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espanolLas diferencias culturales y linguisticas entre proveedores y usuarios de servicios sanitarios implican barreras para la comunicacion en salud. Aunque es imprescindible sortear barreras linguisticas y lograr aceptabilidad cultural de las comunicaciones, es igualmente importante considerar que tanto las relaciones interculturales como las sanitarias se caracterizan por ser asimetricas, y son por tanto relaciones de poder. La interculturalidad, idealmente, requiere ciertas condiciones de igualdad en las interacciones, que posibiliten dialogo, intercambio y aprendizaje a partir de racionalidades, tradiciones y valores entre distintos actores. Pero dado el caracter normativo y prescriptivo de la salud, la comunicacion sanitaria puede reforzar asimetrias e impedir la disolucion de barreras culturales. Un factor que sostiene las relaciones asimetricas entre proveedores de servicios de salud y usuarios, es que unicamente los primeros se reconocen como poseedores de conocimiento legitimo y cientifico. Experiencias exitosas en America Latina y Canada han logrado integrar el conocimiento en salud de pueblos originarios a las practicas institucionales. El reto es trasladar esta experiencia al ambito de la comunicacion. Este ensayo propone que la comunicacion intercultural en salud puede enriquecerse a partir de procesos de co-produccion de conocimiento de base comunitaria. Se reflexiona sobre algunas experiencias canadienses y latinoamericanas y un problema de salud concreto - la diabetes- para delinear algunas lecciones aprendidas sobre comunicacion en salud intercultural que buscan aportar a la formacion profesional de mediadores interculturales en comunicacion sanitaria y a enriquecer la comunicacion intercultural en salud, con base en produccion conjunta de conocimiento EnglishCultural and linguistic differences between providers and users of health services imply barriers to health communication. Although it is imperative to overcome linguistic barriers and to achieve cultural acceptability of communications, it is equally important to consider that both, intercultural and health relationships, are characterized by asymmetry and power relations. Interculturality, ideally, requires certain conditions of equality in the interactions, which enable dialogue, exchange and learning from rationalities, traditions and values between different actors. But healthcare's nature is normative and prescriptive. Health communication could be reinforce asymmetries and difficult the dissolution of cultural barriers. One factor that support the asymmetric relationships between health service providers and users is that only the former are recognized as having legitimate and scientific knowledge. Successful experiences in Latin America and Canada have succeeded in integrating the health knowledge of indigenous peoples into institutional practices. The challenge is to transfer this experience to the field of communication. This essay proposes that intercultural health communication can be improvment by processes of co-production of knowledge, community-based. Thinking about some Canadian and Latin American experiences and a specific health problem - diabetes - there are some lessons learned about intercultural health communication that can contribute to the professional training of intercultural mediators in health communication and to enrich intercultural health communication, based in coproduction of knowledge.

Aportes para la comunicación en salud intercultural: la coproducción de conocimiento en diabetes