insp national institute of public health, mexico b. pelcastre; m. márquez; s. meneses; m. ruiz; c....

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National Institute of Public Health, Mexico

B. Pelcastre; M. Márquez; S. Meneses; M. Ruiz; C. Amaya; Y. Gómez

Ethical Issues on Indigenous Communities’ Reproductive Health

and Gender Violence: The Experience of Casa de la Mujer

Indígena *

* Funding provided by SALUD-2005-02-14445CONACYT

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Mexican indigenous communities

12.7 million total indigenous population in Mexico

At least 62 native languages are spoken by over 7.6 million of them

60% live in municipalities with high degree of marginality

80% live with less than US$8 a day

25.5% are illiterate

XII Census 2000/CONAPO/INIPresidencia de la República, Plan Nacional de Desarrollo 2007-2012, Gobierno de los Estados Unidos Mexicanos, Presidencia de la República, México, 2007: 200-202

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Health services

Health services for indigenous population: lag behind

72.5% do not have access to health insurance schemes

Triple discrimination: ethnicity, gender, and social class

Infant mortality rate: 58% higher

Reproductive risk: three times higher

(CDI, 2000)

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HealthNational average

Indigenous

Life expectancy 75 years old 69 years old

Maternal mortality 51/100 000 283/100 000

Infant malnutrition 17.7% 44%

Anemia in pregnancy and breastfeeding women

26.4% 40%

CDI,2000/*Guerrero, Oaxaca 120, Chiapas 110

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Background: Casa de la Mujer Indígena

• Its goal is to implement a culturally appropriated model of attention to sexual and reproductive health, including gender violence, for indigenous women

• First established in 2003• Now its number has grown to five Houses in four

states : Chiapas (1), Guerrero(1), Puebla (1) and Oaxaca (2)

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Location of Health Houses

Guerrero

Puebla

Oaxaca

Chiapas

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Chiapas

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Organizational Structure Coordinator

Areas of attention: psychological, legal and medical

Health services

Municipal authorities

Local institutions

6-8 female workers (violence and maternal health)

CDI-National Commission: development for indigenous groups (Budget)

NGO (formal networks)

External counselor

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Activities and Services

AttentionDelivery (by midwives)Pap testReferencesCompany (counselors)TranslatorsPsychological Legal Medical

PreventionWorkshops

PromotionRadioBrochures

Sexual and reproductive health

Violence

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Actors

Indigenous women

Indigenous menIndigenous female

workers

Local authorities

Ethnic and gender identity between suppliers and users

Share of language and cultural symbols

Gender inequities are acceptable

Threat perception

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Ethical Issues

How could we continue with the indigenous women's empowerment process?

How do we include men in the process (refuse informed consent and avoid threaten behavior from them)?

What must we protect? (health women/traditional social values)

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Thank you!!

bpelcast@correo.insp.mx

San Cristóbal de las Casas, Chiapas