Jorge Luis Cruz Burguete

La economía del grupo doméstico: determinante de muerte materna entre mujeres indígenas de Chiapas, México

OBJETIVO: Evaluar la situacion economica y las relaciones de genero en cuanto factores determinantes de muerte materna en la subregion de Patwitz, en Chiapas, Mexico. METODOS: Se realizo un estudio cuantitativo y cualitativo mediante la aplicacion de una encuesta a 158 familias, entrevistas a profundidad a personas vinculadas con los casos de muerte materna y a lideres sociales de la region, asi como grupos focales con parteras. RESULTADOS: La toma de decisiones respecto a la salud de la mujer en el seno de la familia constituye un problema critico por cuanto depende exclusivamente del esposo y los familiares de este. Cuando el embarazo o el parto conllevan algun riesgo, tal situacion introduce restricciones en la eleccion de opciones de atencion fuera de la comunidad, de modo que 48,7% de los casos obstetricos son atendidos por parteras, 45,3% por familiares y 6% por la pareja. El problema se agrava por la alta marginacion y el muy bajo indice de desarrollo humano que caracterizan a la region estudiada, por la falta de acceso de las mujeres a la posesion de bienes, incluida la herencia de la tierra, y por el hecho de que 97,7% de ellas hablan solamente lenguas indigenas. CONCLUSIONES: Las inequidades por razones de genero en las familias indigenas, aunadas a una economia que no cubre las necesidades basicas, son factores que contribuyen a que las mujeres no reciban atencion en el proceso reproductivo. Debido al bajo nivel socioeconomico, las decisiones que se toman en torno a la atencion del embarazo, el parto y el puerperio tienen un alto costo en la salud y en la vida de las mujeres.OBJECTIVE:To assess the determining role of financial situation and gender relations on maternal mortality among Indigenous women in Chiapas, Mexico. METHODS:A quantitative/qualitative study was performed by means of a survey of 158 families, as well as in-depth interviews of persons linked to cases of maternal death, community leaders from throughout the region, and focal groups composed of traditional birth attendants. RESULTS:Decision-making surrounding womens health within the household is a critical problem because it is entirely in the hands of the husband and his relatives. In cases of high-risk pregnancy or birth, options for seeking care outside the community become limited, so that 48.7% of all obstetric cases are assisted by traditional birth attendants, 45.3% by relatives, and 6% by the mate. The problem is compounded by the high level of marginalization and very low human development index that characterize the region under study, by womens exclusion from the ownership of goods, including land, and by the fact that 97.7% of women only speak indigenous languages. CONCLUSIONS:Gender inequities within Indigenous families, together with a household economy that does not cover the basic necessities, are among the factors that keep women from receiving the necessary care during their reproductive processes. Because of the low socioeconomic status these women have, decisions surrounding care during pregnancy, birth, and the puerperium take a large toll on their health and their lives.OBJECTIVE To assess the determining role of financial situation and gender relations on maternal mortality among Indigenous women in Chiapas, Mexico. METHODS A quantitative/qualitative study was performed by means of a survey of 158 families, as well as in-depth interviews of persons linked to cases of maternal death, community leaders from throughout the region, and focal groups composed of traditional birth attendants. RESULTS Decision-making surrounding womens health within the household is a critical problem because it is entirely in the hands of the husband and his relatives. In cases of high-risk pregnancy or birth, options for seeking care outside the community become limited, so that 48.7% of all obstetric cases are assisted by traditional birth attendants, 45.3% by relatives, and 6% by the mate. The problem is compounded by the high level of marginalization and very low human development index that characterize the region under study, by womens exclusion from the ownership of goods, including land, and by the fact that 97.7% of women only speak indigenous languages. CONCLUSIONS Gender inequities within Indigenous families, together with a household economy that does not cover the basic necessities, are among the factors that keep women from receiving the necessary care during their reproductive processes. Because of the low socioeconomic status these women have, decisions surrounding care during pregnancy, birth, and the puerperium take a large toll on their health and their lives.