Sociocultural Conditions and Health-Service Access Challenges in the Javaé Community of Boa Esperança Village, Tocantins, Brazil: A Qualitative Study for Local Diagnosis and Public Policy Implications
Jussara Resende Costa
Department of Medicine, University of Gurupi (UnirG), Gurupi, Tocantins, Brazil.
Marcilene de Assis Alves Araújo
Department of Medicine, University of Gurupi (UnirG), Gurupi, Tocantins, Brazil.
Mateus Silva Santos
Department of Medicine, University of Gurupi (UnirG), Gurupi, Tocantins, Brazil.
Ludmila Franco
Department of Medicine, University of Gurupi (UnirG), Gurupi, Tocantins, Brazil.
Roger Antonio Morais Queiroz *
Department of Medicine, University of Gurupi (UnirG), Gurupi, Tocantins, Brazil.
Roberto Neves Prado Telles Neto
Department of Medicine, University of Gurupi (UnirG), Gurupi, Tocantins, Brazil.
Maria Eduarda Franco Godoy Tadeu
Department of Medicine, University of Gurupi (UnirG), Gurupi, Tocantins, Brazil.
Laura Nascimento Barroso
Department of Medicine, University of Gurupi (UnirG), Gurupi, Tocantins, Brazil.
Yana Camargo
Department of Medicine, University of Gurupi (UnirG), Gurupi, Tocantins, Brazil.
Yuri Fortaleza Passos Martins
Department of Medicine, University of Gurupi (UnirG), Gurupi, Tocantins, Brazil.
*Author to whom correspondence should be addressed.
Abstract
Aims: To analyse the social, cultural, educational and environmental conditions of the Javaé (Inỹ) community of Boa Esperança Village on Bananal Island, Tocantins, Brazil, and to identify locally reported challenges and assets relevant to public policy and community-led initiatives.
Study Design: Descriptive qualitative field study with a structured village-level identification component.
Place and Duration of Study: Boa Esperança Village, municipality of Lagoa da Confusão, state of Tocantins, Brazil, between August and September 2024, in articulation with the University of Gurupi (UnirG).
Methodology: Data were produced through three analytic sources: a Village Identification Form recording 141 residents in 40 households, semi-structured interviews with three purposively selected community leaders (the chief, the deputy chief and a female elder), and participant observation recorded in a field diary. Analysis primarily involved deductive thematic content analysis across seven predefined axes, with multi-source comparison used to identify convergence and divergence. A community assembly supported collective authorisation and contextual confirmation of the broad priority domains but was not treated as a fourth independently coded dataset.
Results: The village-level form recorded a young age structure, with 87 of 141 residents (61.7%) aged 0-14 years and 18 residents aged 60 years or over. Housing was predominantly of simple masonry and thatch construction, with some dwellings in a precarious condition. Water was obtained from the Javaés River and from one communal well; no routine quality monitoring was reported. Electricity supply was unstable, communication was intermittent, and travel to the nearest urban centre with specialised services required more than two hours. Leadership accounts described continuing ritual practices and the central role of elders in knowledge transmission. Subsistence agriculture, seasonal fishing, small-animal husbandry and handicraft were reported as the principal productive activities, with cash-transfer programmes and handicraft sales supplementing household monetary resources. External pressures included reported illegal fishing, fires, unregulated tourism and observed riverbank erosion. Specific needs were organised into four broad domains: health, education, income and production, and territory and environment; housing improvement was also reported as an infrastructure need.
Conclusion: Cultural continuity and structural constraints coexist in Boa Esperança. The findings support consideration of locally grounded, intersectoral planning across health, education, livelihoods, infrastructure and environmental management while remaining explicitly limited to this single-village descriptive study.
Keywords: Indigenous peoples, health of indigenous peoples, social determinants of health, qualitative research, culture, public policy