Incorporación del enfoque intercultural en el sistema de salud peruano: la atención del parto vertical / Incorporation of an intercultural approach in the Peruvian health care system: the vertical birth method

ABSTRACT

Peru has a large indigenous population (40 percent of the total), made of 72 distinct groups. These peoples are at a great disadvantage compared to the mestizos and other groups that are more closely connected with the dominant culture. The political and economic inequality and inequities are particularly stark with regard to health conditions. National policy and plans have not considered the indigenous peoples' values and identity, nor their right to self-determination and control of their land and resources, and even less so, their health knowledge and practices, inasmuch western "modern medicine" has been imposed upon them by the dominant culture. Since 1992, as a result of international forums and academia, as well as a growing movement in Peru to acknowledge the value of cultural diversity and the rights of indigenous peoples, Government proposals, initiatives, and programs were undertaken to incorporate and empower cultural contributions and traditional practices in a way that would not only benefit the indigenous, but also enrich, through various intercultural venues, the stock of cultural traditions and ethnic roots of the greater Peruvian society. This article explores specifically how these intercultural strategies have been rolled out in health care to institutionalize the vertical birth method in rural, predominantly indigenous, communities, and endeavors to assess the decrease in maternal mortality, as well as the difficulties encountered, and mostly overcome, by expressing multiculturalism in the health field.