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The Global Plan of Action for the Health of Indigenous Peoples
- Cathy Tse
- Jun 3
- 4 min read
Who are Indigenous Peoples?
Indigenous Peoples comprise 6.2% of the global population, consisting of 5,000 distinct groups that total 476 million people spread across 90 countries in every region imaginable. The Asia-Pacific region contains the highest proportion (70.5%) of Indigenous Peoples, with Ainu from Japan, Māori from New Zealand, Aboriginal Australians and Torres Strait Islanders being several examples. This is followed by Africa (16.3%), Latin America and the Caribbean (11.5%), North America (1.6%), and Europe and Central Asia (0.1%).
The current healthcare landscape among Indigenous Peoples
While Indigenous Peoples do not have a universally agreed-upon definition under international law and policy, and should not be considered as a monolith, they are united by the disparities in their rights to health despite living in different sociocultural regions. Compared to non-Indigenous populations, Indigenous Peoples have a shorter life expectancy, higher child and maternal mortality rates, and increased risk of contracting infectious diseases.
Indigenous women have higher rates of sexually transmitted diseases and teenage pregnancy, but are less likely to have access to healthcare facilities. Indigenous women from Panama and Russia are six times more likely to die during childbirth, and Maasai women from Kenya are twice as likely to have had no antenatal care.
As a people who have undergone and continue to experience historical trauma from colonisation, displacement and discrimination, one would think that a robust mental health support system is available for Indigenous Peoples. However, mental health in indigenous populations is poorly studied, and formerly colonial English-speaking countries (United States, Australia and New Zealand) have high rates of Indigenous suicide, highlighting the need for Indigenous suicide prevention programmes.
The Inuit and Sámi peoples in the Arctic region face unique challenges, as healthcare services often do not reach their remote locations; this issue is also relevant to Indigenous Peoples in the Caribbean and Latin America.
Indigenous Peoples have the right to health
The right to health encompasses four interlinked elements: availability, accessibility, acceptability, and quality.
Availability
Indigenous Peoples often live in areas lacking functioning health facilities, trained staff, and medicines. The limited data on health among Indigenous Peoples poses an additional challenge in elucidating methods to address coverage inequality.
Accessibility
Even to this day, Indigenous Peoples face discriminatory practices and differential treatment in healthcare settings. This leads to misdiagnosis and mistreatment of severe illnesses and results in heightened mistrust in and reduced usage of health services.
Indigenous Peoples are often politically and socially isolated within the countries they reside in and thus have restricted access to quality healthcare. The remote geographical locations of their communities may also contribute to difficulties in accessing healthcare facilities and services.
Affordability of healthcare services is also a barrier for Indigenous Peoples, as they are socioeconomically marginalised groups. Many Indigenous Peoples engage with the informal economy, which lacks health coverage and insurance under social security schemes.
Lack of accessible health information in Indigenous languages and limited educational opportunities further restrict Indigenous Peoples' agency over their right to health. This isolation from public information and essential services disproportionately affects Indigenous Peoples, especially during public health emergencies like the COVID-19 pandemic.
Acceptability
The lack of an intercultural approach in providing healthcare for Indigenous Peoples is one of the key reasons for low motivation in health-seeking behaviours, utilisation of healthcare services, communication with healthcare professionals, and adherence to treatment. Indigenous values surrounding health involve environmental, spiritual, and cultural elements that are often neglected in favour of conventional medical approaches.
Quality
In addition to having access to scientifically and medically approved services and goods, other determinants of health, such as sanitation and potable water, need to be addressed. Traditional indigenous medicine and practices should be considered alongside mainstream healthcare services as part of Indigenous Peoples’ right to practice their culture.
Self-determination: the key to improved health among Indigenous Peoples
The United Nations is developing a Global Plan of Action for Health of Indigenous Peoples which aims to provide a support framework and coordinate international efforts towards realising the health-related rights of Indigenous Peoples. This plan of action focuses on empowering Indigenous voices and leadership and incorporating Indigenous Peoples’ perspectives and knowledge into advancing equitable health in their communities.
A recent departmental update from the 24th Session of the United Nations Permanent Forum on Indigenous Issues reiterates that the plan must be developed with Indigenous Peoples and not for them, highlighting a sustained global commitment to self-determination. While this initiative is still in relatively early stages, we can expect Indigenous voices and values to resonate in their resilient pursuit to shape their own health and wellbeing.
References
Nguyen T, Ullah S, Looi JC, Allison S, Mulder R, Bastiampillai T. Indigenous suicide rates in the United States, Australia and New Zealand between 2006 and 2019. Aust N Z J Psychiatry. 2023;57(10):1324-1330. doi:10.1177/00048674231167327
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