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Bridging Western and Indigenous knowledge through intercultural dialogue: lessons from participatory research in Mexico

Iván Sarmiento · Germán Zuluaga · Sergio Paredes‐Solís · Anne Marie Chomat · David Loutfi · Anne Cockcroft +1 more

55 citations0/0 files storedBMJ Global Health

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Indigenous Health, Education, and Rights Community Health and Development Cultural Competency in Health Care

Abstract

Indigenous communities in Latin America and elsewhere have complex bodies of knowledge, but Western health services generally approach them as vulnerable people in need of external solutions. Intercultural dialogue recognises the validity and value of Indigenous standpoints, and participatory research promotes reciprocal respect for stakeholder input in knowledge creation. As part of their decades-long community-based work in Mexico’s Guerrero State, researchers at the Centro de Investigación de Enfermedades Tropicales responded to the request from Indigenous communities to help them address poor maternal health. We present the experience from this participatory research in which both parties contributed to finding solutions for a shared concern. The aim was to open an intercultural dialogue by respecting Indigenous skills and customs, recognising the needs of health service stakeholders for scientific evidence. Three steps summarise the opening of intercultural dialogue. Trust building and partnership based on mutual respect and principles of cultural safety. This focused on understanding traditional midwifery and the cultural conflicts in healthcare for Indigenous women. A pilot randomised controlled trial was an opportunity to listen and to adjust the lexicon identifying and testing culturally coherent responses for maternal health led by traditional midwives. Codesign, evaluation and discussion happened during a full cluster randomised trial to identify benefits of supporting traditional midwifery on maternal outcomes. A narrative mid-term evaluation and cognitive mapping of traditional knowledge offered additional evidence to discuss with other stakeholders the benefits of intercultural dialogue. These steps are not mechanistic or invariable. Other contexts might require additional steps. In Guerrero, intercultural dialogue included recovering traditional midwifery and producing high-level epidemiological evidence of the value of traditional midwives, allowing service providers to draw on the strengths of different cultures.

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References

20248 Decolonizing Methodologies: Research and Indigenous Peoples 2009Suspending Damage: A Letter to Communities 2008Handbook of Critical and Indigenous Methodologies 2009Indigenous health part 2: the underlying causes of the health gap 2009Indigenous health part 1: determinants and disease patterns 2012Two-Eyed Seeing and other lessons learned within a co-learning journey of bringing together indigenous and mainstream knowledges and ways of knowing 2012Rethinking cultural competence 1991First Nations and Higher Education: The Four R's--Respect, Relevance, Reciprocity, Responsibility.

Cited by

2022India and its pluralistic health system – a new philosophy for Universal Health Coverage 2022Decolonising global health evaluation: Synthesis from a scoping review 2022Codesign in resource-limited societies: theoretical perspectives, inputs, outputs and influencing factors 2021Maternal health and Indigenous traditional midwives in southern Mexico: contextualisation of a scoping review

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