Who's Judging the Quality of Care? Indigenous Maya and the Problem of “Not Being Attended”
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
In developing countries, lack of trust in the quality of care provided is often cited as a major factor promoting reluctance to seek biomedical help for obstetric emergencies. This article draws on fieldwork among Mayan informants in Sololá, Guatemala, to explore poor perceptions of the quality of care received when seeking obstetric care in the hospital. Using data collected over two years, I set out to understand why interviewees repeatedly complain that hospital staff "do not attend to you." I maintain that the powerlessness of patients to influence the treatment they receive further reduces their trust in the quality of care delivered, ultimately negatively impacting the decision to seek obstetric care. Finally, I argue for the importance of recognizing the influence of the wider historical and social context in creating the dynamics of this interaction. The implications of this research in defining the quality of care and skilled attendance within the quest to make pregnancy safer are discussed.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.005 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it