Doctorado en Salud Pública · 2026
Necesidades multidimensionales de la salud intercultural para la implementación de la telesalud, el caso de la Empresa Social del Estado del Alto Putumayo, Colombia
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Resumen
Objective: Telehealth is essential for expanding access to healthcare services in remote and resource-limited regions, requiring strategies that consider cultural differences. This study aimed to understand the multidimensional intercultural health needs related to telehealth implementation among users and healthcare professionals of the Alto Putumayo State Social Enterprise (ESE), Colombia, during 2024–2025. Study Design: A qualitative study was conducted using a constructivist grounded theory approach with stakeholders from the Alto Putumayo State Social Enterprise (ESE), Colombia. Methods: The study was developed in three phases: (1) semi-structured interviews with five healthcare professionals and four Indigenous and non-Indigenous users, analyzed through open and axial coding using ATLAS.ti 25; (2) two focus groups for selective coding; and (3) communicative validation with five participants. The constant comparative method was applied throughout the analysis. Ethical approval and culturally appropriate consent procedures were obtained. Results: The core category that emerged was termed “Conditional implementation of intercultural telehealth: Negotiation between technological innovation and health self-determination in contexts of asymmetric medical pluralism.” This category integrates the multidimensional intercultural health needs associated with telehealth. Participants revealed that telehealth extends beyond technical aspects and constitutes a political-epistemological process in which users and healthcare professionals negotiate meanings, practices, and implementation conditions according to specific cultural contexts. Conclusions: Intercultural telehealth must move beyond technocentric approaches to recognize community agency and address power asymmetries. A conditional implementation model prioritizes intercultural negotiation, self-determination, and respect for diverse medical rationalities.