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Several indigenous, vulnerable and marginalised communities, and those in fragile contexts such as those affected by conflict, displacement or natural disasters face exclusion and discrimination from the policies, programme and health care services. The modalities of exclusion, non-inclusiveness and discrimination are reflected in the health care programmes and policies that are designed and the kind of health care that is made available. It is estimated that 370 million indigenous people live in more than 70 countries around the world (WHO). In addition, there are other vulnerable communities such as 'ethnic or tribals' (Africa), adivasis and Dalits (India) and Roma people (East-Southern Europe), those living in conflict zones who face barriers in accessing affordable and appropriate health care. The methodologies of exclusion and non-inclusiveness vary across communities. In many countries, for example, the official national language is different from their native language and any health care information is unavailable in native languages. In countries such as East-southern Europe, the ethnic minorities such as Roma People and the Rohingyas in Myanmar (South East Asia) live like permanent refuges from time immemorial as they do not even enjoy the status of citizens in their own countries. In several countries they are ethnic, religious or linguistic minorities.
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