Indigenous Peoples’ access to Health Services
In the second chapter, Dr. Mukta S. Lama provides an overview and analysis of the situation of indigenous peoples in the Asian region. The Asian subregions include a multitude of indigenous groups who comprise 70 per cent of the estimated 350 million indigenous peoples worldwide. Indigenous peoples in Asia die younger, have higher rates of malnutrition and child mortality, and carry high burden of “diseases of the poor”, namely undernutrition and infectious diseases. Dr. Lama points out that the health of indigenous peoples is often not considered a priority by national governments and as a result, health care needs remain unheard in health care planning with weak representation of indigenous peoples in the government system. Dr. Lama concludes that the exercise of right to self-determination is important in enabling indigenous peoples to revive and reclaim their cultural traditions and indigenous identity and self-esteem based on positive images that are crucial for their overall health and well-being. Such autonomy would also involve empowering indigenous peoples to preserve and develop their own solutions and plans to improve their health rather than imposing solutions upon them. The third chapter by Dr. Ketil Lenert Hansen analyses the major health issues confronting Sami peoples in Norway, Finland, Sweden and Russia and the Inuit in Greenland. The chapter includes an analysis of the unique challenges faced by the indigenous peoples living in the far north due to their specific socioenvironmental location with an increased risk of health problems compared with the average national statistics. Dr. Ketil Lenert Hansen specifies the major constraints to delivering good quality health care in the North and at the same time outlines how traditional healing is being integrated within health services for indigenous peoples. In the fourth chapter, Dr. Myriam Conejo Maldonado provides an overview and analysis of the situation of indigenous peoples in the Central and South America and the Caribbean region and illustrates the stark contrast in access to health services between the indigenous and nonindigenous populations. Indigenous peoples live in poverty and comprise 60 per cent of the poor in the region. Several countries in the region have included an intercultural approach to health in their development plans. However, sociocultural and linguistic barriers still exist, as well as barriers in terms of geographical location and lack of access to health care. Dr. Myriam Conejo Maldonado concludes that there must be a new approach to health services for indigenous peoples based on interculturality, human rights, and collective rights. The fifth chapter on North America emphasizes the complex arrangements that the United States and Canada has with indigenous peoples in terms of health policies. To a large degree, jurisdictional conflict between state/provincial and federal governments impact on the accessibility and comprehensiveness of health services for indigenous peoples. The challenges for indigenous peoples in both Canada and the United States are to 1) take control of their own personal health to achieve balance in life; 2) assume authority and control over health and social services which impact their lives; and 3) design and implement a sustainable health system which meets their unique needs. The role of the federal and provincial governments is to work in partnership with indigenous peoples to design and implement health systems. In chapter six, Dr. Collin Tukuitonga provides a background of the historical, political and cultural factors that have shaped events in Pacific countries that have influenced the health status of indigenous peoples. Dr. Collin Tukuitonga describes the current health situation; the social determinants of health, health service funding and delivery; and the initiatives that have been shown to be effective in improving indigenous peoples’ access to all levels of health care. While there are number of initiatives under way in developed countries that are designed to improve access to
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