Mamás de la Frontera: Empowering perspectives of Indigenous community health workers along the Putumayo River in the Peruvian Amazon
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Abstract
Introduction: Indigenous peoples in Peru have experienced significant disparities in health and social well-being due to ongoing settler colonialism. Despite significant progress in maternal and neonatal health, regional disparities persist. In response to these challenges, the *Mamás de la Frontera* (Mothers of the Border) program was developed in collaboration with Indigenous communities in the Peruvian Amazon. The program involved training and advocating for community health workers (CHWs) to improve culturally appropriate maternal and child healthcare. This study focuses on the experiences of CHWs as they transitioned from training to community practice.
Methods: Ten CHWs from participating communities near the district of San Antonio del Estrecho were interviewed individually in a semi-structured manner. The transcripts underwent qualitative hybrid coding, integrating an inductive and deductive approach to thematic analysis. The CHWs also participated in a workshop designed to collect their experiences and expectations regarding program training, roles and direct service translation.
Results: Upon applying thematic analysis, four primary themes emerged: (1) roles and responsibilities, (2) cultural practices, (3) training, translation and dissemination, and (4) barriers and needs experienced by CHWs. Each theme included respective sub-themes, providing more detail and specificity. The photo workshop complemented the formalised qualitative findings, further emphasising the perceptions and feedback of CHWs regarding topics such as role satisfaction, community dynamics and belonging.
Conclusions: The findings reinforce the existing empirical evidence on the experiences of Indigenous CHWs, emphasising the components of program implementation and the adaptation of healthcare delivery in rural Amazonian settings. CHWs play a vital role in promoting maternal and child health and community well-being. The implications of this work are to further inform culturally integrative, strength-based community health programming, prevention strategies, advocacy, resource development and health system reform, with the aim of better supporting Indigenous populations in Peru.
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