Ciencia & saude coletiva最新文献

Obstetric healthcare for Indigenous women remains a severe problem in low-income countries with great cultural diversity and a colonial past. The work of health professionals to prevent complications leading to maternal deaths is paramount, yet in these contexts, they face significant challenges in implementing culturally competent services. This paper aims to present findings from an ethnographic study that attempted to document the experience of health professionals providing obstetric services in order to show the complex sociocultural contexts in which they perform their work.

The study aimed to identify protection strategies used by Indigenous peoples during the COVID-19 pandemic. Analyzing 56 articles from 2020 to May 2021 across four areas -community organization, governance, communication, and territorial approaches - it found that structural vulnerabilities shaped their responses. The spread of the virus was influenced by environmental, social, and cultural factors. Indigenous groups employed diverse strategies like collective decision-making and traditional knowledge. Challenges included data suppression and barriers to ethnic identification. The study emphasizes the need for greater Indigenous autonomy in data management and effective coordination among government, civil society, and Indigenous organizations.

The National Policy for the Care of Indigenous Peoples (NPCIP) faces an enormous challenge in operationalization regarding the training and qualification of health professionals to work in an intercultural context. In this article, we open a dialogue with the proposal of a Meeting of Knowledges (MK) as a teaching and learning strategy capable of promoting a critical intercultural education. We seek to reflect on the possible impact of MK in the health field for transforming the university environment, as well as healthcare for Indigenous communities, towards an entrenched, democratic, pluriepistemic, and transdisciplinary perspective.

The present study aimed to analyze notifications of intimate partner violence (IPV) against indigenous women in the macro-region of Dourados-MS, Brazil, from 2009 to 2020. This is a cross-sectional study with secondary data from registered reports in the Notifiable Diseases Information System (SINAN) of indigenous women who suffered violence. Descriptive statistics of the variables and Poisson regression were performed to determine the prevalence ratio (PR). IPV represented 56.6% of reports. The most reported types of violence were physical violence (93.3%) and psychological violence (27%). In the adjusted analysis, IPV was associated with women with partners (PR 1.32, 95%CI 1.19; 1.46), and women in situations of repeated violence (PR 1.15, 95%CI 1.05; 1.25) and at home as the place of occurrence (PR 1.13, 95%CI 1.01; 1.29). The majority of reports of violence against indigenous women registered in the Dourados health macro-region were perpetrated by an intimate partner. Knowledge of the profile of violence that arrives at health services, combined with associated factors, should enable the implementation of strategies aimed at reducing the number of cases.

In recent decades, affirmative actions have enabled Indigenous people to access medical school, historically occupied by white people with high family incomes. This research analyzed experiences of otherness by Indigenous people in federal medical schools. This qualitative, exploratory study adopted interviews and conversation circles, with the participation of 40 students from 15 courses. We established four categories of analysis: encounter between "strangers" and the medical school; differences and inequalities; relationships with students and teachers; and conflicts and transformations. We noticed that medical schools are unwelcoming to Indigenous people, with racism, intolerance, and tutelage, when their differences become inequalities, resulting from structural processes in these Brazilian institutions. The Indigenous presence in medical courses reveals social inequalities, causes conflicts, and initial transformations, pointing out paths for plurality and social justice, and possibilities for medical education with visibility and actions for the health of Indigenous peoples.

Brazil, one of the world's largest agricultural producers and consumers of pesticides, has expanded its agricultural area in the southern region of Mato Grosso do Sul, intensifying environmental contamination and increasing the vulnerability of indigenous populations. This research assessed the presence of pesticides in the waters of two indigenous communities in MS, Retomada Guyraroká and Aldeia Jaguapiru. Between 2021 and 2022, three sampling campaigns of surface, supply, and rainwater were conducted, considering the agricultural calendar. The study followed the LARP/UFSM protocol. In total of 22 active ingredients (AIs) were found, among these, 41% cause serious health effects, and 68% are banned in the European Union. Fipronil, 2,4-D, Atrazine are the among the most frequent IA found. Results show that these communities are exposed to pesticides, violating their rights to health and food sovereignty.

Primarily since the early 2000s, Indigenous peoples in Brazil have become beneficiaries of social security and income transfer policies, such as the program known as Bolsa Família (Family Allowance). Few field studies have evaluated the magnitude and significance of monetarization in Indigenous social lives and economies. To this end, between 2019 and 2020, the present work conducted an ethnographic study and survey in two villages of the Rikbaktsa people in the Brazilian Amazon. The quantitative results showed the social dissemination of money from governmental Programs and other activities, producing marked income classes. Important transactions were not captured, considered as "helps" that could not be denied by those with a given amount of money. Like an Indigenous "Bolsa Família", hybrid resources were redistributed in a heated-up village market, counteracting socioeconomic differences and unequal conditions. The discussion takes place in a globally unfavorable sociopolitical context that exacerbates historical inequalities expressed in the living and health conditions of Indigenous peoples. This research contributes to the production of data and the proposal of culturally sensitive methodologies to estimate and enable the governance of public policies for/by Indigenous people, which are recommended to reverse these inequities.

The study evaluates the nutritional and metabolic profile of the adult population of the Xingu Indigenous Territory by gender and base hub. It was developed in 18 villages from 2017 to 2019. Anthropometry and clinical, physical examinations were conducted in loco in individuals over 18. A total of 1,598 Indigenous people were evaluated, with a mean age of 36.7 years. Of these, 50.6% were male, 53.2% lived in the Leonardo Base hub, 22.7% in Diauarum, 12.3% in Pavuru and 11.8% in Wawi. Women had a higher prevalence (p < 0.05) than men, respectively, of underweight (2.0% vs. 0.1%), normal weight (46.1% vs. 37.4%), central obesity (63.4% vs. 21 .8%), low HDL cholesterol (77.7% vs. 72.9%) and Metabolic Syndrome (29.0% vs. 23.5%). In comparison, men had a higher prevalence (p < 0.05) than women, respectively, of overweight (46.3% vs. 37.5%), high triglycerides (34.5% vs. 28.2%) and high blood pressure levels (13.1% vs. 8.6%). The Leonardo and Wawi base hubs had the worst nutritional and cardiometabolic results. Overall, subjects had a high frequency of noncommunicable diseases and cardiometabolic risk. Urgent measures need to be taken to control this situation.

In this interview, Weibe Tapeba, secretary of Indigenous Health at the Ministry of Health in the Lula Government, discusses the process of reorganizing the Secretariat of Indigenous Health (SESAI) and Indigenous protagonism in the new administration. Among the points highlighted by the interviewee are the assessment of the Indigenous health scenario within the current political context of the Ministry of Health, dialogues with Indigenous movement organizations, as well as collaboration with research and educational institutions. The interview highlights the importance of developing strategies aimed at restructuring SESAI and improving Indigenous health public policy in Brazil through extensive coordination, involving planning, management, funding, and Indigenous social participation with Social Control. The secretary emphasizes the need for political cooperation within the federal government to promote the development of a policy of "comprehensive care in Indigenous territories," arguing that the concept of primary health care needs to be expanded to ensure that the principles of SUS are effectively guaranteed to Indigenous peoples in Brazil.

The Indigenous Health Conferences (IHC) have been the political spaces for expressing and consolidating ideas and proposals. However, in 1993, the "First Indigenous Health Forum" was held a few months before the second IHC. With a historical approach, this paper aimed to understand the organization and impacts of this Forum in the construction of Brazilian Indigenous Health policies during the 1990s. We analyzed an unpublished set of documents organized as a Dossier by Dr. István Varga and deposited in the University of São Paulo's library. We discuss that a strong connection with the First Indigenous Health Forum was established between the first and second IHC. The argumentative structures and proposals formulated in the First Indigenous Health Forum were reinforced during the subsequent events culminating in the Second IHC.