International Journal of Environmental Research and Public Health · 6 authors, 4 centres
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This study used participatory action research to develop a culturally adapted flowchart for managing children with fever among traditional healers in rural Ecuador. The main finding is that 50% of healers used the flowchart, but only 15% referred patients to biomedical systems, with limitations including reliance on focus groups and lack of differentiation between ethnic groups.
Indigenous populations in rural Ecuador face high child mortality and infectious diseases, with traditional healers playing a key role in care. Methods: This participatory action research (PAR) involved 65 healers over four years (2016-2021) in four phases: observation via eight focus groups, planning to create a culturally adapted flowchart, action through ten training workshops with 56 healers, and evaluation via a survey one year later with 60 healers. Key Results: Healers used hands to check fever and focused on alarm signs like dehydration and inactivity. The flowchart was used by 50% of healers, but only 15% transferred patients to biomedical systems, with 70% of transfers accompanied by healers. 60% found the flowchart moderately useful. Limitations: The study relies on focus groups and does not differentiate between cosmovisions of Shuar and Kichwa groups; deeper data collection with interviews could be beneficial. Implications: The findings highlight the need for collaboration between traditional and biomedical health systems, training programs, and culturally adapted tools to improve child health in indigenous communities, though clinical outcomes are not directly measured.
