This document contains the definitions of different concepts and terms related to the practice of Traditional Medicines, used in different areas in the Americas region: in academia, by health and social science professionals; in international organizations; at the governmental level by personnel working with, attending or providing health services to indigenous, Afro-descendant, Roma and other ethnic populations; and by specialists of these populations, holders of the knowledge and know-how of these medicines.

Ancestral Medicine: Refers to the health system that the ancestors were inspired by the logic and laws of nature, which has its own definition of health and disease, which establishes its own code of ethics, its own classification of diseases, its own therapies and treatments, which has been transmitted to the present day in a traditional way. Ancestral medicine handles a bi-directional technology (practical and symbolic), which is what differentiates it from the others.

Reference: Ministry of Public Health Ecuador – DNSI (document-definitions)/(unpublished)

Ancestral Wisdom: This is the indigenous peoples’ own spiritual knowledge, practiced culturally for thousands of years and transmitted through generations by the spiritual authorities, allowing the physical and cultural existence of the indigenous peoples.

Reference: Artículo 78. Decreto Número 1953 de 2014, Por el cual se crea un régimen especial con el fin de poner en funcionamiento los Territorios Indígenas respecto de la administración de los sistemas propios de los pueblos indígenas hasta que el Congreso expida la ley de que trata el artículo 329 de la Constitución Política de Colombia.

Afro-descendant: refers to people born outside Africa who have ancestors from that continent and whose history is related to forced migrations and diaspora (dispersion of ethnic groups).

The term “Afro-descendant” was adopted at the Regional Conference of the Americas, held in December 2000 in Santiago, Chile (preparatory to the Third World Conference against Racism, Racial Discrimination, Xenophobia and Related Intolerance, held in Durban, South Africa, from August 31 to September 8, 2001), to recognize the descendants of African peoples who came to the Americas during the colonial era as a result of the slave trade, and who have historically been victims of racism, racial discrimination, poverty and exclusion, with the consequent repeated denial of their human rights.

This term has been subject to localisms, such as Afro-Mexican, Afro-Panamanian, Afro-Peruvian, Afro-Colombian, Afro-Ecuadorian, among others. As well as to different forms of self-identification of people who have a common ancestry, such as the terms “negro” “moreno” “pardo” “zambo” “preto” and “creole”, or meanings that refer to collective communities such as “quilombolas” in Brazil; “raizales”, “consejos comunitarios”, “palenqueras y palenqueros” in Colombia; “garífunas” in Central America; “mascogos” in Mexico; or “maroons” in Suriname (DESCA-Afro-en, pag. 17).

The term Afro-descendant encompasses different forms of self-identification adopted by people of African descent for the IACHR; in the case of the Americas this population corresponds, for the most part, to descendants of African people who were enslaved in the framework of the transatlantic slave trade. (DESCA-Afro-en, pag.17).


Economic, Social, Cultural and Environmental Rights of Persons of African Descent

Allopathic medicine: The biomedical culture expressed through the Western medical system has established itself worldwide as the model capable of solving, if not all, most of the population’s health problems, regardless of the social and cultural contexts in which the disease develops.


Articulation with health systems or services: promotes the articulation of activities between health professionals and traditional medicine, under the concept of complementarity and with the use of norms and agreements that guarantee timely and quality care for the population, and respect for the decisions of individuals and communities. Health personnel shall respect traditional and/or ancestral medical systems, the development of their own models of care and shall seek to articulate the provision of health services with the practices of traditional and/or ancestral medicine, thus making it possible to respond to the needs of indigenous peoples, Afro-descendants and others in their socio-cultural context and in the territory they inhabit.

Reference: “Política Andina de Salud Intercultural” (Andean Intercultural Health Policy). ORAS/CONHU, 2019.

Black communities: In Colombia, this is understood as the group of families of Afro-Colombian ancestors that have their own culture, share a history and have their own traditions and customs within the rural-population relationship, which reveal and preserve an awareness of identity that distinguishes them from other ethnic groups.

Reference: “Ley 70 de 1993”. Congress of Colombia,

Collective rights: Peasant communities, indigenous peoples and nomadic and transhumant communities are recognized as subjects of collective rights. Given that rural communities frequently carry out one or more traditional and collective activities in order to subsist, it establishes that the recognition of communities linked to small-scale agricultural production also includes communities engaged in artisanal or small-scale agriculture, livestock raising, pastoralism, fishing, forestry, hunting and gathering. In other words: other rural communities in addition to peasant communities.

In order to be considered holders of the human rights recognized in the Declaration, these communities must engage in – or seek to engage in – small-scale agricultural production to subsist or trade, and rely significantly, though not necessarily exclusively, on family or household labor, and other non-monetized ways of organizing labor, and have a special dependence on and attachment to the land.The rights the Declaration aims to enshrine are, therefore, those fundamental to promoting and protecting the collective interests of these specific legal subjects. The rights in question generally concern the free, prior and informed consent of the community; the possibility of creating their own food and agricultural systems; the collective management of land, seeds or other natural resources; as well as the enjoyment of the benefits of resource development and conservation.


Community health worker: A volunteer person elected or recognized by his/her community who promotes healthy practices in families and the development of his/her community, working in coordination with health personnel and other social actors.


Cosmovision: In its most literal meaning, it is the vision or global conception of the universe (RAE), and consists of the constructions, premises, interpretations, and ideologies of a sociocultural group, which determines how the world and the relationships in that world are perceived. It can be described as “lenses”, models or maps from which people perceive reality.

Reference: (adaptation)

Worldview, that is, the perspective, concept or mental representation that a given culture or person forms of reality. Therefore, a cosmovision offers a frame of reference for interpreting reality, which contains beliefs, perspectives, notions, images and concepts.

Reference: Significado de Cosmovisión (Qué es, Concepto y Definición) – Significados

Cultural competencies: understood as the skills and abilities to interact and negotiate with culturally diverse groups, communicating in a respectful and effective manner in accordance with the multiple identities of the participants or users, encouraging attitudes of respect, tolerance, dialogue and mutual enrichment, noting that truth is plural and relative, and that diversity can be a source of wealth.


Cultural diversity: Refers to the manifold ways in which the cultures of groups and societies find expression. These expressions are passed on within and among groups and societies.  Cultural diversity is made manifest not only through the varied ways in which the cultural heritage of humanity is expressed, augmented and transmitted through the variety of cultural expressions, but also through diverse modes of artistic creation, production, dissemination, distribution and enjoyment, whatever the means and technologies used.


Cultural relevance: Implies,

– The adaptation of all service processes to the geographic, environmental, socioeconomic, linguistic and cultural characteristics (practices, values and beliefs) of the service area.

– The valuation and incorporation of the cosmovision and conceptions of development and well-being of the diverse population groups that inhabit the locality, including both the originally settled populations and the populations that have migrated from other areas.


Cultural or sociocultural adaptation: This consists of adapting the technical procedures of the health intervention to the conceptions, attitudes and practices of culturally diverse communities, so that the care provided is more familiar to their own customs and traditions.

Reference: Adecuacion Cultural Ecuador Ami | PDF | Interculturalidad | Pobreza (

Cultural or sociocultural adaptation is one of the strategies to put into practice the element of acceptability, understood as the adjustment in accordance with medical ethics and the sociocultural particularities of the actions oriented to health care in the case of indigenous peoples.


Equity: this is a principle of justice that seeks to make the right to health effective for people who currently suffer from inequalities in access to comprehensive health care, by reducing health gaps and giving priority to those who need it most in their cultural context.

Equity as a principle is pursued with health services that guarantee access, opportunity, availability and acceptability of actions so that they are appropriate to the epidemiological profiles, socio-cultural needs and rights of indigenous, Afro-descendant and other tribal peoples.

Reference: Política Andina de Salud Intercultural / Organismo Andino de Salud – Convenio Hipólito Unanue — Lima: ORAS-CONHU; 2019. Pag 15.

Ethnic: “In English the term ethnic refers to “of or relating to large groups of people classed according to common racial, national, tribal, religious, linguistic, or cultural origin or background” (Merriam-Webster, 1987: 147). Moreover, in American English the term “ethnic” is even accepted as a noun: “a member of an ethnic group, especially : a member of a minority group who retains the customs, language, or social views of the group (Merriam-Webster, 1987)”. Finally, the dictionary includes the term ethnicity with the meaning of “ethnic quality or affiliation”, dating its incorporation in 1950 (Merriam-Webster, 1987)”.

Ethnic diversities refer to the set of these diversities in a given social and geographic space.


Ethnic belonging. This refers to the identification of persons as members of one of the ethnic groups recognized in Colombia.

Reference: Manual de conceptos CNPV 2018 ( 

Ethnic group: In the most literal meaning, ethnicity (ethnos= gr. people) are human communities defined by racial, linguistic, cultural affinities (RAE).

“In English, the term ethnic refers to “of or relating to large groups of people classed according to common racial, national, tribal, religious, linguistic, or cultural origin or background” (Merriam-Webster, 1987: 147). Moreover, in American English the term “ethnic” is even accepted as a noun: “a member of an ethnic group; especially, a member of a minority group who maintains the customs, language, or social beliefs of his or her group (Merriam-Webster, 1987)”. Finally, the dictionary includes the term ethnicity with the meaning of “ethnic quality or affiliation”, dating its incorporation in 1950 (Merriam-Webster, 1987)”.

Ethnic diversities refer to the set of these diversities in a given social and geographic space.

“The use of the term “ethno” as a prefix appears in the denomination of relatively recent scientific disciplines that study specific aspects of non-Western societies, such as their systems of knowledge, communication, aesthetic expression and values: ethnobotany, ethnolinguistics, ethnomusicology, ethnophilosophy”.

“ethnic segments or groups identify themselves as having a common origin and carrying elements, traits, or important characteristics of their own or a common culture; and whose members also participate in group activities and practices that serve to maintain and reproduce or recreate such cultural characteristics. For Breton (1983: 12), this constitutes the broad sense of the term: “a group of individuals united by a complex of common characteristics […] whose association constitutes a system of its own, an essentially cultural structure: a culture. [The ethnic] is the community, united by a particular culture”.


Ethnic relevance: matching the supply of policy actions with the real, heterogeneous and dynamic needs of the demand of the different ethnic groups.


Ethnic self-identification: This is the way a person perceives him/herself, taking into account his/her customs, ancestors and whether he/she feels part of an ethnic group. For example, a person may consider himself ashaninka, awajún, quechua, afroperuvian, mestizo, among others.


Ethnicity: The recognition of ethnicity is in general a relatively new process, derived in turn from the variety of socio-cultural dynamics of each country in the region. Hence, the conceptualization of ethnicity can hardly be applied equally to each of the national realities, and the operationalization of each conceptualization reflects these variations, for example, in the census exercise -under the consideration of ethnic diversity-.

It also makes it possible to introduce (or address the problems associated with the concept of race) the discussion of the concept of race and helps to understand and eradicate this concept, which has especially ideological and negative implications.

Ethnicity implies […] “an intergenerational and collective cultural continuity” or “one’s own character or nature […] that derives from immersion in that cultural continuity” (Fishman, quoted by Villarreal et al.: 359). There are several perspectives on ethnicity, but all of them basically share in attributing certain characteristics to it: language, common ancestors, prolonged occupation of a geographical space -territory-. Ethnic identity,


Ethno: “The use of the term “ethno” as a prefix appears in the denomination of relatively recent scientific disciplines that study specific aspects of non-Western societies, such as their systems of knowledge, communication, aesthetic expression and values: ethnobotany, ethnolinguistics, ethnomusicology, ethnophilosophy”.


Ethnobotany: Ethnobotanical studies are concerned with the totality of functions that plants perform in a culture. The uses of plants, as well as the interrelationships of man with them, are a product of history, in which the physical and social environments intervene, in addition to the inherent qualities of plants.


Gender: It is based on the equitable exercise of roles that contribute to the integral development of the individual, family, community and diverse society.

Reference: Política Andina de Salud Intercultural / Organismo Andino de Salud – Convenio Hipólito Unanue — Lima: ORAS-CONHU; 2019. Page 13.

Good Living / Sumak kawsay: According to Luis Macas, Quechua lawyer and former president of CONAIE, Sumak Kawsay is more than Good Living. Good Living is translated into Kichwa: Alli Kawsay, whose meaning is conformity, to reach a state of well-being, to live better, or which would be equivalent to say also, economic prosperity, comfort, which does not compare with the true meaning of Sumak Kawsay.

Sumak is the fullness, the sublime, excellent, magnificent, beautiful, superior. Kawsay, is life, is being. But it is dynamic, changing, it is not a passive matter. Sumak Kawsay, is then, life in fullness, or life in splendor, expresses the supreme, life in the community system. Life in material and spiritual excellence.


Harmony: In traditional medicine, the notion of harmony has to do with balancing the forces that constitute life and relationships with human beings and those of nature. A special component in this conception is the one that relates it to spirituality, as well as to the understanding of opposites and complementarity. However, the term in the context of traditional medicine requires various perspectives and contexts, and mainly their respective Cosmovision. In the context of traditional medicine this can be seen through shamanic (or chamanic) practices where they involve reconstituting an order prior to the rupture of equilibrium and “is integrated by a set of concepts and conceptions about the human body and its functioning, so that the role of the shaman is to maintain balance and harmony with the cosmos”.

Reference: own elaboration (Marco Andrade, Perú) and quote from:

Heal: Action of healing, a difference is established between curing and healing; a person can be cured -from an illness-, but not healed -in a spiritual or emotional perspective-.

“Healing is a process that goes beyond healing the physical body. It is an amazingly powerful emotional, mental and spiritual process that brings us closer to who we really are and our purpose in this world. To heal is to return to our state of wholeness.”


Healing: in an etymological sense, healing as such has to do with the reestablishment or recovery of health or elimination of the disease (remission or disappearance) -RAE-. It also has to do with the action of healing with different therapeutic means and purposes. However, in the context of traditional medicine a cure goes beyond recovery, reestablishment, or remission, it is connected with other aspects (human and non-human) and with other dimensions of health that allow healing; in this sense, a person may have been cured, for example, of a physical ailment, but may not be cured of other aspects surrounding the physical problem. Healing in this sense is intertwined with many aspects, for example, the symbolic (Concept basis for discussion).

Reference: RAE and own elaboration (Marco Andrade Perú)

Healing ceremonies: These refer to different types of rites through which the shaman fights evil and disease. They acquire different degrees of complexity according to the severity of the sick person and have territorial variations.

Reference: Adapted from “El Machitun como Texto” Moulian,R and Oyarce, Ana Maria.

Health-Disease: What in some cultures falls into the category of health, in others belongs to the sphere of disease. Each human group also has its own perception of what illness is, and the definitions given of it do not necessarily coincide. It could be said that disease is fundamentally a way of classifying a set of significant facts in a culture that do not depend on objective conditions from a medical-scientific perspective.

Reference: Prat, Pujadas y Comelles (1980:46). In “Sobre el contexto social del enfermar”. En M KENNY y J.DE MIGUEL (Editors), La antropología médica en España, Anagrama, pp. 43-68, Barcelona

Health Equity: Is a fundamental component of social justice that indicates the absence of avoidable, unfair or remediable differences among groups of people due to their social, economic, demographic or geographic circumstances. PAHO defines health equity as both its mission— “To lead strategic collaborative efforts among Member States and other partners to promote equity in health…” and as its first value— “Equity: Striving for fairness and justice by eliminating differences that are unnecessary and avoidable.” Health equity emphasizes that most of the differences in health status and outcomes between groups are not the result of biological differences, rather they result from social and economic processes that create and recreate differences in access to health.


Health promotion: “Health promotion enables people to take greater control of their own health. It encompasses a broad range of social and environmental interventions aimed at benefiting and protecting individual – and collective – health and quality of life by preventing and addressing the root causes of health problems, rather than focusing solely on treatment and cure. It has three essential components: 1) Good health governance, 2) Health education, 3) Healthy cities.

Health promotion is also based on the incidence of social determinants of health.


Herbal medicines: includes herbs, herbal material, herbal preparations and finished herbal products, which contain as active ingredients parts of plants, or other plant materials, or combinations of these elements.


Holistic: “Doctrine that advocates the conception of each reality as a whole distinct from the sum of its component parts” (RAE). Therefore, when talking about “Holistic Health”, ‘It is understood that all parts of the human being are intimately interconnected. The focus is on the person, both in the physical, emotional, mental, spiritual and social aspects’, and one would add the cultural aspects that are part of that whole.

This totality is the union of mind, body and spirit; it means that the human being is a totality, not the sum of the parts (Aristotle, 300 BC).


Imbalance: lack of equilibrium, disorder (RAE). In traditional medicine, imbalance and that which imbalances can have several expressions, but above all it has to do with ruptures in the order of the human relationship, of the relationship with nature and the relationship in general with the cosmos. Many of the imbalances have a clear social expression (Definition basis for discussion).

Reference: RAE and own elaboration (Marco Andrade, Perú).

Indigenous Peoples: In the past, when reference was made to indigenous populations, they were referred to as “Indians”, “savages” or “uncivilized”. These denominations contained a negative connotation that suggested links with a primitive and underdeveloped lifestyle. The concept of “indigenous people” has developed since the 1980s. In this way the expression “indigenous” means something similar to “born within an area”. Thus reflecting the special relationship that indigenous peoples have with their natural environment.

Indigenous peoples:

Despite this, there is still disagreement over the term indigenous “peoples”. This concept is an integral part of the UN Charter of International Rights. However, many states reject it and prefer the term indigenous “population”. The Convention on Biological Diversity (CBD) excludes both categories and takes up the unprecedented concept of “community”.

Despite their different cultures, indigenous peoples, in most cases, share a special relationship and management with nature. In recent years, they have been able to speak out at the international level to protect their culture and rights. 


Integrality: refers to a global (holistic) vision of the multiple aspects related to health: the spiritual, the organic and the environment; the individual, the family, the community, the cosmos and the spiritual world; in order to implement processes of health promotion, prevention, care and rehabilitation of diseases and damages; in a pertinent, timely, uninterrupted and suitable manner.

Reference: Política Andina de Salud Intercultural / Organismo Andino de Salud – Convenio Hipólito Unanue — Lima: ORAS-CONHU; 2019.

Intercultural approach: it is aimed at producing, firstly, an impact on the care model by developing strategies for cultural relevance in the organization and delivery of health services; secondly, it seeks the complementarity of official and traditional ancestral medical systems. It acquires diverse expressions according to regional particularities, with a main axis, to achieve the participation and commitment of native peoples in the process.

Reference: Sáez, Margarita. Protección En Salud a Pueblos Indígenas e Interculturalidad.  Módulo IX, OISS, EUROSOCIAL, 2008.

Intercultural appropriateness: refers to the implementation of policies that favor an intercultural relationship.


Intercultural health: The term interculturality refers to the expression “between cultures”, not simply as a contact, but as an exchange in health based on respect. Interculturality is a dynamic and permanent process of communication and learning relationship between cultures under conditions of mutual legitimacy and equality, which is built between people and groups, knowledge and culturally different practices.

Reference: Sáez, Margarita. “Interculturalidad en salud Chile: de la teoría a la práctica”. En PRIORIDADES EN SALUD Y SALUD INTERCULTURAL Fernando Lolas, Douglas K. Martin y Álvaro Quezada Editores. Centro Interdisciplinario de Estudios en Bioética, Chile, 2007.

Intercultural Facilitators: in the design of intercultural health models in the health care network, they act as mediators between the communities and the health teams, in order to incorporate their knowledge of ancestral medicine to the biomedical approach. At the same time, they are in charge of ensuring and supporting communication between the person and the health team that attends him/her, advising the sick person and the health team of the facility so that in the diagnostic process as well as in his/her treatment, the significant cultural aspects for the recovery of his/her health are taken into account. They promote dialogue between both types of medicine, between the health center staff, the sick person and his/her family, and the traditional healers for the different health care required, and finally, they carry out the referral and counter-referral processes to and from the traditional doctors and the health center.


Interculturality: is the way of coexistence in which people, groups and institutions, with diverse cultural characteristics and positions, live together and relate in an open, horizontal, inclusive, respectful and synergetic manner in a shared context*.

Interculturality implies a process that allows for the constructive interrelation and interaction between people, social groups, knowledge and diverse knowledge. This social construction requires a) recognition and respect for differences (political, social, ethnic, gender and generational) and cultural diversity; b) exchange of knowledge and experiences for mutual enrichment; c) dialogue and equitable intercultural relations; and d) harmonious coexistence between different socio-cultural groups.

Interculturality proposes the definition of specific conditions for equitable interaction between different cultural groups, each with a truth, a special worldview (cosmovision) and a frame of reference and paradigms regarding different aspects of reality.


Interculturally in health: aims at recognizing and complementing different cultural health systems, respecting the scope of each one of them, in relations of otherness among the agents of the different health systems and guaranteeing access to both health services in an environment that provides the same conditions, treatment and opportunities without distinction of class, sex, age, beliefs, ethnicity or culture; feeling that the freedom of the other is the support of my essence.

Reference: Política Andina de Salud Intercultural / Organismo Andino de Salud – Convenio Hipólito Unanue — Lima: ORAS-CONHU; 2019. Page 11.

Intercultural health models/Intercultural Health Models: understood as the way in which the management of the health facility is designed, organized, implemented, evaluated and updated in a joint and coordinated manner, respecting the principles that guide cultural relevance in health care. The implementation of an intercultural health model is based on the recognition of rights, active and effective participation in health, and consultation among the actors involved. This implies an exercise of dialogue between traditional and western medical systems and between these and the community in an environment of trust, respect and self-determination.

Reference: Adapted from  SciELO – Salud Pública – Salud intercultural y el modelo de salud propio indígena Salud intercultural y el modelo de salud propio indígena (

Intersectoriality: “coordinated intervention of institutions representing more than one social sector, in actions aimed, in whole or in part, at addressing problems related to health, well-being and quality of life” (FLACSO, 2015).


-An important strategy in the Primary Health Care approach, because health problems will not be solved exclusively by the health sector, but in coordination with the different institutions or sectors that have an impact on integral health wellbeing. With respect to indigenous and Afro-descendant peoples and others, it involves access to and care of the land, water and territory, agricultural production and cultivation, food consumption and preparation, including the production of medicinal plants.


Knowledge dialogues or intercultural dialogues: these are processes of communication and exchange between people and groups from different origins or cultures. They constitute a horizontal exchange of knowledge, know-how and perceptions in the face of problems, in such a way that in this space an intercultural flow between the parties is encouraged, with the purpose of building social practices that improve the health and wellbeing of groups, communities and individuals, with emphasis on cultural diversity. 

In the case of the health sector, exchanges are carried out between certain groups or individuals and trained health personnel. Their objective is, among others, to improve access to health services and build intercultural health, with emphasis on the resolution of previously identified problems and their causes, mutual understanding and the creation of solid links.

Reference: PAHO,

Kumpania (singular): communities called kumpañy or kumpeñy, consisting of groups of extended family patrigroups, belonging to one or several lineages that have established alliances among themselves, mainly through marriage exchanges, and that carry out a symbolic appropriation of the place where they survive in terms of cultural sustainability. They are named after the cities where they are located or, failing that, after the most important nearby city where they are located.

Reference: DNP, Pueblo Rrom – Gitano- de Colombia: Haciendo camino al andar. 2010. Pueblo Rrom Gitano.pdf (

Medicinal plants: those plants that can be used whole or in specific parts to treat diseases in humans, animals, or to cure injuries.


According to WHO (1979) a medicinal plant is defined as any plant species that contains substances that can be used for therapeutic purposes or whose active principles can serve as precursors for the synthesis of new drugs.

Medical pluralism: coexistence of different medical systems within a society, which maintain a cooperative relationship.

Reference: Jesús Gómez Payé, Bolivia, II Cumbre Mundial MTCI

Multiethnic: Comprising or bringing together several ethnic groups (RAE). The difference (ethnic – racial) is recognized without the intention of relating to each other.

Participation: the right of individuals, communities and peoples to intervene in the decisions of the State in matters that affect the exercise of their rights and their quality of life. Active participation of peoples in the formulation, implementation and evaluation of public policies, plans and projects, making available to them the necessary instruments for their exercise: information, resources, procedures, in a horizontal relationship of joint work with health services.

Reference: Política de Salud y Pueblos Indígenas. Ministerio de Salud, Chile.2006

Phytotherapy: Phytotherapy is defined as the use of products of plant origin for therapeutic purposes, to prevent, alleviate or cure a pathological condition, or with the objective of maintaining health.

The concept of herbal medicines includes herbs, herbal material, herbal preparations and finished herbal products, which contain as active ingredients parts of plants, or other plant materials, or combinations of these elements.


Pluriethnic: Refers to the fact that it comprises or has characteristics of various ethnic groups. This concept is linked to pluricultural, that refers to those territories in which different cultural traditions coexist, developed by various ethnic groups or population groups.


Practitioners of traditional medicine: a group of people recognized in their community for the knowledge they possess of ancestral knowledge in the field of health care that has served to restore the health of the members of their community. This knowledge may have been learned from their ancestors or from other members of the community, through oral transmission or permanent practice. These practitioners have different names depending on the activities they perform and the culture to which they belong.

Reference: Blanca Elena Luque, MINSA, Perú

Racism: any theory, doctrine, ideology or set of ideas that enunciates a causal link between the phenotypic or genotypic characteristics of individuals or groups and their intellectual, cultural and personality traits, including the false concept of racial superiority.

Racism gives rise to racial inequalities, as well as to the notion that discriminatory relations between groups are morally and scientifically justified.


Racism constitutes discrimination based on the racial ascription attributed to an individual or group.

Rights-based approach: integrates the norms, standards and principles – equality, equity, responsibility, empowerment and participation – of the international human rights system into development plans, policies and processes. It implies non-discrimination and attention to groups considered vulnerable, taking into account that there is no single, universal definition of who is vulnerable, so a basic requirement is to have disaggregated information that makes it possible to make them visible in each specific context (Salinas and Castro 2011).


Ritual: “It is a set of acts carried out in a repetitive way, of a mythical-magical nature, which acquires an allegorical meaning. It can be private (such as having a lucky charm blessed or sacred with which an indigenous person goes hunting in the jungle or forest) or public (socially shared), when greeting, the whole community or a family, a deity of the mountain.

Rituals can take place on special occasions (weddings, births, deaths, change of marital status); the so-called rituals of passage or initiations can be daily, such as saying “cheers” and dripping the drink that one is going to serve to the earth, or greeting in the morning by raising the palms of the hands facing the sunrise.

In the original groups, it is often a practice to propitiate or ward off supernatural forces with established religious acts to put human beings in contact with deities, whose characteristics are essentially unknown to the common people”.

Reference: aún nos cuidamos (final).pdf (

Roma: Gypsies, Roma, Gypsies or Gypsy people are a community or ethnic group originating from the Indian Subcontinent, dating back to the Middle Kingdoms of India, with common cultural traits but with enormous differences between their subgroups. They are mainly settled in Europe, as they are in fact the largest ethnic minority in the European Union, although they are also present, but to a lesser extent, in the rest of the world.


Self-recognition: Refers to the sense of belonging that a person expresses to a collective in accordance with his or her identity and ways of interacting within and with the world; it refers to the individual’s awareness of sharing certain creations, institutions and collective behaviors of a given human group. Each person freely and on his own recognizes himself as belonging to an ethnic group, by sharing, practicing, or participating in specific and distinctive values, concepts, uses, and customs.

Reference: Departamento Administrativo Nacional de Estadística -DANE-. Censo Nacional de Población y Vivienda -CNPV- 2018. MANUAL DE CONCEPTOS. Colombia, July 2019.

Social determinants of health: The World Health Organization defines the social determinants of health (SDH) as “the circumstances in which people are born, grow, work, live and age, including the broader set of forces and systems that influence the conditions of everyday life”. These forces and systems include economic policies and systems, development programs, social norms and policies, and political systems. The above conditions may be highly different for various subgroups of a population and may result in differences in health outcomes.  It may be inevitable that some of these conditions will be different, in which case they are considered inequalities, just as it is possible that these differences may be unnecessary and avoidable, in which case they are considered inequities and, therefore, appropriate targets for policies designed to increase equity.


Sociocultural or intercultural epidemiological profiles: This is called intercultural epidemiology as a component of an intercultural model of health. It is a theoretical and methodological research strategy based on the analysis of cultural meanings between health teams and indigenous, mestizo, peasant and Roma communities regarding health and disease, life and death, healing and care. It is an approach specific to each situation and each community, arising from the interdisciplinary and intercultural dialogue between medicine, anthropology and the knowledge of people from different health cultures.  Dialogue, moreover, in which the limits of each discipline, theoretical-practical approach or worldview are set.

Reference: Oyarce, et. Al. Criterios de definición de lo étnico en los estudios epidemiológicos en salud. Cultura y territorio: bases para una epidemiología intercultural. Servicio de Salud Araucania Sur. Ministerio de Salud. Págs: 29-34, Santiago de Chile, 1996.

Structural racism: refers to “the ways in which society is set up in such a way that advantages and opportunities are given preferentially to those of one race over those of another,” said co-author Dr. Mitchell Elkind, a neurologist at New York-Presbyterian/Columbia University Irving Medical Center in New York City.

Structural racism is built on accusing the State of being unaware of the problem of racism that black populations have historically been victims of. By denying its existence, there is no manifest will to solve it. Ignorance of racism prevents the construction of state programs and policies to reduce the existing gap between Afro descendants and the rest of the nation.


Structural racism should be understood as this institutional design that maintains in practice the subalternization of racially articulated populations and individuals. Hence, this dimension of racism crosses the entire institutional edifice. This racism is embodied in concrete actions and omissions that, derived from the very functioning of the institutional system, have the effect of reproducing inequalities and hierarchies between racialized individuals and populations.

Structural racism underpins a series of privileges for some populations and individuals to the detriment of others.


Structural racism, all the factors, values and practices that contribute to the reproduction of the statistically significant association between race and class (defined here as the combination of economic situation and professional insertion), that is, everything that contributes to the fixation of non-white people in positions of less prestige and authority, and in the least remunerated professions.


Kehinde Andrews, a British professor of Black Studies at Birmingham City University, told The Independent: “Structural racism refers to the systematic oppression of ethnic minorities that leads to the disparities we see in terms of income, employment, health, and so on.

Structural racism is characterized by denying or hiding the existence of racism. In other words, it is about historical processes that, through a set of factors, values, symbols and practices, produce and reproduce stereotypes (legitimate and non-legitimate) placing one group of people above another. Thus, certain actions are normalized and legitimized where one sector is privileged and another is excluded based on phenotype, nationality, culture, religion, place of residence, class, sex and gender.


Territorial approach: is based on the vision of indigenous peoples, afro-descendants and others in the daily harmonious living with the visible and the invisible, generating a wellbeing and dynamic balance with Nature, in the Life processes that govern the planet. This ecological vision of the integral care of earth, water and space should guide the design, implementation and/or adaptation of public health policies.

Reference: Política Andina de Salud Intercultural / Organismo Andino de Salud – Convenio Hipólito Unanue — Lima: ORAS-CONHU; 2019. Pag 13.

Traditional ancestral medicine: is the set of practices and knowledge (transmitted orally) based on the use of natural resources and spiritual therapies to improve health. In addition to treating common illnesses, it also cures ethno-cultural illnesses. Some of them are: bad wind, ojeados, espanto, relapses, fall matrix, stress, fractures, diabetes, bone pain, among others. This kind of medicine is an essential part of the culture of Afro-descendant peoples.

Reference: Medicina tradicional ancestral – Rescatando la Historia (

Traditional or Ancestral Medical Systems: A medical system is a network of ideas and practices related to the causes and cure of diseases, which is determined by socio-cultural, economic, religious, educational and family aspects; it must be congruent with the health beliefs and heritage of the community. Every medical system subsumes theory about the conception, causation, classification and effects of disease, health care, therapeutic resources (drugs, herbs, divination, surgery or acupuncture) and practitioners (doctors, nurses, dentists, healers, midwives), all integrated into a conceptual and ideological scheme.


Traditional (ancestral) therapists: Traditional therapists are those who use a series of therapeutic resources inherited from their ancestors to prevent and treat the ailments of the members of their communities. These therapeutic resources can be quite eclectic and combine ancestral knowledge with other knowledge acquired through experience, from other traditions, and even from the therapeutic practices of religious groups. Some therapists also include elements of the same biomedicine promoted by official health establishments.


Traditional Doctor: people who practice traditional medicine (precise definition could not be found).

Source: own definition by Marco Andrade (Peru).

Traditional knowledge: refers to the set of knowledge, values, attitudes and practices shared by a community in a given geographical area.1 Traditional knowledge is transmitted to new generations in community and family spaces. Traditional knowledge is part of the community’s cultural identity.

Traditional knowledge is part of a cultural system and can be categorized according to the following dimensions:

-Symbolic (such as values, symbols, archetypes, myths, spirituality, religion or, often, several different religions);

-social (organizational patterns for family and community ties and support, systems of administration, and political systems for decision-making and conflict resolution, etc.);

-technological (skills, expertise, technology, agriculture, cooking, architecture, etc.).


Traditional knowledge” (TK) is the wisdom, experience, skills and practices that are developed, maintained and transmitted from generation to generation within a community and that often form part of its cultural or spiritual identity.


Traditional knowledge refers to the knowledge, innovations and practices of Indigenous and local communities (ILCs) related to genetic resources. This traditional knowledge has been developed through the experiences of communities over the centuries, adapted to local needs, cultures and environments and passed on from generation to generation.


Traditional Medicine: Traditional medicine is the whole body of knowledge, skills and practices based on indigenous theories, beliefs and experiences of different cultures, whether explainable or not, used for the maintenance of health, as well as for the prevention, diagnosis, improvement or treatment of physical or mental illnesses.


Universal access to health: “Universal access to health and universal health coverage imply that all people and communities have access, without any kind of discrimination, to comprehensive, appropriate and timely, quality health services determined at the national level according to needs, as well as access to safe, effective, and affordable quality medicines, while ensuring that the use of such services does not expose users to financial difficulties, especially groups in conditions of vulnerability.

Universal access to health and universal health coverage require determining and implementing policies and actions with a multisectoral approach to address the social determinants of health and promote a society-wide commitment to fostering health and well-being. The right to health is the core value of universal health coverage, to be promoted and protected without distinction of age, ethnic group, race, sex, gender, sexual orientation, language, religion, political or other opinions, national or social origin, economic position, birth, or any other status. (CD53/5, Rev. 2 and CD53/R14 PAHO/WHO, 2014).” Reference:

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