Limitations to institutional delivery among Ashaninka mothers of the Peruvian Amazon

According to the World Health Organization (WHO), 2.8 million mothers and newborns die each year from preventable causes, highlighting inequalities in access to quality healthcare services. The study describes the factors that limit institutional childbirth among Ashaninka mothers in the Peruvian Amazon.

The research was descriptive, using a questionnaire administered to 152 Ashaninka mothers from five communities in Río Tambo.

Most Ashaninka mothers who gave birth at home were between 25 and 29 years old, lived with their partners, came from the Koterini Tarzo community, were Catholic, had incomplete secondary education, were housewives, and had a paternal income of less than or equal to 1000 PEN. They chose home birth for cultural reasons such as privacy, tradition, and economics, preferring traditional birth attendants because of their cultural acceptance and experience. Cultural practices included the burial of the placenta, the use of herbs such as "piri piri," and vertical births. The perception of inadequate facilities and the prevalence of cesarean sections limit the acceptance of institutional childbirth. Added to this is a preference for female healthcare personnel, a lack of information about health procedures, and the prohibition of cultural practices.

There is a need to reform the maternal care model in Indigenous contexts, involving healthcare personnel, policymakers, and local authorities to create culturally relevant and accessible services. It is suggested that an intercultural approach be integrated into professional training and that traditional medicine be combined with the healthcare system. Future studies should evaluate the impact of these interventions on maternal and perinatal outcomes in Indigenous communities.