Impressions of Interculturality and Health Care in Bolivia: Three Cases from Cochabamba

Considerable health disparities exist that result in both poorer health outcomes and relatively low accessibility of health care for the world’s indigenous populations. States and global/international health organizations have prioritized indigenous health. Intercultural health care plays a pivotal role in this prioritization. Recent governmental changes in Bolivia, a country in which two thirds of the population self-identify as indigenous, have resulted in state discourse centered on decolonization and interculturality that advocates indigenous rights as well as economic and popular democracy. Research that focuses on how intercultural policies are practiced on the ground or on how individuals are experiencing these policies is lacking. Using qualitative data gathered from semi-structured interviews of three individuals living in and around Cochabamba, Bolivia, this thesis explores participants’ thoughts and experiences of interculturality, health, and the Bolivian healthcare system. Results are contextualized 1) through a discussion of the intercultural health care literature based on Latin American examples and 2) according to two health behavior theories: Social Cognitive Theory and the Structural-Ecological Model. The results presented here raise concerns about the implementation and effectiveness of intercultural healthcare policies. Participants have noticed very little change as a result of new polices and are skeptical of the motivations driving interculturality. Additional factors, such as substantial financial barriers, impede intercultural health care. Research that investigates how intercultural health care functions on the ground and in practice in Bolivia has repercussions for health policy on a global scale. The research presented here is of public health importance because, if the goal is to improve the health of indigenous peoples worldwide, a more critical consideration of the implementation of intercultural healthcare efforts, of which this thesis is part, is necessary