The Health of the Indigenous Population in Mexico

The Health of the The Health of the Indigenous Population in Indigenous Population in

MexicoMexico

Carlos ZollaCarlos Zolla

COMISIÓN NACIONAL PARA EL DESARROLLOCOMISIÓN NACIONAL PARA EL DESARROLLODE LOS PUEBLOS INDÍGENAS – MEXICO, 2004DE LOS PUEBLOS INDÍGENAS – MEXICO, 2004

INDIGENOUS POPULATION IN MEXICOINDIGENOUS POPULATION IN MEXICO

TOTAL POPULATION IN MEXICO, 2000 TOTAL POPULATION IN MEXICO, 2000 97,438,41297,438,412

Population 5 years and older that speaks Population 5 years and older that speaks an Indigenous language (HLI)an Indigenous language (HLI) 6,044,547 6,044,547 Population ages 0 - 4 in homes where family headPopulation ages 0 - 4 in homes where family head

or partner speaks an Indigenous languageor partner speaks an Indigenous language 1,233,455 1,233,455 Do not speak an Indigenous language but feel Do not speak an Indigenous language but feel they are Indigenous (self-declared)(Sampling)they are Indigenous (self-declared)(Sampling) 1,103,312 1,103,312

TOTAL REGISTERED INDIGENOUS POPULATIONTOTAL REGISTERED INDIGENOUS POPULATION 8,381,314 8,381,314

TOTAL ESTIMATE, INDIGENOUS POPULATIONTOTAL ESTIMATE, INDIGENOUS POPULATION 12,403,00012,403,000

DISTINCTIVE CHARACTERISTICS OF THE DISTINCTIVE CHARACTERISTICS OF THE INDIGENOUS POPULATION IN MEXICOINDIGENOUS POPULATION IN MEXICO

The most numerous population in Latin America: The most numerous population in Latin America: 12,403,000.12,403,000.

Strong cultural and linguistic diversity: 86 Strong cultural and linguistic diversity: 86 languages and dialects are spoken in Mexico. languages and dialects are spoken in Mexico.

80% of the population lives in the Central-South-80% of the population lives in the Central-South-Southeastern states.Southeastern states.

There are big ethno-linguistic groups (nahuas, There are big ethno-linguistic groups (nahuas, mayas, mixtecos, zapotecos, otomíes, tzeltales, mayas, mixtecos, zapotecos, otomíes, tzeltales, tzotziles: between 1,400,000 y 300,000), and tzotziles: between 1,400,000 y 300,000), and small groups: kiliwas, paipai, cochimí, kukapás, small groups: kiliwas, paipai, cochimí, kukapás, kikapús, with less than 500 people each.kikapús, with less than 500 people each.

DISTINCTIVE CHARACTERISTICS OF THE DISTINCTIVE CHARACTERISTICS OF THE INDIGENOUS POPULATION IN MEXICOINDIGENOUS POPULATION IN MEXICO

The highest marginalization ratios in the country and a The highest marginalization ratios in the country and a strong territorial dispersion.strong territorial dispersion.

They live in regions with important mining, touristic, They live in regions with important mining, touristic, biological, hydric, forestal, and eolic. Relevant handicrafts biological, hydric, forestal, and eolic. Relevant handicrafts and a solid ancient culture. and a solid ancient culture.

Notably rich medical flora (the world’s second or third Notably rich medical flora (the world’s second or third largest) and ample knowledge on traditional and home largest) and ample knowledge on traditional and home medicine. medicine.

Intense regional, national and international migration in the Intense regional, national and international migration in the last years.last years.

RURAL-URBAN DISTRIBUTION OF THE INDIGENOUS RURAL-URBAN DISTRIBUTION OF THE INDIGENOUS POPULATION IN MEXICO, 2000POPULATION IN MEXICO, 2000

65% of the HLI live in rural areas (locations with 65% of the HLI live in rural areas (locations with less than 2,500 inhabitants)less than 2,500 inhabitants)

19% live in semi-urban areas (locations with more 19% live in semi-urban areas (locations with more than 2,500 and less than 15,000 inhabitants)than 2,500 and less than 15,000 inhabitants)

16% in urban areas (locations with more than 16% in urban areas (locations with more than 15,000 inhabitants)15,000 inhabitants)

THE INDIGENOUS PEOPLES AND THEIR THE INDIGENOUS PEOPLES AND THEIR HABITATHABITAT

Traditional rural areasTraditional rural areas

Mexican citiesMexican cities

Agroindustrial areas and their surroundingsAgroindustrial areas and their surroundings

Rural areas and cities in the United States Rural areas and cities in the United States of America and Canadaof America and Canada

DISTRIBUTION OF THE INDIGENOUS POPULATION.DISTRIBUTION OF THE INDIGENOUS POPULATION.LocationsLocations

Locations with 70% and more of indigenous population: Locations with 70% and more of indigenous population: 17,43617,436

Locations with 70% and more of indigenous population and Locations with 70% and more of indigenous population and less than 100 inhabitants: 8,263less than 100 inhabitants: 8,263

Locations with 40% - 69% of indigenous population and less Locations with 40% - 69% of indigenous population and less than 100 inhabitants: 1,255than 100 inhabitants: 1,255

Locations with less than 40% of indigenous populaton and Locations with less than 40% of indigenous populaton and less than 100 inhabitants: 8,088less than 100 inhabitants: 8,088

Total of locations with indigenous population and less than Total of locations with indigenous population and less than 100 inhabitants: 16,351100 inhabitants: 16,351

SOURCES: (CONAPO, 2000. INI, 2000a. ORDPI-INI, 2002. SSa, 2001a. SSa, 2001b. SERRANO CARRETO SOURCES: (CONAPO, 2000. INI, 2000a. ORDPI-INI, 2002. SSa, 2001a. SSa, 2001b. SERRANO CARRETO et al.et al., 2002), 2002)

MARGINALIZATION OF THE INDIGENOUS MARGINALIZATION OF THE INDIGENOUS POPULATION IN MEXICO, 2000POPULATION IN MEXICO, 2000

Total of indigenous municipalities or where indigenous population Total of indigenous municipalities or where indigenous population is present: 871 (100%)is present: 871 (100%)

Indigenous municipalities with VERY HIGH MARGINALIZATION: 300 Indigenous municipalities with VERY HIGH MARGINALIZATION: 300 (37.4%)(37.4%)

Indigenous municipalities with HIGH MARGINALIZATION: 407 Indigenous municipalities with HIGH MARGINALIZATION: 407 (50.7%)(50.7%)

Indigenous municipalities with MEDIUM MARGINALIZATION: 79 Indigenous municipalities with MEDIUM MARGINALIZATION: 79 (9.8%)(9.8%)

Indigenous municipalities with LOW MARGINALIZATION: 12 (1.5%)Indigenous municipalities with LOW MARGINALIZATION: 12 (1.5%)

Indigenous municipalities with VERY LOW MARGINALIZATIONIndigenous municipalities with VERY LOW MARGINALIZATION: 3 : 3 (0.4%)(0.4%)

MARGINACIÓN DE LA POBLACIÓN INDÍGENA.MARGINACIÓN DE LA POBLACIÓN INDÍGENA.ViviendaVivienda

Total of homes: 2,051,444Total of homes: 2,051,444

Indigenous homes with tap water: 64.0% (National: Indigenous homes with tap water: 64.0% (National: 84.3%). 84.3%). Durango; 32.3%. Veracruz: 35.1%. San Luis Potosí: 36.2%Durango; 32.3%. Veracruz: 35.1%. San Luis Potosí: 36.2%

Indigenous homes with electricity: 83.1% (National: Indigenous homes with electricity: 83.1% (National: 95.0%). 95.0%). Durango: 31.6%. Chihuahua: 31.9%. Nayarit: 51.1%Durango: 31.6%. Chihuahua: 31.9%. Nayarit: 51.1%

Indigenous homes with dirt floor: 43.7% (National: 13.2%). Indigenous homes with dirt floor: 43.7% (National: 13.2%). Guerrero: 75%. Chiapas: 71.0%. San Luis Potosí: 70.9%.Guerrero: 75%. Chiapas: 71.0%. San Luis Potosí: 70.9%.

Indigenous homes with exclusive sanitary service: 73.6% Indigenous homes with exclusive sanitary service: 73.6% (National: 85.9%).(National: 85.9%).Guerrero: 36.8%. Nayarit: 37.5%. Durango: 46.3%Guerrero: 36.8%. Nayarit: 37.5%. Durango: 46.3%

Homes that cook with wood fire: 62.4 (Nacional: 17.2%). Homes that cook with wood fire: 62.4 (Nacional: 17.2%). San Luis Potosí: 85.8%. Chiapas: 85.7%. Guerrero: 83.8%. San Luis Potosí: 85.8%. Chiapas: 85.7%. Guerrero: 83.8%.

MARGINALIZATION OF THE INDIGENOUS MARGINALIZATION OF THE INDIGENOUS POPULATION.POPULATION.

IncomeIncome

Monetary income of the indigenous Monetary income of the indigenous population as a result of workingpopulation as a result of working

(SMM: Monthly Minimum Wages)*(SMM: Monthly Minimum Wages)*

Does not get paid for work: 25%Does not get paid for work: 25% Receives up to 2 SMM: 56%Receives up to 2 SMM: 56% Receives more than 2 SMM: 19%Receives more than 2 SMM: 19%

* 1,298.70 pesos = 113.92 dollars* 1,298.70 pesos = 113.92 dollars


Illiteracy in municipalities with indigenous Illiteracy in municipalities with indigenous populationpopulation

Percentage of illiteracy amongst people 15 years Percentage of illiteracy amongst people 15 years and older: 25%and older: 25%

Women: 32%Women: 32% Men: 18%Men: 18%

Illiterate HLI women: 43.3%Illiterate HLI women: 43.3% Non illiterate HLI women: 10.4%Non illiterate HLI women: 10.4%

Illiterate HLI men: 23.4%Illiterate HLI men: 23.4% Non illiterate HLI men: 6.7%Non illiterate HLI men: 6.7%


Backwardness in EducationBackwardness in Education

Municipalities by degree of backwardness in education, 2000

0

100

200

300

400

500

600

700

800

Muy Alto Alto Medio Bajo Muy Bajo

Nacional Indígenas


HealthHealth Life expectancy seven years less than the rest of the population Life expectancy seven years less than the rest of the population

(69/76)(69/76)

High chronic malnutrition ratiosHigh chronic malnutrition ratios

Predominant infectious diseases (intestinal infections, influenza, Predominant infectious diseases (intestinal infections, influenza, pneumonia, pulmonary tuberculosis)pneumonia, pulmonary tuberculosis)

General, childhood, preschool, school-age and maternal mortality General, childhood, preschool, school-age and maternal mortality higher than in national populationhigher than in national population

Persistence of the so-called residual diseases (for example Persistence of the so-called residual diseases (for example tracoma, in Chiapas)tracoma, in Chiapas)

Predominant “poverty pathology” (Cholera, malaria, dengue fever, Predominant “poverty pathology” (Cholera, malaria, dengue fever, lepra, etc)lepra, etc)

INFANT MORTALITY RATE, BY INDIGENOUS INFANT MORTALITY RATE, BY INDIGENOUS LANGUAGE SPEAKERS, 1990-2000LANGUAGE SPEAKERS, 1990-2000

Speaks an indigenous languageSpeaks an indigenous language Does not speak Does not speak an an indigenous indigenous

languagelanguage

19901990 60.9 / 100060.9 / 1000 36.9 / 100036.9 / 1000 19951995 48.3 / 100048.3 / 1000 29.0 / 100029.0 / 1000 20002000 38.5 / 100038.5 / 1000 24.9 / 100024.9 / 1000

Sources: CONAPO, Sources: CONAPO, La situación demográfica en México, 1998La situación demográfica en México, 1998 y y Programa Nacional de Población, 2001-2006Programa Nacional de Población, 2001-2006

INFANT MORTALITY BY ETHNOLINGUISTIC INFANT MORTALITY BY ETHNOLINGUISTIC GROUP GROUP (Deaths for each 1000)(Deaths for each 1000)

MayaMaya 37.937.9 OtomíOtomí 40.140.1 ZapotecoZapoteco 40.440.4 MazahuaMazahua 44.744.7 CholChol 47.247.2 NáhuatlNáhuatl 48.348.3 TzoltzilTzoltzil 52.652.6 OtherOther 53.353.3 Tzeltal Tzeltal 53.453.4 HuastecoHuasteco 53.653.6 MazatecoMazateco 55.655.6 MixtecoMixteco 56.256.2 TotonacaTotonaca 57.057.0

NATIONALNATIONAL 24.9 (Between 21.0 and 22.0, 24.9 (Between 21.0 and 22.0, for for 2002)2002)

Sources: CONAPO, Sources: CONAPO, La situación demográfica en México, 1998La situación demográfica en México, 1998 y y Programa Nacional de Población, 2001-2006Programa Nacional de Población, 2001-2006

PRESCHOOL AND SCHOOL-AGE MORTALITY PRESCHOOL AND SCHOOL-AGE MORTALITY IN THE INDIGENOUS POPULATION.IN THE INDIGENOUS POPULATION.

Relative weight of deathsRelative weight of deaths

Pre-school mortality (1 - 5 years)Pre-school mortality (1 - 5 years)

National: 12%National: 12% Indigenous: 19%Indigenous: 19%

School age mortality (6 - 14 years)School age mortality (6 - 14 years)

National: 1.8% National: 1.8% Indigenous: 3.3%Indigenous: 3.3%

Source: SSa, 2001Source: SSa, 2001

MALNUTRITION IN INDIGENOUS MALNUTRITION IN INDIGENOUS POPULATIONSPOPULATIONS

Chronic malnutrition in girls and boys: delay in Chronic malnutrition in girls and boys: delay in growth (small for their age) in almost half (44%) growth (small for their age) in almost half (44%) of the population (17.7% national)of the population (17.7% national)

Micronutrient deficiency and anaemia (36% Micronutrient deficiency and anaemia (36% indigenous; 27% non indigenous)indigenous; 27% non indigenous)

Important deficiencies in iron, zinc, vitamins C Important deficiencies in iron, zinc, vitamins C and A (between 12 and 50% of the indigenous and A (between 12 and 50% of the indigenous children)children)

Four of ten pregnant women have anaemia Four of ten pregnant women have anaemia (almost twice as many than in the general (almost twice as many than in the general population)population)

MORTALITY BY SELECTED CAUSES.*MORTALITY BY SELECTED CAUSES.*NATIONAL AND INDIGENOUSNATIONAL AND INDIGENOUS

CAUSE CAUSE NATIONALNATIONALINDIGENOUSINDIGENOUS

______________________________________________________________________________________________________________ Diabetes mellitusDiabetes mellitus 3636 1616

TumorsTumors 5353 3333

Heart diseaseHeart disease 6969 4646

CirrhosisCirrhosis 2424 2323

PneumoniasPneumonias 2222 2929

TuberculosisTuberculosis 44 99

MaternalMaternal 44 1414

DiarrheaDiarrhea 1111 3434

*Rate for each 100,000 inhabitants*Rate for each 100,000 inhabitantsSource: SSa, 2001Source: SSa, 2001

The ten main causes of health care needs referred by The ten main causes of health care needs referred by traditional therapists from traditional medicine in the traditional therapists from traditional medicine in the 3,025 areas covered by the Program IMSS-COPLAMAR3,025 areas covered by the Program IMSS-COPLAMAR

Cause of health care need %

1. “Mal de ojo” (witchcraft) 55.03 2. Digestive disorders 49.26 3. Scare-Ghost 33.81 4. “Caída de mollera” 30.75 5. Dysentery 22.57 6. Air 20.95 7. Diarrhea 18.72 8. Sprains (musculoskeletal) 18.41 9. Harm (witchcraft) 14.04 10. Anginas 9.98

Source: ZOLLA, Carlos et al. Diccionario enciclopédico de la medicina tradicional mexicana, México, INI, 2000, 2 vols.

THE NATIONAL HEALTH SYSTEM - MEXICOTHE NATIONAL HEALTH SYSTEM - MEXICO

Secretariat of Health (SSa)*Secretariat of Health (SSa)* Instituto Mexicano del Seguro Social (IMSS)*Instituto Mexicano del Seguro Social (IMSS)* Instituto de Salud y Seguridad Social para los Instituto de Salud y Seguridad Social para los

Trabajadores del Estado (ISSSTE)Trabajadores del Estado (ISSSTE) Secretariat of National Defense (SEDENA)Secretariat of National Defense (SEDENA) Marine Secretariat (SEDEMAR)Marine Secretariat (SEDEMAR) Petróleos Mexicanos (PEMEX)Petróleos Mexicanos (PEMEX)

* They have care schemes for “open population”, not * They have care schemes for “open population”, not affiliated to social security schemes. IN the case of affiliated to social security schemes. IN the case of IMSS, a through the program IMSS-OportunidadesIMSS, a through the program IMSS-Oportunidades

THE HEALTH SYSTEM AS AN ORGANIZED SOCIAL THE HEALTH SYSTEM AS AN ORGANIZED SOCIAL RESPONSERESPONSE

We perceive the health system as a We perceive the health system as a kind of organized social response to kind of organized social response to

face the impact of disease, face the impact of disease, accidents, imbalance or death. accidents, imbalance or death.

THE HEALTH SYSTEM - MEXICOTHE HEALTH SYSTEM - MEXICO

ACADEMIC, MODERN OR ALLOPATHIC MEDICINE ACADEMIC, MODERN OR ALLOPATHIC MEDICINE (Institutional and private)(Institutional and private)

DOMESTIC OR HOME MEDICINEDOMESTIC OR HOME MEDICINE

TRADITIONAL MEXICAN MEDICINE (Traditional Indigenous TRADITIONAL MEXICAN MEDICINE (Traditional Indigenous Medicine)Medicine)

HOMEOPATHIC MEDICINEHOMEOPATHIC MEDICINE

ALTERNATIVE OR COMPLEMENTARY MEDICINE ALTERNATIVE OR COMPLEMENTARY MEDICINE (Acupuncture, Naturopathy, Digitopuncture, Iridiology, etc)(Acupuncture, Naturopathy, Digitopuncture, Iridiology, etc)

THE HEALTH SYSTEM IN MEXICOTHE HEALTH SYSTEM IN MEXICO

MA MT

MD

H MTCH

A - D

N

THE REAL HEALTH SYSTEM IN THE INDIGENOUS THE REAL HEALTH SYSTEM IN THE INDIGENOUS REGIONS IN MEXICOREGIONS IN MEXICO

ACADEMIC INSTITUTIONAL OR PRIVATE ACADEMIC INSTITUTIONAL OR PRIVATE MEDICINE (Secretaría de Salud, Programa MEDICINE (Secretaría de Salud, Programa IMSS-OPORTUNIDADES)IMSS-OPORTUNIDADES)

TRADITIONAL INDIGENOUS MEDICINE TRADITIONAL INDIGENOUS MEDICINE (Healers, midwives, herbal healers, bone (Healers, midwives, herbal healers, bone healers, prayers, snake people, etc)healers, prayers, snake people, etc)

HOME OR DOMESTIC MEDICINE (mainly HOME OR DOMESTIC MEDICINE (mainly housewives)housewives)

THE HEALTH SYSTEM IN THE INDIGENOUS REGIONS THE HEALTH SYSTEM IN THE INDIGENOUS REGIONS WITH INSTITUTIONAL SERVICESWITH INSTITUTIONAL SERVICES

Academic Medicine

(MA)

Traditional Medicine

(MT)

Home or Domestic Medicine

(MT)

IT IS IMPORTANT TO OBSERVE THE RELATIONSHIP IT IS IMPORTANT TO OBSERVE THE RELATIONSHIP BETWEEN DOMESTIC OR HOME MEDICINE, BETWEEN DOMESTIC OR HOME MEDICINE,

TRADITIONAL MEDICINE AND ACADEMIC OR TRADITIONAL MEDICINE AND ACADEMIC OR ALLOPATHIC MEDICINE WITHIN THE REAL HEALTH ALLOPATHIC MEDICINE WITHIN THE REAL HEALTH

SYSTEMSYSTEM

MAMT

MD

It is the population that associates the different It is the population that associates the different health models in reality and uses them as a health models in reality and uses them as a

complement.complement.

MA MT

MD

Locations (17,859)Locations (17,859)

Have health services: 2,064 (11.6%)Have health services: 2,064 (11.6%) Have access to health services: 6,227 (34.9%)Have access to health services: 6,227 (34.9%) Do not have access to health services: 9,559 (53.6%)Do not have access to health services: 9,559 (53.6%)

Population (4,403,986)Population (4,403,986)

Have health services: (1,721,032): 39.1%Have health services: (1,721,032): 39.1% Have access to health services: 1,205,884 (27.4%)Have access to health services: 1,205,884 (27.4%) Do not have access to health services: 1,477,070 (33.5%)Do not have access to health services: 1,477,070 (33.5%)

*Locations with 40% and more HLI*Locations with 40% and more HLI

**Unidades de la SSa e IMSS-Oportunidades. Se tiene acceso **Unidades de la SSa e IMSS-Oportunidades. Se tiene acceso cuando la unidad está a menos de 2,500 m. de la localidad. cuando la unidad está a menos de 2,500 m. de la localidad.

PERCENTAGE OF DISTRIBUTION OF LOCATIONS AND POPULATION

IN THE RURAL INDIGENOUS LOCATIONS* BY ACCESS TO HEALTH SERVICES**, 2000

PERCENTAGES OF DISTRIBUTION OF THE LAST CHILDREN PERCENTAGES OF DISTRIBUTION OF THE LAST CHILDREN BORN ALIVE BY AGENT WHO ASSISTED THE MOTHER DURING BORN ALIVE BY AGENT WHO ASSISTED THE MOTHER DURING

DELIVERY, BY CONDITION OF INDIGENOUS LANGUAGEDELIVERY, BY CONDITION OF INDIGENOUS LANGUAGE1994-19991994-1999

Speaks an Indigenous LanguageSpeaks an Indigenous Language Does not Does not speak an I. L.speak an I. L.

Doctor: Doctor: 25.4%25.4% 64.6%64.6% Nurses: Nurses: 2.2% 2.2% 2.8% 2.8% Midwife: Midwife: 57.2%57.2% 28.7%28.7% Others: Others: 2.0% 2.0% 1.3% 1.3% Family or friend: Family or friend: 8.5% 8.5% 1.4% 1.4% Nobody: Nobody: 4.7% 4.7% 1.2% 1.2%

Source: Encuesta de Salud Reproductiva en el Ámbito de Source: Encuesta de Salud Reproductiva en el Ámbito de IMSS-Solidaridad, 1999, CONAPO, 2004.IMSS-Solidaridad, 1999, CONAPO, 2004.

THE REAL HEALTH SYSTEM IN INDIGENOUS THE REAL HEALTH SYSTEM IN INDIGENOUS REGIONS WITHOUT INSTITUTIONAL SERVICESREGIONS WITHOUT INSTITUTIONAL SERVICES

DOMESTIC OR HOME MEDICINE

TRADITIONAL MEDICINE

FACTORS THAT HAVE FOSTERED EMIGRATION OF FACTORS THAT HAVE FOSTERED EMIGRATION OF THE INDIGENOUS POPULATION IN THE LAST 20 THE INDIGENOUS POPULATION IN THE LAST 20

YEARS (I)YEARS (I)

Factors Affected region or indigenous groups

ECOLOGICAL Low land productivity Oaxaca, la Montaña de Guerrero, r

mazahua-otomí region, and Sierra Tarahumara

Climatological phenomena: draughts, freezing, hurricanes

Sierra Tarahumara and regions close to the coast

Wasted time in the temporary agricultural cycle of the place of origin

Practically all regions

Changes in the productive quality of the soil caused by monoculture and other causes of ecological degradation

Yucatán, totonaca region in Veracruz, Huastecas, petroleum areas in Veracruz and Tabasco, and Sierra Norte de Puebla


YEARS (II)YEARS (II)

Factors Affected region or indigenous groups

LAND OWNERSHIP

Problems with agrarian distribution or lack of land ownership

Huastecas, Chiapas and Huicot area

Land used for raising cattle Huastecas, totonaca de Veracruz and Chiapas

Forced sale of cooperative lands and change in the use of the soil with development goals (dams, railroads, factories, and roads)

Petroleum zones in Veracruz, zona nahua, mazahua and otomí, State of Mexico, Tehuantepec Isthmus, Sierra Tarahumara, zona nahua in Guerrero and Papaloapan region


YEARS (III)YEARS (III)Factors Affected region or indigenous groups

CRISIS IN PRICES OF AGRICULTURAL PRODUCTSLower costs for coffee, agave fiber, sugar, tobacco, cocoa, orange, tomato, avocado and others

Chiapas, las Huastecas, chocho-mixteca-popoluca region, Sierra Norte de Puebla, region in Veracruz, nahua region in Oaxaca and Puebla, nahua region in Veracruz, chontal zone in Tabasco, Huicot region, and Yucatán Peninsula

Demand for agave fiber cancelled Yucatán PeninsulaLower demand for palm tree products because of products made of plastic or synthetic fibers

Montaña de Guerrero, Sierra Tarahumara, and Oaxaca

Lower demand for products that are produced at a very small scale by indigenous people: ceramics, palm tree products, regional fruit, wooden objects, regional candy, etc.

Practically all regions

STRATEGIC GUIDELINES FOR HEALTH CARE STRATEGIC GUIDELINES FOR HEALTH CARE FOR AND WITH INDIGENOUS POPULATIONFOR AND WITH INDIGENOUS POPULATION

Foster the tasks of designing, promotion and Foster the tasks of designing, promotion and implementation of a NEW STATE POLICY implementation of a NEW STATE POLICY specifically oriented towards improving the health specifically oriented towards improving the health situation and the living conditions of the situation and the living conditions of the indigenous populationindigenous population

Promote the implementation of an INTER-Promote the implementation of an INTER-CULTURAL HEALTH CARE MODEL (MIAS) for the CULTURAL HEALTH CARE MODEL (MIAS) for the indigenous population indigenous population

Promote the creation of an INFORMATION SYSTEM Promote the creation of an INFORMATION SYSTEM that allows periodic health diagnoses of the that allows periodic health diagnoses of the indigenous populationindigenous population

STRATEGIC GUIDELINES FOR HEALTH CARE STRATEGIC GUIDELINES FOR HEALTH CARE FOR AND WITH INDIGENOUS POPULATIONFOR AND WITH INDIGENOUS POPULATION

Guarantee full access to health care services for Guarantee full access to health care services for all the indigenous population (mainly SSa all the indigenous population (mainly SSa [Sistema de Protección Social en Salud/Seguro [Sistema de Protección Social en Salud/Seguro Popular de Salud], IMSS-Oportunidades).Popular de Salud], IMSS-Oportunidades).

Promote and develop local resources for health, Promote and develop local resources for health, especially traditional indigenous medicine.especially traditional indigenous medicine.

Formulate a MONITORING SCHEME of health Formulate a MONITORING SCHEME of health actions as part of the evaluation and follow-up actions as part of the evaluation and follow-up tasks of public action with the indigenous tasks of public action with the indigenous population, assigned by law to the Comisión population, assigned by law to the Comisión Nacional para el Desarrollo de los Pueblos Nacional para el Desarrollo de los Pueblos Indígenas.Indígenas.

Documents

The Health of the Indigenous Population in Mexico