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)
