Cultural Sensitivity and Global Pharmacy Engagement in Latin America: Argentina, Brazil, Ecuador, Guatemala, and Mexico

By Haack, Sally L.; Mazar, Inbal et al. | American Journal of Pharmaceutical Education, May 2019 | Go to article overview

Cultural Sensitivity and Global Pharmacy Engagement in Latin America: Argentina, Brazil, Ecuador, Guatemala, and Mexico


Haack, Sally L., Mazar, Inbal, Carter, Erin M., Addo-Atuah, Joyce, Ryan, Melody, Preciado, Laura Leticia Salazar, Lucano, Luis Renee Gonzalez, Ralda, Aliz Lorena Barrera, American Journal of Pharmaceutical Education


INTRODUCTION

Schools and colleges of pharmacy in the United States have demonstrated an increased interest in global health. (1-3) Three factors are driving this change: changes in higher education that emphasize globalization, increased visibility of global health care needs, and resource expansion resulting in increased opportunities for students and universities. (4) Similar to students in other health professions, US pharmacy students are increasingly pursuing Latin American field experiences in part because of the proximity of the region to the United States and the reasonable travel costs. Little information is available in the pharmacy literature regarding how students should prepare to provide culturally appropriate care in these settings, despite the importance of having cultural sensitivity and humility.

Latin America consists of predominantly Spanish-and Portuguese-speaking nations. These nations comprise nearly 13% of the earth's total land surface area and share similarities as a result of their history of colonization by Spain or Portugal. (5) Mexico, Central and South America, and the Spanish-speaking Caribbean islands of Puerto Rico, Cuba, and the Dominican Republic make up Latin America (Table 1). There are differences between countries and even within countries with respect to the cultural beliefs, values and customs, languages, socioeconomic status, and education of the people. The examples provided in this paper may not be generalizable to all cultural groups and individuals in Latin America. The health aspects of several Latin American nations are discussed, with a particular focus on Argentina, Brazil, Ecuador, Guatemala, and Mexico (Figure 1 and Table 2). These North, Central, and South American nations were selected to demonstrate the cultural and linguistic diversity of the region and to provide comparisons in population, education, political stability, spending designated to health, and additional factors that influence national health outcomes. Although Spanish-speaking Caribbean countries are not the focus of this paper, some of the cultural considerations discussed can serve as a guide for further exploration of those countries. Information about Puerto Rico can be found within the Caribbean review in this themed issue.

METHODS

This paper was developed using mixed methodologies which are described in the introduction article of this special theme. (6) The expert knowledge and experience of individuals who have lived in Latin America as well as health care providers native to Latin America were used to support and corroborate the existing literature referenced in this paper.

RESULTS

General Country Information

Argentina. The Argentine Republic, more commonly called Argentina, covers a surface area of 2.8 million square kilometers, making it the eighth largest country in the world and the second largest country in South America after Brazil. (7) Geographically, the country has a very diverse terrain, encompassing mountain ranges, lowlands, and plains, and equally diverse climatic conditions including tropical, subtropical, temperate, and subpolar areas. (7) The population of Argentina is approximately 43.5 million. The population is 97% European, mostly of Spanish and Italian descent, and 3% Mestizo (mixed Amerindian and white), Amerindian, and other nonwhite groups. (7) Spanish is the official language and is spoken by the majority of the population. Most of the people live in urban areas and are Roman Catholic (92%). (7)

Major industries in Argentina are in food processing, vehicle manufacturing, oil refinery, machinery and equipment, textiles, and chemical and petrochemical products. Soybeans and soybean derivatives, petroleum and gas, vehicles, corn, and wheat are the chief export commodities. (7) Argentina, along with Brazil, Paraguay, and Uruguay are the original members of the South American trading block known as MERCOSUR (El Mercado Comun del Sur) or the Southern Common Market. …

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