The Hegemony of the Biomedical Model from the representations of health care worker in the context of a health care model with an intercultural approach in Chugchilán, Ecuador

Abstract This article aims to discover the intercultural practical approach in the context of the Comprehensive Healthcare Model within family, community, and interculturality in Chugchilán, Ecuador, via the recognition of knowledge, perceptions, and practices applied by the health team in maternal and child care. In this ethnographic study 21 health professionals, both Indigenous and non-indigenous from Chugchilán Health Center have participated, among the Indigenous health care workers were the primary health care technicians. The techniques applied were participant observation and in-depth interviews. The observed scenarios were the Health Center and excursion with community to record their daily life experiences. The generated data were examined using thematic content analysis. It showed that the operating biomedical hegemonic model could constitute one of the main limitations in the development of the intercultural approach. Even though Indigenous healthcare team holds an ambiguous and sometimes contrary role to the biomedical model, it has emerged as a counter-hegemonic element and real conciliator between biomedical and indigenous knowledge in intercultural contexts of care-self-care. Resumen Este artículo pretende conocer cómo se pone en práctica el enfoque intercultural en el contexto del Modelo de Atención Integral de Salud con enfoque Familiar, Comunitario e Intercultural en Chugchilán (Ecuador), mediante los conocimientos, percepciones y prácticas que aplica el equipo de salud en la atención materno-infantil. Estudio etnográfico, en que participaron 21 profesionales sanitarios entre profesionales indígenas -técnicos de atención primaria de salud- y no indígenas del Centro de Salud. Las técnicas llevadas a cabo fueron observación participante y entrevistas en profundidad. Los datos generados se analizaron mediante análisis del contenido temático. El análisis de los datos evidenció que la hegemonía del modelo biomédico operante podría constituir una limitación en el desarrollo del enfoque intercultural, sin embargo, el personal de salud indígena, desde su rol ambiguo y contrario al modelo biomédico, emerge como un elemento contrahegemónico y articulador real entre los saberes biomédicos e indígenas en contextos interculturales de atención-autoatención.