RESUMO
OBJECTIVE: To explore social determinants of drinking water beliefs and practices among the Tz'utujil Maya of Santiago Atitlán, Guatemala, through analysis of demographics, socioeconomic status, memory of historical events, sensory experience, and water attitudes. METHODS: Parallel mixed (qualitative and quantitative) methods, including participant observation, in-depth interviews based on a purposive sample, and 201 semi-structured interviews based on a regional quota sample, were used to collect data from March 2007 to August 2008. Data analysis included the use of grounded theory methodology and Pearson's chi-square test for independence. RESULTS: Qualitative results based on grounded theory highlighted how memory of the Guatemalan Civil War and Hurricane Stan, attitudes about Lake Atitlán water, and the taste and smell of chlorine influenced Tz'utujil Maya drinking water beliefs. Quantitative survey results revealed that differences in ethnicity, literacy, years of schooling, distrust of the water supply during the Civil War and Hurricane Stan, and current beliefs about Lake Atitlán and tap water quality were associated with significantly different water self-treatment practices. CONCLUSIONS: In accordance with social determinants of health paradigms, demographic, socioeconomic, social, cultural, political, and historical factors continue to be significant determinants of water-related health. Public health water interventions must address inequalities related to these underlying factors in order to achieve maximum effectiveness.
Assuntos
Cultura , Etnicidade/psicologia , Halogenação , Conhecimentos, Atitudes e Prática em Saúde , Índios Centro-Americanos/psicologia , Poluição da Água , Purificação da Água/métodos , Abastecimento de Água , Adulto , Comportamento do Consumidor , Estudos Transversais , Tempestades Ciclônicas , Feminino , Água Doce , Humanos , Masculino , Pessoa de Meia-Idade , Odorantes , Eliminação de Resíduos , Saneamento , Meio Social , Fatores Socioeconômicos , Paladar , Confiança , GuerraRESUMO
OBJECTIVE: To explore social determinants of drinking water beliefs and practices among the Tz'utujil Maya of Santiago Atitlán, Guatemala, through analysis of demographics, socioeconomic status, memory of historical events, sensory experience, and water attitudes. METHODS: Parallel mixed (qualitative and quantitative) methods, including participant observation, in-depth interviews based on a purposive sample, and 201 semi-structured interviews based on a regional quota sample, were used to collect data from March 2007 to August 2008. Data analysis included the use of grounded theory methodology and Pearson's chi-square test for independence. RESULTS: Qualitative results based on grounded theory highlighted how memory of the Guatemalan Civil War and Hurricane Stan, attitudes about Lake Atitlán water, and the taste and smell of chlorine influenced Tz'utujil Maya drinking water beliefs. Quantitative survey results revealed that differences in ethnicity, literacy, years of schooling, distrust of the water supply during the Civil War and Hurricane Stan, and current beliefs about Lake Atitlán and tap water quality were associated with significantly different water self-treatment practices. CONCLUSIONS: In accordance with social determinants of health paradigms, demographic, socioeconomic, social, cultural, political, and historical factors continue to be significant determinants of water-related health. Public health water interventions must address inequalities related to these underlying factors in order to achieve maximum effectiveness.
OBJETIVO: Explorar los factores sociales determinantes de las creencias y prácticas con respecto al agua potable de la población maya tz'utujil, que habita en Santiago Atitlán (Guatemala), mediante el análisis de la información demográfica, la situación socioeconómica, la memoria de hechos históricos, la experiencia sensorial y las actitudes con respecto al agua. MÉTODOS: De marzo del 2007 a agosto del 2008, se recopilaron datos por medio de métodos paralelos mixtos (tanto cualitativos como cuantitativos), como la observación de participantes, entrevistas en profundidad basadas en un muestreo intencionado y 201 entrevistas semiestructuradas basadas en un muestreo por cuota regional. En el análisis de los datos se usó el método de la teoría fundamentada o muestreo teórico y la prueba de la chi al cuadrado de Pearson para la independencia. RESULTADOS: Los resultados cualitativos basados en la teoría fundamentada pusieron de relieve que los recuerdos de la guerra civil guatemalteca y del huracán Stan, las actitudes acerca del agua del Lago Atitlán, y el gusto y el olor del cloro influían las creencias de los tz'utujiles con respecto al agua potable. Los resultados cuantitativos de la encuesta indicaron que las diferencias a raíz del grupo étnico, el alfabetismo, los años de escolaridad, la desconfianza del abastecimiento de agua durante la guerra civil y el huracán Stan, y las creencias actuales acerca de la calidad del agua del Lago Atitlán y del agua de grifo estaban asociadas con prácticas de autotratamiento del agua sumamente diferentes. CONCLUSIONES: En consonancia con el paradigma de los factores sociales determinantes de la salud, los factores demográficos, socioeconómicos, sociales, culturales, políticos e históricos siguen siendo determinantes significativos de la salud en relación con el agua. Para que puedan lograr la mayor eficacia posible, las intervenciones de salud pública con respecto al agua deben abordar las desigualdades relacionadas con estos factores fundamentales.
