Une publication récente de Valéry Ridde et la stagiaire postdoctorale Loubna Belaid, membres du RRSPQ, et de P. Cloos parue dans le Canadian Journal of Public Health.
Résumé des auteurs:
OBJECTIVES: This study aims to describe how health professionals and managers put forward ethnocultural arguments to explain the partial failure of a maternal health policy and to discuss the potential impact of such ethnocultural representations on access to care.
METHODS: This was a qualitative research socio-anthropologic in nature, making use of several methods of data collection, including in-depth interviews, informal discussions, non-participant observations conducted in health facilities, and a documentary analysis. In-depth interviews were conducted with 16 health professionals and 10 health district managers. Interviews were recorded and transcribed. The study took place in Djibo district, Burkina Faso.
RESULTS: Ethnic identification, cultural practices related to childbirth (modesty, discretion, presence of women at the birth), the social status of women (low decision-making power), nomadism and social organization of population groups and their resistance to change are erected as “cultural barriers” to the maternal health policy. The widespread use of these representations by health professionals and managers contributes to the stereotyping and blaming of some social groups while hiding the structural factors that in fact have a greater influence on the use of maternal health services.
CONCLUSION: This article highlights the danger of the excessive use of ethnocultural representations based on culturalistic ideology in public health policies in conveying stereotypes of certain groups. Thus, to understand the success or the failure of health policies, it remains important to consider the quality of contact between communities and the health system; structural factors, including the capacity of households to meet the expenses of health care; and distances between villages and health centres. These elements would contribute to a better understanding of the disparities uncovered with regard to the use of health services indicators.