Indigenous People’s Rights and Accountability
The 400 million indigenous people worldwide represent a wealth of linguistic and cultural diversity, as well as traditional knowledge and sustainable practices that are invaluable resources for human development . However, indigenous people remain on the margins of society in high, middle and low-income countries, and they bear a disproportionate burden of poverty, disease, and mortality compared to the general population [2,3]. These inequalities have persisted, and in some countries have even worsened, despite the overall improvements in health indicators in relation to the 15-year push to meet the Millennium Development Goals [4,5]. Attention garnered by the social determinants of health framework has enriched the understanding we have of the complex conditions that give rise to inequalities in indigenous health. This lens has brought into focus the structural and socio-political factors that contribute to health inequalities, illuminating the intersecting conditions of poverty, social and political exclusion, discrimination and land loss that shape indigenous people’s health [6,7,8]. Historically, indigenous health has been framed as a problem of poor health indicators to be solved through targeted service delivery. This approach is simplistic and ignores the political and legal barriers described above. Our argument is that an accountability framework offers a better approach and strategies to tackle the political, social, economic and legal causes of inequitable indigenous health.
1. Establishing the thematic hub with an initial concept, objectives and action plan.
2. To build alliance and networking of the thematic hub with global and regional networks, academia and with policy makers and policy space.
3. Strengthening the practice around indigenous health and accountability through production of knowledge and enhancing the analytical skills of practitioners.
4. To generate knowledge of academic standard and dissemination to global audience
5. To develop a thematic component for the Global Symposium (GS)on Social Accountability in Health to be held in early 2019
Knowledge hub anchor:
The anchor will be the Center for the Study of Equity and Governance in Health Systems (CEGSS by its initials in Spanish), based in Guatemala. CEGSS has over a decade experience engaging with the governance structures and conditions of marginalization that impact indigenous health. Indigenous people of 23 ethnicities make up 45% of Guatemala’s 14 million inhabitants. They experience stark inequalities in income, health and education resulting from decades of social and economic exploitation, and were particularly targeted by the country’s military dictatorships during the 36 year-long internal war. This conflict left 200,000 victims, who were predominantly indigenous, and contributed to the worsening of already weak public services in rural and impoverished areas . In our primary line of work, CEGSS supports the development of a citizen-led initiative for state accountability for the right to health in rural indigenous municipalities. Through our experiences, we have gained critical insights into the complex nature of pathways to redressing inequity and the potential of systems thinking approaches to enhance efforts to promote indigenous health. To meet the challenge of engaging with the conditions underlying inequalities and promoting transformational change, equity-oriented research and practice in the field of indigenous health requires: engaging power, context-adapted strategies to improve service delivery, and mobilizing networks of collective action. The experience gained by CEGSS will be shared through this knowledge hub. Also other organization and individuals members of the hub will share their own learning and experiences. Within CEGSS, the specific persons responsible to coordinate the hub will be Dr. Walter Flores.
Knowledge hub core members:
At the moment, the following individuals have communicated their interest to become part of the core group that will lead the knowledge hub together with CEGSS: