Institutional practices in maternal health according to social class. Bogotá, Colombia, 2018.

Abstract

Objective: To understand institutional practices in healthcare as relates to women during pregnancy, childbirth and the postpartum period according to social class in Bogota.

Methods: Qualitative study based on the critical hermeneutics paradigm. Critical ethnographic method with theoretical sampling. The participants included 9 women and 8 health-care professionals from the city of Bogotá, attending public and private healthcare institutions that serve populations under both the subsidized as well as the contributive regimes of the General Social Security System. Overall, 38 in-depth interviews were conducted during a 13 month period, with 62 instances of support to the mothers in terms of prenatal care, vaccination, labor, postpartum visits, follow-up tests, psychoprophylactic course, hospitalization and waiting room. Triangulation analysis on Atlas Ti.

Results: Taking into account the discourse of the different players, observations and context, two categories were found to be determining factors of inequities: "Market-regulated health" and "Over- sight and control in health services".

Conclusions: It is advisable in medical practice to build competencies in the population in order to ensure the realization of the rights of women and healthcare personnel. Qualitative research offers the opportunity to promote the transformation of medical rationale affecting women.