Ethnic inequalities in reproductive, maternal, newborn and child health interventions in Ecuador: A study of the 2004 and 2012 national surveys

Rios-Quituizaca, Paulina; Gatica-Domínguez, Giovanna; Nambiar, Devaki; Santos, Jair L Ferreira; Barros, Aluísio J. D.

doi:10.1016/j.eclinm.2022.101322

Cited by 7 publications

(6 citation statements)

References 29 publications

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“…Similarly, pain management has generally been guided by their own cultural values (37), although these ndings may be described in more details in the near future (38). This same aspect of vulnerability has been observed in Ecuador among the Kichwa population, particularly in young women of reproductive age (39). Considering the speci cities of indigenous women, the wide global distribution of chronic pelvic pain, and its negative impact on people's quality of life, this study aims to identify the prevalence of chronic pelvic pain and describe the associated factors in this population.…”

Section: Introductionmentioning

confidence: 66%

Prevalence of chronic pelvic pain and associated factors among indigenous women of reproductive age in Ecuador

Vargas-Costales,

Rosero,

Mazin

et al. 2024

Preprint

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Background:Chronic pelvic pain is a common disease that affects approximately 4% of women of reproductive age in developed countries. This number is estimated to be higher in developing countries, with a significant negative personal and socioeconomic impact on women. The lack of data on this condition in several countries, particularly those in development and in socially and biologically vulnerable populations such as the indigenous, makes it difficult to guide public policies. Objectives: To evaluate the prevalence of chronic pelvic pain (dysmenorrhea, dyspareunia, non-cyclical pain) and identify which variables are independently associated with the presence of the condition in indigenous women from Otavalo-Ecuador. Design: A cross-sectional study was carried out including a sample of 2429 women of reproductive age between 14-49 years old, obtained from April 2022 to March 2023. A directed questionnaire was used, collected by bilingual interviewers (Kichwa and Spanish) belonging to the community itself; the number of patients was selected by random sampling proportional to the number of women estimated by sample calculation. Data are presented as case prevalence, odds ratio, and 95% confidence interval, with p < 0.05. Results: The prevalence of primary dysmenorrhea, non-cyclic pelvic pain, and dyspareunia was, respectively, 26.6%, 8.9%, and 3.9%.all forms of chronic pain were independently associated with each other. Additionally, dysmenorrhoea was independently associated with hypertension, intestinal symptoms, miscegenation, long cycles, previous pregnancy, use of contraceptives and pear body shape. Urinary symptoms, late menarche, exercise, and pear body shape were associated with non-cyclic pelvic pain. And, urinary symptoms, previous pregnancy loss, late menarche, hormone usage, and pear body shape were associated with dyspareunia. Conclusion: The prevalence of primary dysmenorrhea and non-cyclical chronic pelvic pain was notably high, in contrast with the frequency of reported dyspareunia. Briefly, our results suggest an association between dysmenorrhoea and conditions related to inflammatory and/or systemic metabolic disorders, including a potential causal relationship with other manifestations of pelvic pain, and between non-cyclical pelvic pain and signs/symptoms suggesting central sensitization. The report of dyspareunia may be influenced by local cultural values and beliefs.

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Section: Introductionmentioning

confidence: 66%

Prevalence of chronic pelvic pain and associated factors among indigenous women of reproductive age in Ecuador

Vargas-Costales,

Rosero,

Mazin

et al. 2024

Preprint

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“… 22 , 26 Women from ethnic minorities tend to experience poor social and economic conditions, which could contribute to greater inequity in access to family planning services and contraceptive methods. 22 , 23 , 27 …”

Section: Discussionmentioning

confidence: 99%

Trends and inequities in adolescent childbearing in Latin American and Caribbean countries across generations and over time: a population-based study

Sanhueza

Costa

Mújica

et al. 2023

The Lancet Child & Adolescent Health

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“…Also, the law does not specify how the intercultural policy will be implemented, who is the guarantor, and through what instruments and assumptions. Consequently, due to the unclear nature of the policy and its implementation, indigenous population face multiple barriers in accessing health care, as a result of the structures that produce inequality, particularly discriminatory and racist ideologies [29]; aspects that any policy committed to equity, such as interculturality in health, should consider identifying actions that allow these conditions to be transformed [30].…”

Section: Discussionmentioning

confidence: 99%

Incorporation of Professionals with Training in Interculturality into Sexual and Reproductive Health Services: Feasibility Analysis

Alcalde-Rabanal,

Pelcastre-Villafuerte,

Meneses-Navarro

et al. 2023

Health & Social Care in the Community

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This study evaluates the political, legal, organizational, and availability of resources for the onboarding of health professionals trained in interculturality for sexual and reproductive health care of the indigenous population in public health services. A case study was carried out using a qualitative methodology that implemented intercultural care strategies in reproductive health in two Mexican states with the presence of indigenous population. In regards of the political feasibility, the interest of the actors, positioning, and power were explored. In regards of legal feasibility, the presence of legal impediments was analyzed. In the case of organizational feasibility, we explored the organizational structure and functions of the personnel. Finally, for evaluating the availability of resources, we analyzed the budget available for hiring personnel with intercultural training. Political feasibility shows that the actors recognize the importance of including personnel with intercultural training for reproductive health care in indigenous population; despite this, in both states, there is no clear position in favor of it. In legal feasibility, no impediment for hiring these personnel was found. In organizational feasibility, the organizational structure of health services does not include a unit to oversee intercultural health services and practices and does not specify intercultural functions in the professional required profiles. In both states, there is no budget allocation for hiring personnel with an intercultural profile. Therefore, intercultural actions implemented are part of the local initiative of decision-makers to respond to reproductive health problems within indigenous population. The overall feasibility assessment does not show clear results in favor of incorporating health professionals trained in interculturality for sexual and reproductive health care for indigenous population. Therefore, it is still necessary to advocate on this issue so that intercultural hiring policies can be explicitly concretized in the acquisition of public health services.

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Ethnic inequalities in reproductive, maternal, newborn and child health interventions in Ecuador: A study of the 2004 and 2012 national surveys

Cited by 7 publications

References 29 publications

Prevalence of chronic pelvic pain and associated factors among indigenous women of reproductive age in Ecuador

Prevalence of chronic pelvic pain and associated factors among indigenous women of reproductive age in Ecuador

Trends and inequities in adolescent childbearing in Latin American and Caribbean countries across generations and over time: a population-based study

Incorporation of Professionals with Training in Interculturality into Sexual and Reproductive Health Services: Feasibility Analysis

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