Social determinants of health in indigenous population in the Paraguayan Chaco. A qualitative and quantitative study
METHODS: A survey consisted of both qualitative and quantitative methods to describe health inequalities, experienced by the aboriginal (IP). as compared to non-aboriginal population (NIP). were carried out. A quantitative household-based questionnaire was conducted using a representative sample of rural households. The qualitative aspect consisted in focus group discussions and individual interviews focusing on health problems and social determinants.
RESULTS: In the home survey, 938 households were interviewed, 552 (IP) and 386 (NIP). 83% of IP had incomplete primary education as compared to 69% of the NIP, in housing conditions: precarious houses was observed in 50% of the IP and 13% of the NIP , basic services: 50% NIP and 0.7% of IP have access to potable water, 53% of IP have access to electricity as compared to 96% of NIP, use of health service: 28% of sick IP and 76% of NIP consulted in a hospital, 34% of IP and 66% of NIP were assisted by medical doctors, 54% of the pregnant IP and 87% of NIP had hospital deliveries. In the qualitative study, arterial hypertension, inadequate medical care, tuberculosis, traffic accidents, teenage pregnancy were identified as the major health problems. The identified determinants included intake of salty water, malnutrition, difficult to access to health services, lack of medicines, influence of other cultures, poverty, low education level.
CONCLUSIONS: The results demonstrate important health disparities within indigenous groups as compared to non- indigenous people. The indigenous health status is largely determined by their low socioeconomic status and marginalization. In addition, changes in traditional life pattern increase susceptibility to chronic diseases.