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Cited by 45Indigenous Health, Education, and RightsGlobal Maternal and Child HealthMaternal and Neonatal Healthcare

Fuzzy cognitive mapping and soft models of indigenous knowledge on maternal health in Guerrero, Mexico

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Sarmiento, Ivan, Paredes-Solís, Sergio, Loutfi, David, Dion, Anna, Cockcroft, Anne, Andersson, Neil·2020·BMC Medical Research Methodology
DOI 10.1186/s12874-020-00998-wPMC PMC7238543
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Abstract

Background: Effective health care requires services that are responsive to local needs and contexts. Achieving this in indigenous settings implies communication between traditional and conventional medicine perspectives. Adequate interaction is especially relevant for maternal health because cultural practices have a notable role during pregnancy, childbirth and the postpartum period. Our work with indigenous communities in the Mexican state of Guerrero used fuzzy cognitive mapping to identify actionable factors for maternal health from the perspective of traditional midwives. Methods: We worked with twenty-nine indigenous women and men whose communities recognized them as traditional midwives. A group session for each ethnicity explored risks and protective factors for maternal health among the Me’phaa and Nancue ñomndaa midwives. Participants mapped factors associated with maternal health and weighted the influence of each factor on others. Transitive closure summarized the overall influence of each node with all other factors in the map. Using categories set in discussions with the midwives, the authors condensed the relationships with thematic analysis. The composite map combined categories in the Me’phaa and the Nancue ñomndaa maps. Results: Traditional midwives in this setting attend to pregnant women’s physical, mental, and spiritual conditions and the corresponding conditions of their offspring and family. The maps described a complex web of cultural interpretations of disease – “frío” (cold or coldness of the womb), “espanto” (fright), and “coraje” (anger) – abandonment of traditional practices of self-care, women’s mental health, and gender violence as influential risk factors. Protective factors included increased male involvement in maternal health (having a caring, working, and loving husband), receiving support from traditional healers, following protective rituals, and better nutrition. Conclusions: The maps offer a visual language to present and to discuss indigenous knowledge and to incorporate participant voices into research and decision making. Factors with higher perceived influence in the eyes of the indigenous groups could be a starting point for additional research. Contrasting these maps with other stakeholder views can inform theories of change and support co-design of culturally appropriate interventions.

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  • FCM has been used with a wide variety of individuals, including illiterate persons and indigenous groups, to explore causes of complex phenomena.

    “It has been used with a wide variety of individuals, including illiterate persons and indigenous groups, to explore the causes of a variety of complex phenomena, including short birth intervals, disaster preparedness and risk reduction, satisfaction of care amongst HIV patients, maternal health, and livelihood vulnerability (Murungweni et al., 2011;Sarmiento et al., 2022;Sarmiento et al., 2020;”

    From Sexual and gender-based violence against South Sudanese refugees in Uganda: a mixed-methods study (2025) · cites this paper as Sarmiento et al., 2020

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Cited by

Sorted by citations

Authors
Sarmiento, I., Paredes-Solís, S., Loutfi, D., Dion, A., Cockcroft, A., & Andersson, N.
Affiliations
  • McGill University (CA)
  • Universidad Autónoma de Guerrero (MX)
ORCID
Venue
BMC Medical Research Methodology
Publisher
Springer Science and Business Media LLC
Published
2020-05-19
Volume
20
Issue
1
Pages
125-125
ISSN
1471-2288 (ISSN-L)
DOI
10.1186/s12874-020-00998-w
PMC
PMC7238543
OpenAlex
W3027727468
Cited by
45
References
3
Citations by year
2026: 6 · 2025: 8 · 2024: 10 · 2023: 7 · 2022: 10 · 2021: 2 · 2020: 2
FWCI
2.91
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Medical Research Methodology (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • eScholarship@McGill (McGill) (submittedVersion, cc-by)
Funders
  • Consejo Nacional de Ciencia y Tecnología (PDCPN-2013-214858)
  • Faculty of Medicine, McGill University (2017)
  • Quebec Population Health Research Network (2018)
  • CeIBa Foundation (201804HI9-406583-290461)
Topics
  • Social Sciences › Health › Indigenous Health, Education, and Rights
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
  • Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
Keywords
maternal health, indigenous knowledge, traditional midwives, fuzzy cognitive mapping, risk and protective factors, gender-based violence, male involvement in maternal health, traditional healers, culturally sensitive interventions, co-design, Guerrero, Mexico
MeSH terms
Maternal Health, Cognition, Female, Humans, Male, Maternal Health Services, Mexico, Midwifery, Pregnancy, Parturition

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