Healthcare inequalities and interculturality in Northern Argentina: A mixed-methods analysis

Abstract

Introduction: Health indicators among Latin America's Indigenous peoples remain lower than national averages, making them one of the most disadvantaged socioeconomic groups. This study characterizes the functioning of the health system in the province of Salta (Argentina) and analyzes the priorities and potential spaces for consensus among key actors regarding perinatal health.Methods: A multiple-choice questionnaire was administered to 609 pregnant women attending primary healthcare centers and hospitals in the province of Salta. Descriptive statistics from its analysis were complemented by twenty in-depth interviews with provincial government officials and Indigenous territorial authorities.Results: Significant disparities were found in travel time to health services between Indigenous and non-Indigenous women. Among Indigenous women, only 20% reported having given birth in a delivery room during their most recent pregnancy. Differences were also observed among Indigenous groups regarding the health services provided, including support during childbirth; choice of birthing position; and the possibility of incorporating traditional practices. Furthermore, Indigenous communities understood health as closely linked to access to land, housing, recognition of rights, and mutual respect, whereas government officials tended to frame health strategies primarily around the development of integrated health service networks.Conclusion: Beyond formal declarations, the intercultural health approach has not been effectively implemented in the Salta health system. However, areas of convergence exist between institutional actors and Indigenous communities, particularly regarding the strengthening of primary healthcare strategies and the promotion of coordination mechanisms between formal health regulations and Indigenous cultural knowledge.