Adherencia a controles prenatales en el norte argentino desde la perspectiva de la interfaz social / Adherence to prenatal care in the north of Argentina from a social interface perspective

Resumen La adherencia a controles prenatales constituye una herramienta fundamental para disminuir la mortalidad materna. Usualmente se piensa la adherencia a partir de las características de las mujeres asistidas o de las particularidades del sistema de salud y sus agentes. Aquí se la aborda como emergente del modo en que se articulan las racionalidades y mundos de vida de profesionales y mujeres asistidas. Se realizó un estudio de casos múltiple buscando a comprender la adherencia a controles prenatales de mujeres rurales. Se realizaron 47 entrevistas en el norte argentino a mujeres embarazadas o que habían sido madres en los últimos años y a agentes del sistema de salud. El contenido de las entrevistas fue codificado con el apoyo del software Atlas Ti. El estudio permitió identificar dos tipos de interacción médico-paciente. El primero se caracteriza por una representación de las pacientes como ignorantes y desinteresadas, lo que lleva al agente a insistir con sus recomendaciones sin atender a las dificultades vividas por las mujeres. El segundo parte de concebir a las mujeres como cumplidoras y responsables, lo que permite un mayor diálogo, aún sin que se observe un interés claro por conocer el contexto de vida de las mujeres atendidas.

Abstract Adherence to prenatal care is fundamental for diminishing maternal mortality. Usually, adherence is considered in terms of assisted women's characteristics or the specificities of the health systems and its professionals. Adherence is addressed here as the emergence of the articulation between the rationales and the life realities of physicians and pregnant women. Aiming to understand the adherence to prenatal care, a multiple case study was conducted in the North of Argentina. A total of 47 interviews of pregnant women or women that had been given birth in the last years and to agents of the health system were conducted. The content of the interviews was coded with the support of Atlas Ti software. The research identified two types or interaction between physicians and patients. The first one is based on physicians' representation of assisted women as being ignorant and disinterested, which leads professionals to insist on their recommendations without taking into account problems faced by women. The second part of conceptions is supported in the representation of women as obedient and responsible, which enables a better dialogue between physicians and patients, albeit without the knowledge of a clear interest of the life context of the women being known.

Expectativas de los extensionistas rurales latinoamericanos y contribuciones psicosociales / Expectativas de extensionistas rurais latinoamericanos e contribuições psicossociais / Latin american rural extensionists' expectations and psychosocial contributions

Buscando identificar las expectativas de los extensionistas rurales sobre la psicología y clarificar las contribuciones de ésta a la extensión se realizó una encuesta a técnicos de 12 países latinoamericanos. El análisis del contenido de las respuestas abiertas identificó como principales expectativas la gestión de procesos grupales y participativos con productores y la capacitación y asesoramiento a extensionistas. Atendiendo a la propuesta de tomar a los productores como objetos de intervención y no como sujetos de cambio que aparece en múltiples encuestas, se destaca la potencialidad de la psicología para generar procesos de reflexión sobre la práctica y sobre los supuestos que la guían.

Buscando identificar expectativas de extensionistas rurais sobre a psicologia e esclarecer as contribuições desta para a extensão, realizou-se um levantamento junto a técnicos de 12 países latinoamericanos. A análise do conteúdo das respostas abertas identificou, como principais expectativas, a gestão de processos grupais e participativos com produtores e a capacitação e assessoramento a extensionistas. Atendendo à proposta de tomar os productores como objetos de intervenção e não como sujeitos de transformação, como em muitas pesquisas, se destaca a potencialidade da psicología para gerar processos de reflexão sobre a prática e sobre as premissas que a orientam.

Striving to identify rural extensionists' expectations of psychology, and to clarify its contributions to rural extension, a research was conducted, in which 654 rural extensionists from 12 Latin American countries were surveyed. The content analysis of the open questions allowed identifying as core expectations the management of group participatory processes; and the training and advice of practitioners. Taking into account that many surveys treat farmers as objects of intervention and not as subjects of change, the potentiality of psychology to generate reflective processes on practice and on the assumptions guiding it, is highlighted.

Problemas enfrentados por extensionistas rurais brasileiros e sua relação com suas concepções de extensão rural / Problems faced by Brazilian rural extensionists and their relationship with their conception of rural extension

Tanto na América Latina como no Brasil assistimos a um retorno e fortalecimento do interesse público pela extensão rural. Neste trabalho, são analisados os problemas enfrentados na sua prática por uma amostra de extensionistas rurais brasileiros e sua relação com suas concepções de extensão rural. Cinquenta e dois extensionistas rurais de diferentes estados responderam a uma enquete enviada por e-mail. Concluiu-se que (1) as dificuldades associadas com o trabalho grupal ou em parceria entre agricultores são o problema mais mencionado, (2) nos técnicos, tende a persistir uma perspectiva difusionista da extensão rural, mesmo contra as diretrizes participativas e dialógicas estabelecidas pela política pública e (3) existe um olhar autocrítico limitado dos extensionistas, os quais tendem a ver os produtores como problema.

In both, Latin America and Brazil, rural extension is recovering acknowledgment in the context of public policy. In this paper, the problems faced in their practice by a sample of Brazilian rural extensionists are described and how they relate to their conception of rural extension is analyzed. 52 rural extensionists of different Brazilian states were surveyed via email. It is concluded that (1) difficulties related to group or associate work among farmers are the most mentioned, (2) a diffusionist conception of rural extension tend to persist, even against the participatory and dialogical principles established by public policy and (3) rural extensionists have a limited self-critical attitude and tend to perceive the farmers as a problem.

Representación de los extensionistas rurales argentinos sobre los pequeños productores / Representação dos extensionistas rurais argentinos sobre os pequenos agricultores / Argentine rural extensionists' representation of small farmers

Actualmente asistimos a un resurgimiento de la extensión rural en América Latina. Procurando contribuir a la comprensión de los fundamentos psicosociales de las prácticas extensión, se estudió la representación social que los extensionistas tienen de los pequeños productores a partir de una encuesta realizada a técnicos que trabajan en distintas instituciones publicas argentinas (n=219). Las preguntas abiertas fueron categorizadas siguiendo los principios de la Teoría Fundamentada. Luego, los resultados de esta etapa fueron cuantificados, asociados con diferentes variables sociodemográficas y utilizados para la construcción de clusters. Existen cuatro grandes áreas de la representación que se relacionan de manera compleja con distintos modelos de extensión rural. La primera área describe a los productores como aprovechados o dejados de lado por actores más poderosos, la segunda como portadores de escasos recursos para salir adelante, la tercera con características internas negativas y la cuarta como poseedores de capacidades y recursos.

Assistimos atualmente a um ressurgimento da extensão rural na América Latina. Buscando contribuir á compreensão dos fundamentos psicossociais das práticas de extensão, estudou-se a representação social que os extensionistas rurais têm dos pequenos produtores através duma enquete feita a técnicos que trabalham em diferentes instituições públicas da Argentina (n = 219). As perguntas abertas foram categorizadas de acordo com os princípios da Grounded Theory. Depois, os resultados obtidos nesta etapa foram quantificados, relacionados com diferentes variaveis sociodemográficas e utilizados para a construção de aglomerados (clusters). Há quatro áreas principais de representação as quais estão relacionados de forma complexa com diferentes modelos de extensão rural. A primeira área descreve a os produtores como explorados ou deixado de lado por actores sociais mais poderosos, a segunda como tendo recursos limitados para progredir na vida, a terceira como pessoas que têm características internas negativas, e quarto como tendo capacidades e recursos persoais.

Nowadays, rural extension is resurging in Latin America. Aiming at contributing to understand the psychosocial foundations of rural extension practices, the rural extensionists' social representation of small farmers was studied. In this vein, 219 extensionists working in different Argentine public institutions were surveyed. The open questions were analyzed following Grounded Theory. Then, the results of this phase were quantified and related to different socio-demographic variables. Also, a cluster analysis was conducted. Four areas of the representation highlight. One describes small farmers as set aside and taken advantaged of by more powerful social actors; the second as not having resources to 'get ahead'; the third as possessing negative internal characteristics and the last one as owners of useful capacities and resources.

Expectativas de los agentes de desarrollo rural argentinos sobre la Psicología y sobre la inserción profesional de los psicólogos en el ámbito de la extensión rural / Argentine rural development agents' expectations about Psychology and about the employability of psychologists in the area of rural extension

La Psicología posee una importante potencialidad para trabajar en el ámbito de la extensión y el desarrollo rural. No obstante, no existe evidencia empírica suficientemente amplia de las expectativas de los agentes de desarrollo sobre la Psicología. Por este motivo se realizó una investigación transversal de carácter cuantitativo. La muestra fue no probabilística incidental e incluyó participantes de todas las regiones de Argentina. Se encuestó a extensionistas rurales que trabajan en las principales instituciones que realizan extensión rural en el ámbito público. La encuesta, que fue respondida por 219 sujetos (9.06% del total nacional) incluyó preguntas cerradas sociodemográficas y abiertas respecto de las expectativas sobre la Psicología. Las preguntas abiertas fueron categorizadas y organizadas con el apoyo de la teoría fundamentada y el software Atlas Ti. Las categorías fueron convertidas en variables para estudiar su relación con las preguntas sociodemográficas con apoyo del software SPSS. Se concluye que la mayor parte de los extensionistas rurales del ámbito público argentino (un 88%) considera que la Psicología podría ayudarlos a resolver algunos de los problemas a los que se enfrentan, por ejemplo, brindando capacitación y asesoramiento a extensionistas rurales así como participando en equipos interdisciplinarios de extensión rural. Además, podrían trabajar directamente con productores en la gestión de procesos grupales. En términos generales, se destaca la potencialidad de la Psicología en el ámbito del trabajo grupal, la comunicación, el apoyo emocional y el cambio de actitudes y prácticas. Finalmente, se destacan las limitaciones de la investigación realizada.

Many scholars have argued that rural extension and development processes need an interdisciplinary approach, one that includes contributions from different sciences, particularly social ones. In this context, social and community psychology have a great potential to address this topic. In spite of this potentiality, psychology has produced scarce useful contributions to rural development and to extension processes. Additionally, limited empirical support has been given to probe this potentiality, which makes this a theoretical argument. Thus, a cross-sectional, quantitative investigation was conducted in Argentina. An incidental, non-probabilistic sample was used, which included participants from all regions of the country. Rural extension agents working in the National Institute of Agrarian Technology, the ProHuerta Program and the Under secretariat of Family Farming of the Ministry of Agriculture, Husbandry and Fisheries were surveyed via email. Local authorities of these institutions helped the researchers to send and receive the completed surveys indifferent ways. The reply to the poll was voluntary. 219 completed forms (143 men and 76 women) were received, which represent 9.06% of rural extensions working in public institutions in Argentina. The survey included socio-demographic,closed questions, and open ones regarding the problems faced by rural extensions in their everyday practice and their expectations about Psychology as a mean to address them. In order to analyze the open questions, different categories of analysis were built and thoroughly described to cope with ambiguous cases, which were used to categorize all replies. In this process, grounded theory and Atlas Ti software were utilized. Next, these categories were transformed into dichotomist variables, expressing the presence of the category presence of the variable and its absence, the absence of the variable. Then all variables were incorporated to SPSS software, which allowed for the quantification of the results and the study of statistical relationships between different variables. The most important result of this investigation is that 88% of the Argentine rural extensionists working in the National Institute of Agrarian Technology, the ProHuerta Program and the Under secretariat of Family Farming consider that Psychology can contribute to solve at least some of the problems they face when doing rural extension. Interestingly, this represents a very high and unexpected percentage, given psychology is not a social science traditionally related to rural issues or settings. In consequence, it is clear that there is a potential demand for psychologists in the field of rural development processes, which is not being addressed. Additionally, the replies allowed for the description of the role psychologists should fulfill when working in this field, from rural extensions’ point of view. They argue that psychologists could work with both, them and farmers. On the one hand, they could train, advice and provide with practical tools to rural extensionists. Additionally, they could take part in interdisciplinary rural extension teams. In practical terms, they could contribute in fields such as cooperative processes and group management, design and implementation of projects, understanding of small farmers’ rationale, conflict resolution, lack of adoption of technologies, and scarce participation and commitment to development projects. On the other hand, psychologists also could work directly with small farmers, providing training in different topics, and managing groups, particularly in the case of participatory processes. Additionally, they could strengthen small farmers’ self-esteem, a problem that rural extensionists related to passive attitudes and fatalism. To conclude, it is important to underline that, knowing this expected role, psychologists should start a dialogue with rural development agents in order to generate a shared conception of psychologist working in the field of rural extension, which includes both, psychologists’ and rural extensionists’ point of view.

Cooperación y desconfianza en campesinos formoseños: aportes de la psicología a la formulación de estrategias y metodologías de desarrollo rural / Cooperation and distrust in argentinean peasants: Contributions from psychology to the design of strategies and methodologies of rural development

Las políticas de Desarrollo Rural orientadas a la población campesina, usualmente incluyen el apoyo a emprendimientos de carácter asociativo. Sin embargo y pese al importante contenido psicosocial de tales procesos, llama la atención la ausencia de trabajos realizados desde la psicología en relación a esta cuestión en particular y a la problemática campesina en general. Por esto, para aportar desde dicho campo disciplinar a la comprensión de estos fenómenos, se presentan los resultados de una investigación sobre cooperación y desconfianza en campesinos formoseños. Para realizarla, fue utilizada una metodología cualitativa basada en la observación participante y en la toma de entrevistas. Así, se describen las dificultades para el trabajo cooperativo y las estrategias propuestas para llevarlo adelante desde la perspectiva de los actores. En este proceso, se profundiza en la comprensión de la desconfianza, especialmente hacia los potenciales dirigentes, como el mayor inconveniente para asociarse y se analiza el rol de las narraciones de engaños y traiciones que circulan en la comunidad. Finalmente, se reseñan los interrogantes que deja abiertos la investigación y se señala la importancia de abrir una línea de investigación psicosocial sobre la problemática campesina para aportar a la formulación e implementación de políticas de desarrollo rural.