CALIDAD Y COSTO DE LOS SERVICIOS

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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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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 US8
• a day
• 25.5 are illiterate

XII Census 2000/CONAPO/INI Presidencia de la Repú
blica, 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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Health
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
Puebla
Chiapas
Guerrero
Oaxaca
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Chiapas
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Organizational Structure
Coordinator Areas of attention psychological, le
gal 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
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Activities and Services
Attention Delivery (by midwives) Pap test Refer
ences Company (counselors) Translators Psycholo
gical Legal Medical Prevention Worksho
ps Promotion Radio Brochures
Sexual and reproductive health
Violence
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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
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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_at_correo.insp.mx
San Cristóbal de las Casas, Chiapas