Welfare and quality of life of the population of guaranda: towards universal health coverage.

Artigas Lelong, Berta (1); Sánchez Marimón, Ester (1); Gaibor, Mariela (2); Calles, Eduardo (2); Yañez Juan, Aina (1) (2018). 'Welfare and quality of life of the population of Guaranda: Towards universal health coverage.' Paper presented at the annual conference of the HDCA, Buenos Aires, Argentina 2018.


Abstract


Introduction:


One of the challenges facing the world is the reduction of inequalities, which affect the well-being of people. Within the framework of the 2030 agenda, the 3rd Sustainability Objective aims to promote a healthy life and well-being for all people of all ages, guaranteeing access and coverage in health. Health affects all aspects of life, from how much we enjoy it to the work we do. Thus following Venkatapuram, health is considered as a metacapacity and quality is analyzed through the ten central human capacities of Nussbaum. This study moves away from a classical conception of health, oriented towards the disease, to be framed in a multidimensional and holistic conception of health. The evaluation of the quality of life is not only universal coverage but it is to live a life with sense and meaning through the freedom of choice. And also including the Capability Approach (CA), based on social justice, that allows analyzing the welfare of people. In this way, it has been possible to analyze the quality of life of a vulnerable group such as the population living in poverty of Guaranda, in order to identify their values ​​and purposes that shape their perception of a good life based on freedom and participation for the transformation of healthy and emancipated


Aims:


To analyze the quality of life of the population living in poverty, starting with the CA and real and perceived capacity of the population to access and use the Health Services.


 Methodology:


Qualitative study from the CA from an ethno-sociological perspective, through semi-structured interviews and discussion groups. In the population established in the poverty segment (n = 77), of Guaranda, by sex and age. A script was designed based on the dimensions of ICECAP and the 10 CA capacities. The interviews were conducted by two researchers of the team, one of them being native, facilitating communication with the indigenous population. An analysis of the content and comprehension of the discourse was carried out. It was deconstructed and codified into categories: (1) Body Health and Life: accessibility, coverage, health problems, food, water and sanitation (2) Control, affiliation and physical security: housing, work, participation and security; (3) Education, imagination, senses and thinking; (4) Relations and emotions: family, friends and neighbors; (5) Leisure; (6) Practical reason: global self-perception of quality of life. And, in all of them, the value and the freedom to improve aspects of their life was collected. Atlas ti.8.0 software was used.


Results:


 There are differences between indigenous and mestizo population, expressing: difficulties related to access and coverage of the health system; health problems about family planning counselling, environmental sanitation, malnutrition, poverty, lack of work, migration and feelings of loneliness. They show access to drinking water and value their participation in regulatory meetings. As proposals for improvement in their life, they raise closeness to the family and change of their residence.


Conclusions:


Although health policies in Ecuador contemplate coverage and access to the health system for the entire population, there are differences among the indigenous population living in rural communities, away from urban centers.


There are deficiencies in the exercise of some capacities in the indigenous population.


It is necessary to develop and implement interventions to improve the quality of life in a situation of poverty.


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