Aging in rural, indigenous communities: an intercultural and participatory healthcare approach in Mexico

Abstract

From an ethno-gerontological perspective, new models are needed to fulfill the health needs of the indigenous older adult population in Mexico. In this paper we developed a comprehensive healthcare model, interculturally appropriate, designed to meet the needs of Mexican indigenous older adults. The model was constructed using a qualitative design with semi-structured interviews of older adults, health providers, and available health resources in three Mexican indigenous regions. An ethnographical review was carried out to contextually characterize these communities. At the same time, a comprehensive bibliographic revision was made to identify socio-demographic markers. Results pointed out that Mexican indigenous older adults are not covered by any type of social health insurance program. Their health problems tend in large part to be chronic in nature due to the lack of early diagnosis and treatment. There is a need for trained human resources in the field of gerontology encompassing the sociocultural context of the indigenous groups. The geographical location of these communities limits the permanent presence of healthcare givers and thus limits access to continuous care. Traditional healthcare givers, able to speak the native language, are a great asset allowing the invaluable possibility of direct verbal communication. Based upon the data gathered from indigenous older adults and service providers, in tandem with evidence from the literature, we identified key elements for successful intervention and designed an intervention model. We concluded that indigenous older adults are a more vulnerable group, given that aside from being elderly in a country where the health needs of these populations exceed the capacity of existing healthcare services, their ethnicity serves as an added barrier preventing their access to the limited available healthcare resources. To achieve uniformity in providing health care, today's health systems need to address intercultural and participative aspects of healthcare models.

Successful ageing in older persons belonging to the Aymara native community: exploring the protective role of psychosocial resources

“…The first is the importance of maintaining certain indigenous cultural practices, both specifically in the area of health and generally in social interaction. The second element is the fact that this community competently interacts and participates in the daily life of the broader society (that is, the non-indigenous society), with which it shares customs, social and economic exchanges and the use of the same language (Pelcastre-Villafuerte et al, 2017 ).…”

Patients with more comorbidities have better detection of chronic conditions, but poorer management and control: findings from six middle-income countries

“…Policies also need to address continual accessibility to healthcare after first diagnosis. In MICs, it is not uncommon for patients to travel from rural residences to the urban areas to seek medical treatment, limiting their ability to regularly visit healthcare services and continue treatment, which results in suboptimal control of NCDs [52,70,71]. In addition, there are complexities of insurance policies.…”

How have researchers defined and used the concept of ‘continuity of care’ for chronic conditions in the context of resource-constrained settings? A scoping review of existing literature and a proposed conceptual framework

“…Table 2 provides a summary of how the concepts of CoC were used. Continuity, defined as care delivered over time, was mentioned in more than half the articles ( n = 11) and was less likely to appear in articles using system analysis [36–46]. Four reports defined lack of continuity as care provided by several health providers [40, 43, 47, 48], while four focused on continuity as the quality of the patient–professional relationship [40, 41, 43, 45].…”

“…All papers focusing on the consistency of providers or the patient–professional relationship were reporting patient or provider perspectives. Eleven articles focused on continuity as the coordination of care across levels and disciplines [36–39, 41, 45, 46, 49–52]; only two of the provider perspective articles discussed the informational component of continuity in particular [41, 49]. Finally, six articles discussed continuity with attention to adherence and compliance to treatment [47, 53, 54], access and availability of care [40, 46], or quality of care [55].…”