Interculturality in the daily routine of primary health care: The case of the health model in Guainía, Colombia

Abstract Colombia is currently implementing a new health model, which is being tested initially in a region of the Amazon, with the main objective of primary health care with an intercultural approach. It is a cut of a doctoral thesis outlined by the case study methodology, which aimed to understand the daily construction process of primary health care from the perspective of indigenous and health professionals in Guainía, Colombia. Twenty-two indigenous users and 26 health professionals participated in the study, as well as three key participants. The data were collected through semi-structured interviews and direct observation, and were later transcribed and analyzed by Bardin’s thematic content analysis technique. The results show that interculturality, as a permanent process of negotiations and articulations present in the daily lives of indigenous and health professionals, is a fundamental part of the construction of primary health care in Guainía. In it materializes the encounter and exchange of heterogeneous forms of thinking-knowledge, that allow new interpretations and reinventions of knowledge and practices in health, although this process is permeated by conflicts, ambiguities, asymmetries and contradictions.摘要 哥伦比亚目前正在推行全新的卫生模式，该模式率先在亚马孙区域开展试点，核心目标是构建跨文化导向的初级卫生保健体系。本数据集节选自一项采用案例研究方法的博士论文，该研究旨在从哥伦比亚瓜伊尼亚地区的原住民与卫生专业人员视角出发，探析初级卫生保健的日常构建进程。本次研究共纳入22名原住民使用者、26名卫生专业人员，另有3名核心参与者参与研究。研究数据通过半结构化访谈与直接观察法采集，后续经转录后，采用巴丁（Bardin）主题内容分析技术开展编码与分析。研究结果显示，跨文化性作为原住民与卫生专业人员日常交往中持续存在的协商与协调进程，是瓜伊尼亚地区初级卫生保健构建工作的核心组成部分。该进程具体体现为异质性思维与知识形态的相遇与交流，催生了卫生领域知识与实践的全新解读与再造，尽管这一过程始终充斥着冲突、模糊性、不对称性与矛盾。