Atención primaria intercultural de salud en Alta Talamanca, región austral de Costa Rica
aprendizajes del EBAIS China Kichá
DOI:
https://doi.org/10.62701/revmedica.v13.5489Keywords:
Atención primaria intercultural de salud; pueblos indígenas; EBAIS China Kichá; Alta Talamanca; equidad en saludAbstract
Intercultural primary health care in Indigenous territories requires organizational models for equitable linguistic mediation. The objective of this article is to systematize the operational and community-based lessons learned from the EBAIS China Kichá clinic in Alta Talamanca, Costa Rica, and to discuss them in light of recent literature. A descriptive case study was conducted, incorporating documentary and newspaper analysis from the period 2022–2025. This analysis included legislative opinions, technical reports, institutional notes, and journalistic pieces that describe the care model. The analysis was structured around five key areas: flexible territorial organization; sociocultural and linguistic mediation; co-governance and local networks; outcomes and legitimacy; and barriers and the regulatory agenda.Global Statistics ℹ️
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References
Aguilar Gavira, S., & Barroso Osuna, J. (2015). La triangulación de datos como estrategia en investigación educativa. Pixel-Bit. Revista de Medios y Educación, (47), 73–88. https://doi.org/10.12795/pixelbit.2015.i47.05
Ahmed, S. K. (2024). The pillars of trustworthiness in qualitative research. Journal of Medicine, Surgery, and Public Health, 2, 100051. https://doi.org/10.1016/j.glmedi.2024.100051
Asamblea Legislativa de Costa Rica. (2023–2024). Expediente 23.392: Declaratoria del EBAIS China Kichá como Institución Benemérita de la Patria (Dictamen afirmativo de mayoría).
Altheide, D. L., & Schneider, C. J. (2013). Qualitative media analysis (2nd ed.). SAGE.
Barbo, G., & Alam, S. (2024). Evidence synthesis – Indigenous people’s experiences of primary health care in Canada: A qualitative systematic review. Health Promotion and Chronic Disease Prevention in Canada, 44(4), 131–151. https://doi.org/10.24095/hpcdp.44.4.01
Borjas García, J. E. (2020). Validez y confiabilidad en la recolección y análisis de datos bajo un enfoque cualitativo. Trascender, contabilidad y gestión, 5(15), 79-97. https://doi.org/10.36791/tcg.v0i15.90
Bowen, G. A. (2009). Document analysis as a qualitative research method. Qualitative Research Journal, 9(2), 27–40. https://doi.org/10.3316/QRJ0902027
Braun, V., & Clarke, V. (2021). Thematic analysis: A practical guide. SAGE.
Caja Costarricense de Seguro Social (CCSS). (2023, 17 noviembre). Ebais China Kichá recibió galardón internacional por sus aportes al mejoramiento de la calidad de vida en población indígena.
Cely Calixto, N. J., Palacios Alvarado, W., & Caicedo Rolón, Á. J. (2023). Conceptos y enfoques de metodología de la investigación. Universidad Francisco de Paula Santander. https://repositorio.ufps.edu.co/server/api/core/bitstreams/7f7338b9-3422-4473-b4f6-509e7e4745bc/content
Dawson, A., Lyons Jaadwa, L., Morey, K., Pearson, O., Harfield, S., Brand Eastern Arrente, T., ... Brown Yuin, A. (2025). Ways of working in Aboriginal and Torres Strait Islander Community Controlled Health Organisations: Describing a conceptual model of comprehensive primary healthcare characteristics. Australian and New Zealand Journal of Public Health, 49(4), 100267. https://doi.org/10.1016/j.anzjph.2025.100267
Fitzpatrick, K. M., Ody, M., Goveas, D., Montesanti, S., Campbell, P., MacDonald, K., Crowshoe, L., Campbell, S., & Roach, P. (2023a). Understanding virtual primary healthcare with Indigenous populations: A rapid evidence review. BMC Health Services Research, 23, 303. https://doi.org/10.1186/s12913-023-09299-6
Fitzpatrick, K., Sehgal, A., Montesanti, S., Pianarosa, E., Barnabe, C., Heyd, A., Kleissen, T. Crowshoe, L. (2023b). Examining the role of Indigenous primary healthcare across the globe in supporting populations during public health crises. Global Public Health, 18(1), 2049845. https://doi.org/10.1080/17441692.2022.2049845
García Segura, A. (2021). Conceptos y prácticas culturales de la medicina ancestral bribri y cabécar en Costa Rica. Cuadernos Intercambio sobre Centroamérica y el Caribe, 18(2), 1–21.
Garza, M., et al. (2025). Health disparities among Indigenous populations in Latin America: A scoping review. International Journal for Equity in Health, 24, 95. https://doi.org/10.1186/s12939-025-02495-2
Hardy, B.-J., et al. (2023). Systematic review of Indigenous cultural safety training interventions for healthcare professionals. BMJ Open, 13(10), e073320. https://doi.org/10.1136/bmjopen-2023-073320
Houghton, N., et al. (2025). Community-driven strategies for primary health care resilience in Latin America and the Caribbean: A scoping review and interviews. The Lancet Regional Health – Americas. https://doi.org/10.1016/S2667-193X(25)00246-7
International Work Group for Indigenous Affairs. (2021). El Mundo Indígena 2021: Costa Rica. https://iwgia.org/es/costa-rica/4130-mi-2021-costa-rica.html
Krippendorff, K. (2019). Content analysis: An introduction to its methodology (4th ed.). SAGE. https://doi.org/10.4135/9781071878781
Lincoln, Y. S., & Guba, E. G. (1985). Naturalistic inquiry. SAGE.
Maceira, D., Peña Quintero, R. E., Suárez, P., & Peña Peña, L. V. (2024). Primary health care as a tool to promote equity and sustainability: A review of Latin American and Caribbean literature. International Journal for Equity in Health, 23, 91. https://doi.org/10.1186/s12939-024-02149-9
Miles, M. B., Huberman, A. M., & Saldaña, J. (2020). Qualitative data analysis: A methods sourcebook (4th ed.). SAGE.
Poitras, M.-E., Vaillancourt, V. T., Canapé, A., Boudreault, A., Bacon, K., & Hatcher, S. (2022). Culturally safe interventions in primary care for Indigenous peoples with chronic conditions: A scoping review. Family Medicine and Community Health, 10(Suppl 1), e001606. https://doi.org/10.1136/fmch-2021-001606
World Health Organization. (2022). Primary Health Care Measurement Framework and Indicators. https://www.who.int/publications/i/item/9789240044210
World Health Organization. (2025, Mar. 26). Primary health care (Fact sheet). https://www.who.int/news-room/fact-sheets/detail/primary-health-care
Yin, R. K. (2018). Case study research and applications: Design and methods (6th ed.). SAGE.
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