Interculturalidad and Chilean health: Stakeholder perceptions and the intercultural hospital delivery model
Bibliographic record
Abstract
This study examined interculturality of Indigenous Mapuche healthcare in Chile’s Makewe Hospital. We conducted a descriptive, qualitative, semi-structured, cross-sectional pilot study interviewing key stakeholders, resulting in 11 interviews of patients, Mapuche and occidental providers, public health professionals, administration, and community leaders. We focused on six topics: services and preferences, community participation, interculturality, access to culturally appropriate care, government integration of Indigenous culture and interculturality promotion, and the future of Indigenous care. All groups believed in the need for both kinds of care. However, for community participation, Mapuche indicated no knowledge of interculturality in healthcare, nor any participation, compared with some professionals who believed there was a focus on it. Interculturality expressed by respect for Mapuche ethnomedicine was uniform; however, integration did not appear to Mapuche as effective, whereas professionals and administration interpreted interculturality as a philosophical goal. Regarding culturally appropriate access, Mapuche responses were focused on practical issues, whereas administration and professionals responded by explaining exclusion of Mapuche machi providers as being sensitive to community desires. Government promotion of interculturality was uniformly agreed to be poor. Finally, the future of Indigenous care was seen by Mapuche both optimistically and pessimistically, due to concerns regarding general cultural preservation, whereas professionals emphasized the need to promote preservation. These results indicate a fractionated understanding of definitions and goals among stakeholders. Future policy should focus upon a broader group to implement interculturality, including nongovernmental organizations, academics, and cultural advisors, combined with community-based participatory research, to promote evidence-based, efficient policy efforts and implementation for interculturality in health for the Mapuche.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.006 | 0.009 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.005 | 0.007 |
| Scholarly communication | 0.005 | 0.003 |
| Open science | 0.001 | 0.008 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 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 itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".