Community Health Profile Report of Indigenous people of Brazil
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Community Health Profile Report of Indigenous people of Brazil
Community health profile is a developmental approach towards identifying the basic issues and causes of a community in the health segment. It sets the basic idea of these major issues on which the government and health agencies work to improve the health quality of that particular population by using the scarce resources of the community efficiently and effectively and by applying the principles of social justice and equity that are in practice (World Health Organization, 2001). This report is the profiling of the indigenous Brazilian community and includes the relevant information that will inform about the health situation and health needs of the indigenous population of Brazil. This will be done with the help of the social health determinants that will describe the factors that affect this population and along with the key characteristics of the population, health status, view of the local people regarding their health, the national and local priorities and the services being provided to the community (World Health Organization, 2001).
The Social Determinants of Health indicate the conditions in which the people are born, live, grow, work and age, and also show the causes of societal health dilemmas such as, depression, cardiac diseases, infections, etc., and also reflect upon the distribution of equity, power and social status (Catalyst, 2017). The profiling of the indigenous community of Brazil will be done through discussion at each step of the ten categories of the ‘SDH Assessment Circle’ (Clendon and Munns, 2018) as shown in figure 1 below:
Figure 1: Social Determinants of Health Assessments Circle
The biological or genetic population of the indigenous of Brazil include over 890,000 people spread across the states which cover 12.5% of the country. This proportion of the indigenous population of Brazil is greatly diversified with 395 ethnic groups which speak 274 languages (Mendes et al., 2018). Due to the differences and diversities in culture, ethnicity lifestyles, there health care that exists is not of a single type, therefore, the health care policies and management is largely affected (Cecilio and Reis, 2018).
Brazil covers almost two-thirds of the Amazon forest and the indigenous territories are spread 1.11 million square km across the Amazon. The culture and needs of these people was connected to forestation, however, it has been largely affected by the influence of non-indigenous people, due to which the cultural strengths, values, beliefs, and needs of the indigenous of Brazil have changed. These cultural changes are in terms of views and ethnological patterns. Their values and needs changed in terms of decreased access to natural resources due to conservation and changes in family size, number of children and occupation (Campos et al., 2019).
Child development in indigenous community of Brazil faces challenges like other indigenous communities around the world. As indigenous people in Brazil are under extreme poverty, around 11.5 million children under the age of six fall in the category where the income-per-month is less than half the minimum wage per capita (Coates et al., 2016). Government made several policies and reforms to improve the health conditions of children of this community, including education and vaccines, keeping in mind the respect for their ethnicity and cultural diversity. The government intervenes with policies such as, the World’s biggest Family Health Program focuses on maternal and child mortality and “…territoriality, mainstreaming, decentralization, and shared responsibility, and population groups with a higher risk of disease or death” (Coates et al., 2016). Other policies include improvement of death rate, illness, and disability, growth and development among children under five years of age, and includes both precautionary and remedial elements that are applied by families and communities as well as by health services (Coates et al., 2016).
The health services for the indigenous people started around 1950s when the Aerial Sanitary Units Service (SUSA), connected to the Ministry of Health, started providing health care to the people in inaccessible areas. Several programs and policies came afterwards and, in 2011, Indigenous Health Coordination providing “…managerial, technical and financial assistance for “Basic Indigenous Health Care” and the “Promotion of Environmental Sanitation on Indigenous Land”, through management of the DSEIs in the States of Pernambuco, Paraíba, Alagoas and Sergipe, with complementary action in the field of all-round health care for indigenous peoples in these States” (Maggi, 2014).
Health practices in indigenous communities of Brazil use traditional methods based on historical experiences and views and the government has taken steps to make alliances with their traditional practices to promote training, awareness and to further advance the health of that communities (IASG, 2014). Since 1988, government initiatives for making health a universal right, the health indicators have improved. The health system changed “…from local innovation, to federal programs and scaling up, and back down to local implementation—helped ensure dissemination of innovative experiences through the health system and clarify jurisdictional responsibilities” (Coelho and Shankland, 2011).
Regarding the physical environments, including geographical factors such as climate change or transportation barriers to care, indigenous communities of Brazil are at a disadvantage due to social transformations occurring from climate change. They believe the diseases like, measles and yellow, fever are re-occurring and women’s menstrual cycles start at an earlier age due to climate changes (Gonzales, 2020).
Social and economic disadvantage in indigenous communities of Brazil are obvious in high rates of poverty and burden of ill health for many indigenous populations. Since the beginning they have struggled for land rights, but now constitutions protect their rights and recognize their territories (Le Tourneau, 2015). Other social and environmental problems include less access to basic health care facilities, barriers to child health care and violations of children’s and women’s rights (Borges and Cruz, 2018).
In case of employment conditions and education conditions, “….Brazil is confronted with a series of challenges in the world of work: high youth unemployment and underemployment, low education quality and a skills gap, high informality and low productivity jobs, and social inequalities” (Bandura and Hammond, 2018).
The government has taken steps to recognize the cultural diversity of indigenous communities of Brazil. Several initiatives include health prioritization, access to primary health care for these people, mental health, child care and women’s health.
All the information above has tell about the basic conditions and status of the indigenous communities of Brazil. The recommendations for improving the health conditions of these communities is to focus on the priorities, such as education, health care, etc., include the views of indigenous people in new systems as well, ensure land rights are protected, build public and lessen the gap between policy and practice.
References
Bandura, R., & Hammond, M. (2018). The Future of Global Stability: The World of Work in Developing Countries. Center for Strategic and International Studies.
Campos, J. L. A., de Lima Araújo, E., Gaoue, O. G., & Albuquerque, U. P. (2019). Socioeconomic Factors and Cultural Changes Explain the Knowledge and Use of Ouricuri Palm (Syagrus coronata) by the Fulni–ô Indigenous People of Northeast Brazil. Economic Botany, 73(2), 187-199.
Catalyst, N. E. J. M. (2017). Social determinants of health (SDOH). NEJM Catalyst, 3(6)..
Cecilio, L. C. D. O., & Reis, A. A. C. D. (2018). Apuntes sobre los desafíos (todavía) actuales de la atención básica en la salud. Cadernos de Saúde Pública, 34(8).
Clendon, J. and Munns, A. (2018). Community Health and Wellness: Principles of primary health care. Elsevier Health Sciences.
Coates, A. R., del Pino Marchito, S., & Vitoy, B. (2016). Indigenous Child Health in Brazil: The Evaluation of Impacts as a Human Rights Issue. Health and Human Rights, 18(1), 221.
Caio de Souza Borges and Julia Cortez da Cunha Cruz. (2018). Country Systems and Environmental and Social Safeguards In Development Finance Institutions: Assessment Of The Brazilian System And Ways Forward For The New Development Bank. Conectas Human Rights.
Gonzales, J. (2020). Green Alert: How Indigenous People are Experiencing Climate Change in the Amazon. Mongabay Series: Amazon Conversation. accessed on 18th August, 2020, available at: https://news.mongabay.com/2020/05/green-alert-how-indigenous-have-been-experiencing-climate-change-in-the-amazon/
IASG, U. (2014). United Nations Inter agency support group report on indigenous peoples’ issues. Land, territories and resources, June.
Le Tourneau, F. M. (2015). The sustainability challenges of indigenous territories in Brazil’s Amazonia. Current opinion in environmental sustainability, 14, 213-220.
Maggi, RS (2014). Indigenous health in Brazil. Brazilian Journal of Maternal and Child Health, 14 (1), 13-14.
Mendes, AM, Leite, MS, Langdon, EJ, & Grisotti, M. (2018). The challenge of primary care in indigenous health in Brazil. Panamerican Journal of Public Health , 42 , e184.
World Health Organization. (2001). Community Health Needs Assessment: An introductory guide for the family health nurse in Europe (No. EUR/01/5019306). Copenhagen: WHO Regional Office for Europe.
