Maternal Mortality and Maternal Health among Indigenous Women and Adolescent Girls
Brief summary of presentation of information made
The evidence from the available data on indigenous women’s maternal health tells us that across the globe, indigenous women and adolescent girls experience significantly worse maternal health outcomes than majority populations. Yet due to a lack of data, this alarming situation is concealed, preventing effective action to address it.
To help bring attention to this issue, UNFPA, UNICEF and UN Women have developed a fact sheet that brings together the available data on the maternal health status of indigenous women and adolescent girls. It analyzes the barriers behind these huge disparities and identifies actions that can be taken to close the gap. With the Sustainable Development Goals (SDGs), states have committed to leave no one behind. Failure to act now will make them unachievable.
The fact sheet was shared on how to discuss with national governments and institutions, international organizations, and civil society. It included how they can work together towards improving maternal health among indigenous women and adolescents girls, and help create a dialogue on closing the implementation gap for the achievement of the SDGs.
- Moderator: Mariam Wallet, Chairperson of the UN permanent Forum on Indigenous Issues
- Benoit Kalasa, Director of Technical Division, UNFPA (speaking on behalf of UNFPA, UNICEF, and UN Women)
- Gloria Ushigua, Coordinator of the Sápara women’s organisation Ashiñwaka, Ecuador
- Carl Soderbergh, Director of Policy & Communications, Minority Rights Group International
Indigenous women die in pregnancy and childbirth more often than other women. Failure to act will render the Sustainable Development Goals (SDGs) unattainable.
The lack of data on the health of indigenous women and adolescent girls is masking huge disparities between populations, preventing effective action to address the problem.
Improving the health of indigenous women and adolescent girls is, however, achievable. It requires states to implement commitments to disaggregate data by ethnicity and age, tackle discrimination, and make health centres physically, financially, and culturally accessible.
Access to health care, including sexual and reproductive health, is a basic right. States have an obligation to ensure that indigenous women and adolescent girls enjoy equal access to health services.
WHY ARE INDIGENOUS WOMEN LEFT BEHIND?
Indigenous women and adolescent girls face considerable barriers to accessing medical treatment, despite typically experiencing higher health risks. While some of these may involve direct discrimination, the reasons are also grounded in a wide range of social, economic, political, cultural and geographical factors. These factors intersect with and impact upon the experiences of indigenous women and adolescent girls in varied and complex ways.
Indigenous women are not a homogenous group, and intersecting and multiple forms of discrimination on the basis of factors such as disability, age, location and sexual orientation and gender identity also affect the experiences of individual women and patterns of experiences.
WHAT NEEDS TO BE DONE?
While there has been progress in addressing indigenous peoples’ marginalization, much greater efforts are needed to tackle disparities between them and majority populations across all sectors. Specifically, the following measures were recommended to ensure that indigenous women and adolescent girls are not left behind in the pursuit of the SDGs:
- Disaggregate data. Health and other data to monitor SDG progress must be disaggregated by a range of categories, including ethnicity, using the principles of data protection, self-identification, participation of indigenous and other marginalised ethnic and cultural groups, and the independence of official statistics. Specifically:
- National governments must consult indigenous communities about the best ways to collect, analyze, and report such data in line with the commitments of the 2030 Agenda for Sustainable Development, and train officials to do so. Data must be analyzed to form the basis of interventions and to address disparities.
- International institutions, donors and Non-Governmental Organizations (NGOs) must include requirements for standard disaggregation by ethnicity in their own reporting mechanisms.
- National statistical offices and line ministries should be strongly encouraged to collect, analyze, and disseminate data collected by ethnic categories in all appropriate surveys at the country level (including DHS and MICS).
- Disaggregated statistics are a starting point. They will clearly show where disparities exist for needed action. To this extent, policy makers also need to understand WHY indigenous women in their countries have higher maternal mortality. Then they need to act to address the barriers. Every maternal death should be fully investigated and as part of this, the ethnicity of the woman should always be recorded. Analysis of this data will reveal trends and patterns of factors that have contributed to indigenous women’s deaths.
Take positive action. Where indigenous maternal mortality is higher than national levels, States must fulfill their duty to take positive action to address this, through:
- Participatory and inclusive action research at national, regional and local levels to identify what barriers are preventing indigenous women, particularly adolescent girls, from benefitting fully from health services, and to implement programs to address them.
- Participatory inclusion audits or reviews of maternal and adolescent health policies and action plans to gather views on how they meet the needs of, or exclude, indigenous women and adolescent girls.
- Allocating appropriate budgets to identify and address socio-cultural and other barriers and monitor the impact of measures taken.
- Incorporating an intercultural approach to sexual and reproductive health (SRH) services to guarantee culturally appropriate health services and medical staff with intercultural competencies.
- Ongoing participatory processes, at the national and community levels, to gather indigenous women's and adolescent girls’ views on services, including the use of complaint mechanisms for indigenous women and their families, and encouraging the use of these mechanisms.
In situations of conflict:
- Where there is conflict or distrust between indigenous communities and the State, trusted third parties (such as inter-governmental organizations (IGOs) and NGOs) may be useful agents for providing services and mediators for rebuilding trust over time.
In conflict-affected regions, IGOs and NGOs who provide SRH services to women and adolescent girls must ensure that indigenous women's and adolescent girls' needs are fully appreciated and factored into service provision plans.
What was of particular significance to share with The Salvation Army globally?
This session was more for information-sharing. Unless you are working with women who are dealing with maternal health and maternal mortality issues, this probably would not mean much. For those who work with indigenous women and girls, this report might give some insight as to some of the struggles they face without all of the tools at their disposal.
Looking at the section 'Situations of Conflict', there is an interesting point suggesting that NGOs be go-to trusted parties. Let this be true for the Salvation Army.
Web links for more information
PDF of UNFPA Strategic Plan: https://www.unfpa.org/sites/default/files/pub-pdf/18-044_UNFPA-SP2018-EN_2018-03-12-1244_0.pdf
Fact Sheet on Maternal Health and Maternal Mortality: https://www.unfpa.org/sites/default/files/resource-pdf/factsheet_digital_Mar27.pdfTags: United Nations, Women, SDG3: Good Health and Well-Being