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dc.contributor.author
Hitziger, Martin
dc.contributor.author
Berger Gonzalez, Mónica
dc.contributor.author
Gharzouzi, Eduardo
dc.contributor.author
Ochaíta Santizo, Daniela
dc.contributor.author
Solis Miranda, Regina
dc.contributor.author
Aguilar Ferro, Andrea I.
dc.contributor.author
Vides-Porras, Ana
dc.contributor.author
Heinrich, Michael
dc.contributor.author
Edwards, Peter
dc.contributor.author
Krütli, Pius
dc.date.accessioned
2017-11-22T11:15:37Z
dc.date.available
2017-10-06T03:27:29Z
dc.date.available
2017-11-22T11:15:37Z
dc.date.issued
2017
dc.identifier.other
10.1186/s13002-017-0170-y
en_US
dc.identifier.uri
http://hdl.handle.net/20.500.11850/191609
dc.identifier.doi
10.3929/ethz-b-000191609
dc.description.abstract
Background Up to one half of the population in Africa, Asia and Latin America has little access to high-quality biomedical services and relies on traditional health systems. Medical pluralism is thus in many developing countries the rule rather than the exception, which is why the World Health Organization is calling for intercultural partnerships to improve health care in these regions. They are, however, challenging due to disparate knowledge systems and lack of trust that hamper understanding and collaboration. We developed a collaborative, patient-centered boundary mechanism to overcome these challenges and to foster intercultural partnerships in health care. To assess its impact on the quality of intercultural patient care in a medically pluralistic developing country, we conducted and evaluated a case study. Methods The case study took place in Guatemala, since previous efforts to initiate intercultural medical partnerships in this country were hampered by intense historical and societal conflicts. It was designed by a team from ETH Zurich’s Transdisciplinarity Lab, the National Cancer Institute of Guatemala, two traditional Councils of Elders and 25 Mayan healers from the Kaqchikel and Q’eqchi’ linguistic groups. It was implemented from January 2014 to July 2015. Scientists and traditional political authorities collaborated to facilitate workshops, comparative diagnoses and patient referrals, which were conducted jointly by biomedical and traditional practitioners. The traditional medical practices were thoroughly documented, as were the health-seeking pathways of patients, and the overall impact was evaluated. Results The boundary mechanism was successful in discerning barriers of access for indigenous patients in the biomedical health system, and in building trust between doctors and healers. Learning outcomes included a reduction of stereotypical attitudes towards traditional healers, improved biomedical procedures due to enhanced self-reflection of doctors, and improved traditional health care due to refined diagnoses and adapted treatment strategies. In individual cases, the beneficial effects of traditional treatments were remarkable, and the doctors continued to collaborate with healers after the study was completed. Comparison of the two linguistic groups illustrated that the outcomes are highly context-dependent. Conclusions If well adapted to local context, patient-centered boundary mechanisms can enable intercultural partnerships by creating access, building trust and fostering mutual learning, even in circumstances as complex as those in Guatemala. Creating multilateral patient-centered boundary mechanisms is thus a promising approach to improve health care in medically pluralistic developing countries.
en_US
dc.language.iso
en
en_US
dc.publisher
BioMed Central
en_US
dc.rights.uri
http://creativecommons.org/licenses/by/4.0/
dc.subject
Intercultural health
en_US
dc.subject
Central America
en_US
dc.subject
Traditional medicine
en_US
dc.subject
Mayan medicine
en_US
dc.subject
Partnerships
en_US
dc.subject
Guatemala
en_US
dc.subject
Boundary management
en_US
dc.subject
Integrative medicine
en_US
dc.title
Patient-centered boundary mechanisms to foster intercultural partnerships in health care: a case study in Guatemala
en_US
dc.type
Journal Article
dc.rights.license
Creative Commons Attribution 4.0 International
dc.date.published
2017-08-08
ethz.journal.title
JOURNAL OF ETHNOBIOLOGY AND ETHNOMEDICINE
ethz.journal.volume
13
en_US
ethz.pages.start
44
en_US
ethz.size
13 p.
en_US
ethz.version.deposit
publishedVersion
en_US
ethz.identifier.wos
ethz.identifier.scopus
ethz.publication.place
London
en_US
ethz.publication.status
published
en_US
ethz.leitzahl
ETH Zürich::00002 - ETH Zürich::00012 - Lehre und Forschung::00007 - Departemente::02350 - Dep. Umweltsystemwissenschaften / Dep. of Environmental Systems Science::02723 - Institut für Umweltentscheidungen / Institute for Environmental Decisions::02351 - TdLab / TdLab
ethz.leitzahl.certified
ETH Zürich::00002 - ETH Zürich::00012 - Lehre und Forschung::00007 - Departemente::02350 - Dep. Umweltsystemwissenschaften / Dep. of Environmental Systems Science::02723 - Institut für Umweltentscheidungen / Institute for Environmental Decisions::02351 - TdLab / TdLab
ethz.date.deposited
2017-10-06T03:27:57Z
ethz.source
WOS
ethz.eth
yes
en_US
ethz.availability
Open access
en_US
ethz.rosetta.installDate
2017-11-22T11:15:40Z
ethz.rosetta.lastUpdated
2018-11-06T03:12:25Z
ethz.rosetta.versionExported
true
ethz.COinS
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