

SIHI Latin America
and the Caribbean Hub
continent: latin america | country: colombia
Barriers and facilitators of equitable community participation in health initiatives among communities in Pueblo Rico, Risaralda
This project explores the intersections of gender and other social stratfiers in the context of social innovations in health among Indigenous and Afro-Colombian communities in Pueblo Rico, Risaralda.
BACKGROUND
In Pueblo Rico, Colombia’s municipality of Risaralda, social innovation in health has historically suffered from inequitable participation, especially among indigenous women. Pueblo Rico, a town with a population of 13,125 people, predominantly resides in rural areas, covering 99.96% of its territory. The town has endured significant challenges due to the Colombian armed conflict and faces high levels of multi-dimensional poverty.
The population of Pueblo Rico comprises 15.1% Afro-Colombian, 36.1% Embera (Indigenous), and 48.8% Mestizo. Initially, it appeared that gender was the primary determinant of participation inequity in the social innovation in health projects. However, upon adopting an intersectional approach, it was revealed that ethnicity, place of residence, and age also played crucial roles in exacerbating the issue for these individuals.
methods and approaches
What we undertook was a comprehensive approach, starting with conducting 10 interviews with women from the community. This was followed by two workshops involving community health leaders. Additionally, we had the opportunity to engage with tenth and eleventh-grade students, which we gladly seized. Subsequently, we organized six focus groups and three audio-visual workshops, culminating in the creation of a co-produced video with the community.
To ensure the authenticity and alignment of our findings with the community’s perspectives, we took the initiative to share the preliminary research results with various stakeholders. This involved institutions, community leaders, social organizations, and students. We aimed to present them with an early version of our current presentation to seek their validation and ensure its accuracy and appropriateness.

insights
Gendered factors influence access to resources, beliefs & perceptions, and social practices.
Limited access to higher education, lack of economic resources, and the lack of women’s autonomy are all barriers which affect equitable community participation in health initiatives.
“[…] If my husband doesn’t give them permission, how are they going to get out of there [village]? They can’t get out of there, because sometimes women have bad husbands. Why? Because the husband beats them a lot and is very jealous. That’s why other women want to talk but they don’t.” (Embera woman, community leader)
Multiple intersecting vulnerabilities for indigenous communities.
Indigenous communities face greater barriers than Afro-Colombian communities to participate in health initiatives due to social exclusion, limited access to resources, and needing to obtain the approval and support from local authorities.
However, achieving equitable participation among these communities is more likely due to the strength of their social organization. On the other hand, the key to promoting participation among the Afro-Colombian population is to generate motivation among community members to join in on the initiatives.
Challenges and opportunities for women’s participation.
In general, although it is more difficult to involve women than men, women’s motivation and commitment is a key factor in carrying out long-term participation processes, especially for indigenous women.
Learn more
This video on the importance of gender equity in leadership in health was co-created with the community and a large component in their capacity strengthening on gender and health leadership. It features interviews with individuals identified as key community health leaders and animated images through stop-motion video using art and other visual products such as jewelry and statues produced by the participants themselves.

Recommendations and implications
for further research, policy and practice
Upon reflection on the implications for further research, we outline the following recommendations:
01
Apply an intersectional gender lens in all phases of the research process is a great way to promote greater inclusivity from proposal writing, results, dissemination and beyond.
02
Involve more diverse actors as field coordinators, which helps to facilitate recruitment among population groups with less representation.
03
Generate trust at the community level and institutional level to ensure transparency about research activities.
04
Reduce communication barriers through local translators, and utilize culturally- and linguistically-adapted hands-on and interactive methods.