and patients during the pandemic has improved health care. Proposals arise to overcome the language barrier such as the incorporation of intercultural translators-mediators and professionals of foreign origin. There is a lack of awareness of the need for training in cultural competence on the part of the nurses in the study. Full article

Globally, and particularly in the Latin American region, international migration continues to grow. Access and use of health care services by migrants vary according to their country of origin and residence time. We aimed to compare the access and use of health care services between international migrants (including settled migrants from Peru, Argentina, Bolivia, Ecuador; Emerging migrants from Venezuela, Dominican Republic, Colombia, Haiti; and migrants from other countries) and the Chilean population. After performing a secondary data analysis of population-based nationally representative surveys (CASEN 2011–2017), access and use patterns (insurance, complementary insurance, non-consultation, and non-treatment coverage) were described and compared among settled immigrants, recent emerging immigrants, others, and locals. Immigrants had a significantly higher uninsured population compared to locals. Specifically, in CASEN 2017, 19.27% of emerging (95% CI: 15.3–24.1%), 11.79% of settled (95% CI: 10.1–13.7%), and 2.25% of locals (95% CI: 2.1–2.4%) were uninsured. After 2013, settled and recent emerging migrants showed higher percentages of non-consultation. Collaborative and interculturally relevant strategies from human rights and equity perspectives are needed. Initiatives with a particular focus on recent immigrants can contribute to reducing the existing disparities in health care access and use with locals due to lack of insurance and treatment coverage. Full article

The COVID-19 pandemic has had a significant impact particularly on the most vulnerable populations, including immigrants, asylum seekers and refugees in the EU. The article depicts the results of the comparative research project “Local Alliance for Integration (LION/GSRI/University of West Attica/81018): Migrant and Refugee integration into local societies in times of the COVID-19 pandemic in Spain and Greece” implementing a qualitative methodology. This article analyses via 32 in-depth interviews the experiences of immigrants, asylum seekers and refugees in Greece, the increased barriers towards integration due to racial and ethnic inequalities, precarity and health disparities during this period which function as a means of perpetuating exclusion in five sectors: (a) formal employment, (b) healthcare, (c) formal education and language training, (d) housing and social care/protection, and (e) intercultural coexistence as well as the new rise of a hostile rhetoric and anti-migrant attitudes under a COVID-19 pandemic populism. The unravelling of the narratives revealed perceptions and practices of inequality and uncertainty as well as of hope. The socioeconomic impact of the pandemic on immigrants, asylum seekers and refugees, similarities and differences that occurred and evidence of the ongoing obstacles they encountered during the pandemic are presented. Policy and practice implications include the implementation of prevention measures by the institutions that are tasked with the responsibility to remove hindrances, address unequal treatment, racial/ethnic and social inequalities and raise awareness on multiple ways in which the COVID-19 pandemic has intensified vulnerability. Full article

In this article, meanings and practices in intercultural health for international migrants in health establishments are described from the perspective of health personnel in the city of Antofagasta in northern Chile. Methodology: The methodology was qualitative with a phenomenological descriptive design, through which discourses from health personnel in the public primary and secondary care system were explored (n = 23). Next, meanings and practices in intercultural health for international migrants in health establishments are described from the perspective of health personnel in the northern Chilean city of Antofagasta. Results: The participants presented trees of thematic categories. There were three thematic categories overall: (1) The meaning of interculturality included features of understanding of the concept, with respect for culture being the transversal axis in all discourses. (2) Practices in health care, where voluntariness, references, and the adequacy or non-technicality of the language are fundamental axes. (3) Training in the intercultural approach, where there is often self-knowledge and lack of supply in the health system. Conclusions: The findings show essential elements to consider in the care of international migrants, including the training and awareness of staff about the intercultural approach through strategies following the local reality in which each health establishment exists. Full article

Indigenous communities in Colombia are facing a critical health situation; alternative health care models based on the vision of the communities themselves are needed. The objective of this research was to create a health care model that decreases health inequities for the Indigenous Awá population of Nariño, Colombia. This study was guided by the paradigm of community-based participatory action research; the process was carried out in 2015 and 2016. The proposed Intercultural Health Care Model is essentially based on health promotion, disease prevention, community empowerment, social participation in health, decentralized health care and coordination between the two medicines (traditional and allopathic). Strategies such as those reported herein, with concerted efforts rather than imposition, maintain human rights and respect for the sovereignty and autonomy of Indigenous people. Full article

Why does someone thrive in intercultural situations; while others seem to struggle? In 2014, Leung and colleagues summarized the literature on intercultural competence and intercultural effectiveness into a theoretical framework. This integrative framework hypothesizes that the interrelations between intercultural traits, intercultural attitudes and worldviews, and intercultural capabilities predict the effectiveness with which individuals respond to intercultural situations. An empirically verified framework can contribute to understanding intercultural competence and effectiveness in health care workers, thus contributing to more equity in health care. The present study sets out to test this integrative framework in a specific health care context. Future health care practitioners (N = 842) in Flanders (Belgium) were questioned on all multidimensional components of the framework. Structural equation modeling showed that our data were adequate to even a good fit with the theoretical framework, while providing at least partial evidence for all hypothesized relations. Results further showed that intercultural capabilities remain the major gateway toward more effective intercultural behavior. Especially the motivation and cognition dimensions of cultural intelligence seem to be key factors, making these dimensions an excellent target for training, practical interventions, and identifying best practices, ultimately supporting greater intercultural effectiveness and more equity in health care. Full article

Background/Aim: Mayotte is a French island in the Indian Ocean. There is no palliative care structure in this territory. The island and its population have specific characteristics: insularity, poverty, coexistence of modern and traditional medicine, importance of religion (Islam) and the presence of many foreigners without health insurance. The aim of this study is to determine the palliative care needs of the Mayotte population and propose the establishment of an appropriate service. Methods: A qualitative study was conducted in Mayotte using interviews with patients and their caregivers, and focus groups were conducted with healthcare professionals involved in their care. Patients requiring palliative care were identified and recruited from the hospital or the patient’s home by healthcare professionals. Results: A total of 62 people participated in the study between May and June 2019. The needs expressed were analysed and then grouped into categories: access to medical care (especially at home), management of physical symptoms (analgesia) and psychological symptoms, organisation of care (coordination between healthcare professionals) and training of healthcare professionals (pain management, palliative care, interculturality and translation), taking into account cultural and religious aspects. Regarding the foreign population, the categories were: improving access to healthcare, access to the social protection system and daily living conditions (transport, food and accommodation). Conclusions: The specific needs of the population, assessed through the study, have led to an original proposal, which differs from the usual structures of palliative care in France. Full article

Many researchers and practitioners agree that a specific skillset helps to provide good healthcare to migrant and minority patients. The sciences offer multiple terms for what we are calling ‘diversity competence’. We assume that teaching and developing this competence is a complex, time-consuming task, yet health professionals’ time for further training is limited. Consequently, teaching objectives must be prioritised when creating a short, basic course to foster professionals’ diversity competence. Therefore, we ask: ‘What knowledge, attitudes and skills are most important to enable health professionals to take equally good care of all patients in evermore diverse, modern societies that include migrant and (ethnic) minority patients?’ By means of a modified, two-round Delphi study, 31 clinical and academic migrant health experts from 13 European countries were asked this question. The expert panel reached consensus on many competences, especially regarding attitudes and practical skills. We can provide a competence ranking that will inform teaching initiatives. Furthermore, we have derived a working definition of ‘diversity competence of health professionals’, and discuss the advantages of the informed and conscious use of a ‘diversity’ instead of ‘intercultural’ terminology. Full article