Bridging Western and Indigenous knowledge through intercultural dialogue: lessons from participatory research in Mexico

Abstract

Indigenous communities in Latin America and elsewhere have complex bodies of knowledge, but Western health services generally approach them as vulnerable people in need of external solutions. Intercultural dialogue recognises the validity and value of Indigenous standpoints, and participatory research promotes reciprocal respect for stakeholder input in knowledge creation.As part of their decades-long community-based work in Mexico’s Guerrero State, researchers at the Centro de Investigación de Enfermedades Tropicales responded to the request from Indigenous communities to help them address poor maternal health. We present the experience from this participatory research in which both parties contributed to finding solutions for a shared concern. The aim was to open an intercultural dialogue by respecting Indigenous skills and customs, recognising the needs of health service stakeholders for scientific evidence.Three steps summarise the opening of intercultural dialogue. Trust building and partnership based on mutual respect and principles of cultural safety. This focused on understanding traditional midwifery and the cultural conflicts in healthcare for Indigenous women. A pilot randomised controlled trial was an opportunity to listen and to adjust the lexicon identifying and testing culturally coherent responses for maternal health led by traditional midwives. Codesign, evaluation and discussion happened during a full cluster randomised trial to identify benefits of supporting traditional midwifery on maternal outcomes. A narrative mid-term evaluation and cognitive mapping of traditional knowledge offered additional evidence to discuss with other stakeholders the benefits of intercultural dialogue. These steps are not mechanistic or invariable. Other contexts might require additional steps. In Guerrero, intercultural dialogue included recovering traditional midwifery and producing high-level epidemiological evidence of the value of traditional midwives, allowing service providers to draw on the strengths of different cultures.

The Two Great Healing Traditions: Issues, Opportunities, and Recommendations for an Integrated First Nations Healthcare System in Canada

“…Trust building is possible through building intentional partnerships for linking biomedical and traditional medicines, 60 shared decision-making approaches that consider culture, 61 and intercultural dialog which sets the stage for respectful and culturally safe engagement. 62 FN recommend collaborative engagements to promote cultural safety in health care. 63,64 Examples abound of such efforts that mirror recommendations of respondents in this study.…”

Safe birth in cultural safety in southern Mexico: a pragmatic non-inferiority cluster-randomised controlled trial

“…This participatory research applies the principles of cultural safety and aims to promote intercultural dialogue between Indigenous and Western health care traditions. The study was part of a bigger initiative to foster intercultural dialogue [ 27 ], in which parties with different cultural backgrounds converge to work out solutions around a shared concern of poorer maternal health outcomes [ 28 , 29 ] by respecting Indigenous skills and ways and recognising the needs of scientific evidence [ 30 ].…”

Maternal health and Indigenous traditional midwives in southern Mexico: contextualisation of a scoping review

“…The scoping review was part of a bigger process to bridge Indigenous and Western perspectives through intercultural dialogue. 37 We contextualised the findings from the scoping review using stakeholder perspectives already gathered in independent exercises in which participants had full control and authorship of the maps. The present review compares patterns between different perspectives.…”