Population and setting

The Wixárika ethnic group live in the Sierra Madre mountains, on the northern tip of Jalisco state. In common with other first nations communities across the globe, Wixárika people maintain a particularly strong relationship with the natural and supernatural world and this continues to influence their understanding of illness causality (Gamlin 2016). Unlike southern Mexican ethnic groups the Wixárika, do not have a system of traditional birth attendants and it is common for women to birth alone or supported by a family member (Chopel 2014). Our study took place in the 14 Wixárika towns and villages that make up the community of Tuapurie, municipality of Mezquitic, with a population of approximately 2500. 77% of Mezquitic’s population of 18084 are indigenous (INEGI 2015a). About half of the population of Tuapurie live in two vehicle-accessible towns, each with a rural health clinic between two and five hours from the nearest hospital, the remainder live in hamlets up to a further six hours on foot.