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* Funding provided by. SALUD-2005-02-14445. Ethical Issues on Indigenous Communities’ Reproductive Health and Gender Violence: The Experience of Casa de la Mujer Indígena *. B. Pelcastre; M. Márquez; S. Meneses; M. Ruiz; C. Amaya; Y. Gómez. National Institute of Public Health, Mexico.
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* Funding provided by SALUD-2005-02-14445 Ethical Issues on Indigenous Communities’ Reproductive Health and Gender Violence: The Experience of Casa de la Mujer Indígena * B. Pelcastre; M. Márquez; S. Meneses; M. Ruiz; C. Amaya; Y. Gómez National Institute of Public Health, Mexico
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/INI Presidencia de la República, Plan Nacional de Desarrollo 2007-2012, Gobierno de los Estados Unidos Mexicanos, Presidencia de la República, México, 2007: 200-202
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)
Health CDI,2000/*Guerrero, Oaxaca 120, Chiapas 110
Its goalis 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) Background: Casa de la Mujer Indígena
Location of Health Houses Puebla Chiapas Guerrero Oaxaca
Organizational Structure Coordinator Areas of attention: psychological, legal and medical 6-8 female workers (violence and maternal health) External counselor CDI-National Commission: development for indigenous groups (Budget) NGO (formal networks) Local institutions Health services Municipal authorities
Activities and Services Attention Delivery (by midwives) Pap test References Company (counselors) Translators Psychological Legal Medical Prevention Workshops Promotion Radio Brochures Sexual and reproductive health Violence
Actors Indigenous women Ethnic and gender identity between suppliers and users Gender inequities are acceptable Indigenous female workers Indigenous men Share of language and cultural symbols Threat perception Local authorities
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) Ethical Issues
Thank you!! bpelcast@correo.insp.mx San Cristóbal de las Casas, Chiapas