Community Perspectives About Sociocultural Conditions Associated With Children's Health Among the Nasa People in Colombia

Background: Health inequalities that affect indigenous peoples have been recently documented by international organizations such as the United Nations Permanent Forum on Indigenous Issues (UNPFII) and the Pan American Health Organization (PAHO). The Nasa reservation in Iquira (Huila) where this study was conducted has one of the highest infant mortality rates in the country.

Objective: Understanding community perspectives about the sociocultural determinants of children's health is crucial in order to develop effective and culturally appropriate public health interventions to address this pressing issue.

Methods: This study employed Community-Based Participatory Research (CBPR) as a methodological framework. Community partnerships in the form of local health committees led the process along with the academic team. Group discussions and photovoice were conducted with a criterion sampling of sages, midwives, traditional doctors, traditional massage therapist, traditional pressure taker (pulseadores), health promoters, community authorities, mothers, students, educators and other key community members.

Results: Grounded qualitative data analyses suggest a loss in the traditional customs and the credibility of ancestral medicine; a move from autonomy to dependence on external food sources; and increased child neglect and environmental pollution as the primary conditions associated with the increase in preventable diseases, malnutrition, and infant mortality.

Conclusions: Community implications include the need to strengthen child-rearing, food production and nutritional practices in accordance with ancestral knowledge. Institutional support is sought to support the implementation of indigenous communities' life plans as well as to adjust the institutional programs offered to communities in a way that they promote ancestral identity and cultural continuity.