Conceptions of child development, assessment, and health among indigenous families in primary care: a qualitative study.

Aim: This exploratory qualitative study examines Indigenous conceptions of child development, health, and developmental assessment from the perspectives of Mapuche, Aymara, and Diaguita families, together with primary health care professionals who provide care to Indigenous children in Chile. Methods: A qualitative study grounded in a constructivist paradigm was conducted using a rapid assessment approach. Semi-structured interviews were carried out with Indigenous families of children under nine years of age and with primary health care professionals working in urban and rural territories. Data were analyzed through thematic analysis, incorporating investigator triangulation and member checking to strengthen analytic rigor. Results: Indigenous families conceptualized child development as a relational, community-based, and holistic process, closely connected to territory, family networks, and cultural practices. Traditional medicine and home-based care were commonly used as first responses to childhood illness, while formal health services were sought primarily for more severe conditions. Both families and health professionals identified tensions with the biomedical model guiding primary health care, including culturally misaligned developmental assessment tools, limited intercultural competencies among professionals, and insufficient recognition of Indigenous identity within routine child health supervision. Conclusion: The findings reveal structural mismatches between standardized child health programs and Indigenous worldviews, with implications for equity, cultural safety, and the organization of primary health care. Addressing inequities in Indigenous child health requires care models that recognize cultural diversity, plural health knowledge systems, and community-based conceptions of child development.