Critical analysis of interculturality in the National Policy for the Care of Indigenous Peoples in Brazil

Abstract

Concern for culturally appropriate and intercultural care, based on linkages and complementarity among health knowledges, has been a priority for ensuring primary health care for indigenous peoples since the Alma-Ata Conference. In Brazil, a country with significant sociocultural variety in the South American indigenous context, a National Policy for the Care of Indigenous Peoples (PNASPI) was established 16 years ago, focusing on the notion of differentiated care. This concept, considered incomplete and contradictory, has been variably operationalized in indigenous primary health care. Therefore, the present article proposes an analysis of the formulation and operationalization of this concept in PNASPI. The analysis brings to light the ethnocentric nature of PNASPI, the numerous contradictions and oversights that fail to encompass the exchanges and linkages with traditional knowledges and with indigenous emic views of health and processes of illness/cure. The reversal of these limitations will require greater epistemological reflexivity, questioning, and surveillance of both the social and political sciences, as well as social movements and indigenous social control, to redefine indigenous primary health care in Brazil in intercultural terms.