A Conceptual Framework for Action Research on the Sociocultural Aspects of Pregnancy and Postpartum Care among Brazilian Indigenous Women
Margareth Santos Zanchetta, Leandro Da Silva De Medeiros, Ingrid Lima Silva, Dirce Stein Backes, Barbara Chyzzy, Fábio Prado Saldanha, Juliana Silveira ColoméBackground
Brazil has recognized the need to investigate the health context of Indigenous Peoples by (a) collecting data on service coverage, barriers, needs, and gaps in access to health care; (b) developing, funding, and implementing plans and strategies for multilingual service delivery (c) reducing gender, social, and cultural inequalities as well as geographical barriers that hinder equitable access to quality health services; and, (d) incorporating an intercultural-intersectoral approach in the development of policies and inclusive-participatory research.
Purpose
Propose an original conceptual framework for action research on the socio-cultural aspects of pregnancy, childbirth, and the postpartum cycle among Brazilian Indigenous women.
Results
An online consultation with healthcare professionals was conducted (April-June 2024) using audio recorded narratives to gather information about the health of pregnant and postpartum Indigenous women. The Canadian model of population health promotion guided information analysis. Fourteen healthcare professionals with experience working in four Brazilian states and with 11 ethnic groups were consulted. A total of 23 modifiable situations were identified, and an original conceptual framework was developed that encompasses the following health promotion areas as modifiable situations: structure of the healthcare network; administrative barriers in healthcare management; operationalization of care delivery; and clinical and social contexts.
Conclusion
This article conceptualizes areas for innovative and socially responsive solutions to amend vulnerabilities in Brazilian Indigenous maternal health. The conceptual framework proposed offers a useful operational foundation for designing future interventions in Indigenous maternal health and for strengthening action research as a transformative methodological strategy in contexts marked by persistent historical and social inequalities.