Indigenous Peoples’ access to Health Services
This challenge becomes more evident in data for indigenous peoples because: ɜɜ I ndigenous peoples have not yet been fully recognized in many States as such, therefore, no provision has been made to collect data. For example, the concept of indigenous peoples is not acknowledged in Tanzania but the government “recognizes the vulnerability of some of the marginalized communities”.68 ɜɜ I ndigenous peoples in the African region are usually lumped together as marginalized groups. This lack of recognition makes it difficult to take bold steps to put strategies in place to collect disaggregated data according to ethnicity. ɜɜ S tates may also be hesitant to collect ethnic-specific data as a way to discourage tribalism and promote national unity and cohesiveness. ɜɜ I ndigenous peoples often live in remote and hard-to-reach areas where collecting data is considered difficult and expensive and since the population is small, it will not have a major impact on the overall results. An example of this is Kenya, where three demographic and health surveys in 1989, 1993 and 1998, omitted northern Kenya, which is inhabited by nomadic pastoralists because the population was less than 4 per cent. The 2003 demographic survey indicated that the national under-five mortality rate was 115 per 1,000 live births, while it was 163 per 1,000 in North-Eastern Kenya.69 ɜɜ C hallenges in data collection included language barriers between data collectors and respondents. ɜɜ A s most of indigenous African communities have low literacy levels, the data are collected by people who do not speak the language or understand the culture. Therefore, obtaining accurate demographic data is difficult. Among the Maasai community obtaining accurate data on maternal and infant deaths is a challenge, as they may never be reported. Further, among the Maasai it is difficult to know which woman has never had a child because the practice is for every married woman to be called the mother of a child. Therefore, in cases where a woman has no child, she is given one by a family member to raise as her own. ɜɜ A nother significant gap is the lack of adequate research on indigenous peoples’ health issues in the African region. During the International consultation of indigenous peoples’ health between 23 and 26 November 1999 the objective was amongst others to provide key elements for the development of World Health Organization policies, strategies and recommendations for the protection of and promotion of the right to health of indigenous peoples. The following recommendations were made to WHO; ɜɜ P romote the systematic collection and reporting of statistics disaggregated by ethnicity by member states. This will require the development of working criteria or definitions of ethnicity and the development of indicators that are able to measure what constitutes a positive health outcome in indigenous peoples’ terms. ɜɜ D evelop, in close consultation with the informal advisory group, a comprehensive research agenda which places emphasis on the broad determinants of health.70 68
Country technical notes on Indigenous peoples issues, United Republic of Tanzania June 2012 and submitted by IWGIA
69
Central Bureau of Statistics (CBS) [Kenya], Ministry of Health (MOH) [Kenya], and ORC Macro. 2004. Kenya Demographic and Health Survey 2003. Calverton, Maryland: CBS, MOH, and ORC Macro.
70
WHO/HSD/00.1.
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