RESUMO
RESUMEN Los pueblos indígenas continúan enfrentándose a diversas barreras de acceso a servicios de salud y nutrición y tienen poca representatividad e inclusión en los procesos de toma de decisiones sobre el tema. Las herramientas de educación alimentaria y nutricional (EAN) con las que cuenta el país no se adecúan a las realidades agroalimentarias de los pueblos indígenas del Vaupés. Este documento describe un proceso de co-construcción de materiales de EAN enfocados especialmente en gestantes, lactantes y niños y niñas menores de 2 años. El material se construyó con tres comunidades indígenas, un grupo de lideresas indígenas y las instituciones de salud locales del departamento del Vaupés. Se realizaron talleres y entrevistas y revisión documental. A partir de dicha información se construyó un rotafolio con 12 mensajes para fortalecer el inicio de la alimentación complementaria en los niños y las niñas con una visión intercultural y para apoyar los procesos de inducción y reinducción del personal que llega a trabajar al territorio. El material promueve las acciones contempladas por la legislación colombiana en las rutas integrales de atención, pero sobre todo las acciones de cuidado propias de los pueblos indígenas. Esta herramienta de EAN articula ambos saberes y aporta los elementos para promover la salud integralmente desde la perspectiva de las culturas locales.
ABSTRACT Indigenous peoples continue to face various barriers to accessing health and nutrition services, and they have little representation and inclusion in decision-making processes regarding these subjects. The food and nutrition education (FNE) tools currently available in the country are not adapted to the agro-food realities of the indigenous peoples of Vaupés. This document describes a process of co-constructing FNE materials focused on pregnant women, infants, and children under 2 years of age. The material was developed in collaboration with three indigenous communities, a group of indigenous leaders, and local health institutions in the department of Vaupés. The process included workshops, interviews, and documentary reviews. Based on this information, a flip chart with 12 messages was created to strengthen the initiation of complementary feeding in children with an intercultural vision and to support the training processes of health personnel who arrive to work in the territory. The material promotes health interventions that are contemplated by Colombian legislation in the comprehensive care routes, but above all, it prioritizes the health interventions of indigenous peoples. This FNE tool integrates both local knowledge and external expertise, providing the elements to promote a comprehensive approach to health that takes into account the local worldviews.
RESUMO
Despite the high prevalence of diabetes in rural Guatemala, there is little education in diabetes self-management, particularly among the indigenous population. To address this need, a culturally relevant education intervention for diabetic patients was developed and implemented in two rural communities in Guatemala. An evaluative research project was designed to investigate if the structured, community-led diabetes self-management intervention improved selected health outcomes for participants. A one-group, pretest-posttest design was used to evaluate the effectiveness of the educational intervention by comparing measures of health, knowledge, and behavior in patients pre- and postintervention. A survey instrument assessed health beliefs and practices and hemoglobin A1c (HgA1c) measured blood glucose levels at baseline and 4 months post initiation of intervention (n = 52). There was a significant decrease (1.2%) in the main outcome measure, mean HgA1c from baseline (10.1%) and follow-up (8.9%; p = .001). Other survey findings were not statistically significant. This study illustrates that a culturally specific, diabetes self-management program led by community health workers may reduce HgA1c levels in rural populations of Guatemala. However, as a random sample was not feasible for this study, this finding should be interpreted with caution. Limitations unique to the setting and patient population are discussed in this article.
Assuntos
Serviços de Saúde Comunitária/métodos , Diabetes Mellitus Tipo 2/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Promoção da Saúde/métodos , Indígenas Centro-Americanos/psicologia , Agentes Comunitários de Saúde/educação , Relações Comunidade-Instituição , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/tratamento farmacológico , Feminino , Georgia , Hemoglobinas Glicadas/análise , Guatemala , Educação em Saúde , Pessoal de Saúde , Inquéritos Epidemiológicos , Hemoglobina A/análise , Humanos , Hipoglicemiantes/uso terapêutico , Masculino , Metformina/uso terapêutico , População Rural , Faculdades de Medicina , AutocuidadoRESUMO
Global health education and health promotion have the potential to engage students, scholars, and practitioners in ways that go beyond the classroom teaching routine. This engagement in global communities, can range from reflection on continuing deep-seated questions about human rights and civic responsibility to the use of health education and promotion-related theoretical, intellectual, and practical skills. In the arena of global health education and promotion, these skills also range from leadership and advocacy to decision making, critical and creative thinking, teamwork, and problem solving. In recent times, there has been a growing interest in cross-cultural collaborations and educational initiatives to improve stakeholder's understanding of global health principles and practices, to enrich the experiences of health professionals, and to improve the lives of those who are disenfranchised and live across borders. In this article of Health Promotion Practice, we highlight two unique cases of cross-national collaborations and provide a glimpse of the various shapes and forms taken by cross-cultural educational initiatives for global health education and promotion. We summarize the history, philosophy, and current working practices relevant to these collaborations, keeping in view the global health domains, competencies, and activities. In addition, we also compare the key components and activities of these two case studies from Rwanda and Mexico, wherein communities in these two countries collaborated with academic institutions and health professionals in the United States.