Intercultural approach and intervention in primary health care: family neglect in indigenous communities

Abstract

Introduction: Child neglect is a public health issue whose understanding in Indigenous contexts requires an intercultural approach and an analysis of the social and historical determinants that shape caregiving practices. When considered in isolation, traditional conceptions of neglect may lead to reductionist interpretations that place blame on families. Therefore, it is essential to understand neglect as a manifestation of structural vulnerabilities and limited access to public policies and services. Objective: To analyze the role of Primary Health Care (PHC) in monitoring and supporting a Terena Indigenous family living in an urban Indigenous community and experiencing social vulnerability. Professional Experience Report: This report is based on the clinical training experience of medical students at a Family Health Unit. The case involved a nine-year-old child presenting with myiasis and incomplete immunization, identified through a mandatory reporting process. The case was addressed using Charles Maguerez's Arch, incorporating active listening, home visits, and mediation by an Indigenous Community Health Worker. Discussion: The family assessment indicated the highest level of risk, prompting the involvement of the social protection network. The report critically examines the unreflective application of Western normative categories in the context of structural determinants affecting the family, including food insecurity, multidimensional vulnerabilities, and gender-related burdens associated with reproductive and caregiving labor in an urban setting. Final Considerations: This report advocates an approach grounded in trust-building, intersectoral collaboration, and a decolonial perspective, emphasizing the role of PHC in territorially grounded care and the importance of practical experience in training physicians with a critical, humanistic perspective and a commitment to health equity.