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How can we improve maternal health experiences for indigenous women?

05/11/18

For the last year or so, Health Poverty Action has been working with the UN Population Fund (the UN’s sexual and reproductive health agency) and the Minority Rights Group to investigate the maternal health experiences of indigenous women and girls. On 30th October, we were excited to take part in the UK launch of the results of our research, at a House of Commons event hosted by the All-Party Parliamentary Groups on Global Health, and on Population, Development and Reproductive Health. It was a really well-attended event, with politicians, government officials and NGOs coming together to discuss our findings and recommendations – and to put pressure on the Department for International Development (DFID) to act on them.

And there is no doubt about the urgent need for action. Our research found that all over the world, indigenous women and adolescent girls experience significantly worse maternal health outcomes than majority populations.  For example, the birth rate for Amerindian adolescent girls is twice that of the general Guyanese population, Maasai women in Kenya are twice as likely to have had no antenatal care, and San women in Namibia are ten times more likely to give birth without skilled attendance. In both Panama and Russia, indigenous women are approximately six times more likely to die in childbirth than the non-indigenous population.

An indigenous San mother waits for her check up at a health centre in a rural Tsumkwe, Namibia.

An indigenous San mother waits for her check up at a health centre in a rural Tsumkwe, Namibia.

The other deeply concerning finding from our research was the lack of data relating to the experiences of indigenous women and girls. We reviewed 90 national surveys of maternal and sexual and reproductive health, and only 27 contained an analysis of data based on ethnicity; and only eight of these provided data relating to indigeneity. As the countries that have signed up to the Sustainable Development Goals – including, of course, the UK – have recognised, the collection and analysis of disaggregated data relating to marginalised groups is essential if we are to achieve the SDGs – in particular, the commitment to Leave No One Behind. The lack of ethnicity data is simply incompatible with that commitment.

So the evidence of the need for urgent action is pretty overwhelming. We hope that the UK government will recognise this need, and respond accordingly – and they have a couple of immediate opportunities to do so.  DFID is shortly due to publish its strategy for how it will use UK aid to strengthen the health systems of poor countries.  This strategy is long-overdue – the International Development Committee (IDC – the group of MPs that scrutinises DFID) initially called for them to develop this strategy over four years ago. The IDC were particularly keen that DFID included action to address the cultural barriers to accessing health services – and our research provides a number of recommendations for how they can do that.

The second opportunity concerns the lack of data relating to the experience of indigenous women and girls. At the moment, DFID’s approach to collecting data to monitor progress towards the SDGs doesn’t take ethnicity data seriously – focusing instead on the four prioritised characteristics of sex, age, disability status, and geography. As noted above, this neglect of ethnicity data must be reversed if we are going to live up to our commitment to ‘Leave No One Behind’. DFID is currently reviewing its approach to data collection, and again, our research provides recommendations for how they can rectify the current short-comings in their approach to collecting ethnicity data.

Read the full factsheet on Indigenous Women’s Maternal Health
and Maternal Mortality.


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