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Cultural advisories in the services of maternity´s health for the indigenous cross-border community Ngäbe Bugle (WHP)

Primary GCM Objectives

Secondary GCM Objectives

    7
    18
    22

GCM Guiding Principles*

*All practices are to uphold the ten guiding principles of the GCM. This practice particularly exemplifies these listed principles.

Sustainable Development Goals (SDGs)

Dates

2021 - Present

Geographic scope

Country:

Regions:

Sub Regions:

Local:

The project is developed in the San Vito Hospital of Coto Brus, in the canton of Puntarenas.This community borders with Panama on the East and is associated with historical indigenous migrations from the Ngäbe Bugle cross-border community

Summary

The Ngäbe Bugle cross-border indigenous population lives between Costa Rica and Panama moving seasonally between the two territories for harvesting, usually with their families. Faced with difficulties related to immigration status, nationality, gender, racism, and abuses of various kinds due to a lack of knowledge of the Spanish language, this population has limited access to national health services. Therefore, the local hospital and IOM incorporated Cultural Advisors services Ngäbe Bugle women who link the medical team and the indigenous population through support and translation to bring maternity health services closer to the Ngäbe Bugle community.

The main activities implemented in this program are:

  • To provide cultural counseling to hospital staff to offer more inclusive and relevant services to the Ngäbe population
  • Accompanying medical officials and Hospital health personnel in periodic visits to Ngäbe territories
  • Provide bilingual Spanish-Ngäbere support services in the health services of the San Vito de Coto Brus Hospital
  • Provide workshops to the population on infectious diseases, basic care, personal hygiene, post-intervention care, care of women before, during and after pregnancy, among other informative activities.

Additionally, IOM supported the hospital to incorporate appropriate and culturally adapted gowns for the population, signage and informative material in the Ngäbere language, decorations allusive to the culture and a delivery room with implements traditionally used by the indigenous people in childbirth.

Organizations

Main Implementing Organization(s)

International Organization for Migration (IOM)

Partner/Donor Organizations

Caja Costarricense del Seguro Social - CCSS

Benefit and Impact

- Indigenous population and migrants have effective access to health services in San Vito of Coto Brus
- Other health centers have shown interest and initiative to start similar projects
- The healthcare providers have increased their capacities to provide adequate services to this population
- The provision of culturally relevant health services to the indigenous population has been shown to improve the provision, coverage and outreach for health care institutions.

Key Lessons

It has been shown that for certain cultures it is neither usual nor reliable to receive health services from people outside their culture, particularly in the maternity area. Through this project it is demonstrated that the involvement of a Ngäbe person in the services increases the trust of this population towards the rest of the health professionals and therefore increases the reach of the services that the Hospital provides. Additionally, the healthcare professionals have learned from the population and have adapted their services in order to make them more accessible and pertinent for their culture.

Recommendations(if the practice is to be replicated)

A long-term institutional sustainability plan must be established from the formulation of the project because once the service is installed it must be able to be actively maintained in order to work at its best.

Innovation

Cultural advisories in health services have represented a whole new vision for the Ngäbe population on the accessibility of health services in San Vito de Coto Brus through language interpretation services, which are fundamental for the provision of health services, the security that a Ngäbe person brings to the population and the adaptation that health professionals have made to ensure adequate care for this population. This initiative has sparked interest in other nearby localities that have made efforts to make their services more inclusive for the indigenous population, such as the Ciudad Neily Hospital. This hospital has also developed appropriate and culturally adapted gowns for the population, signage and informative material in the Ngäbere language, and a delivery room with implements traditionally used by the indigenous people in childbirth.
This practice has provided essential background information for the development of other initiatives related to support cross-border indigenous population. At the present time IOM, carries out the project Piloting Migrant-Sensitive Health Facilities in the Central American Migration Corridor (supported by the IOM Development Fund). This project started in 2023 and will be finished in 2025.
This project aims to promote comprehensive health services in Costa Rica and Guatemala which are accessible, equitable and well suited to indigenous communities’ and migrants' specific needs.
The intended outcome of the project is that the government health centers in Costa Rica and Guatemala utilize the acquired knowledge and tools to provide health care that meets migrants' specific needs.
The project main objectives are: Strengthen the intercultural perspective in the public health services through the creation of a training process aimed at health care personnel and promote the creation of national and local instruments for providing care that is sensitive to the specific needs and vulnerabilities of migrants and other people on the move, including IDPs and indigenous people.

The intercultural training process will be applied to the health care personnel of San Vito of Coto Brus Hospital and the Ciudad Neily Hospital, the latter mentioned has shown interest in the replication of inclusive practices for cross-border indigenous population following the WHP project of Cultural advisories.

Media

Asesorías culturales en los servicios de salud de maternidad para la población indígena Ngäbe Bugle

Asesorías culturales en los servicios de salud de maternidad para la población indígena Ngäbe Bugle

Additional Images

Date submitted:

01 August 2024

Disclaimer: The content of this practice reflects the views of the implementers and does not necessarily reflect the views of the United Nations, the United Nations Network on Migration, and its members.

 

 

*References to Kosovo shall be understood to be in the context of United Nations Security Council resolution 1244 (1999).