• Indigenous and Afro-descendant women and their children have worse health outcomes and use fewer health care resources.
  • To eradicate inequality, affirmative action—policies that promote and guarantee equal conditions, opportunities and treatment for all—is necessary.

 

PANAMA, 9 December 2016 – Most of the differences in perinatal, neonatal, infant and under-5 mortality in Latin America and the Caribbean (LAC) are related to maternal wealth and education rather than to rural or urban residence. This is according to the Health Equity Report 2016, a statistical analysis of health indicators that goes beyond national averages to examine the social and economic variables that impact the health status of children, adolescents and mothers in LAC.

The infant mortality rate of infants under one year old whose mothers have low schooling compared to those whose mothers have a secondary or higher education is seven times greater in El Salvador, three times greater in Bolivia, Guatemala, Colombia and the Dominican Republic, and twice as great in Peru. Key socioeconomic characteristics are associated with differences in the use of health services throughout the continuum of maternal and child care and with poorer nutritional status of children.

“Inequality excludes, humiliates and kills,” says UNICEF Regional Director of for Latin America and the Caribbean, María Cristina Perceval, who stresses that “inequality in health services is a construct, the result of multiple inequities and deprivations since the early years; in most cases, it lasts not only throughout the life cycle but carries enormous potential to replicate beyond particular individuals for generations and generations.” Perceval goes on to argue that “in order to eradicate vital inequality, affirmative actions, such as policies that promote and guarantee equal conditions, opportunities and treatment for all, are essential, especially for the most disadvantaged.” The report recommends incorporating an “inequity perspective” in public health research and statistics to both strengthen and expand data on health equity and to document how structural barriers, both social and economic, lead to these inequalities and also change over time.

 

Revealing statistics

The revised statistics reveal that in 2015, the risk of dying before 28 days of birth in the poorest countries was 2.5 times higher than in richer countries, while the probability of a child dying before reaching the fifth birthday in the lowest income countries was three times higher than in the highest income countries. Indigenous and afro-descendant women receive fewer recommended prenatal visits, are less likely to undergo all recommended health screens tests, and are more than three times more likely to die in childbirth than women of non-indigenous and non-afro-descendant origin.

For Arachu Castro, Director of the Collaborating Group for Equity in Health in Latin America at Tulane University School of Public Health and Tropical Medicine, pregnancy “increases vulnerability to sexual violence, which [in turn] increases the likelihood of chronic stress, miscarriage and other obstetric complications, low birth weight and neonatal mortality”.

“This report,” UNICEF Regional Director María Cristina Perceval asserts, “allows us to understand why it is necessary and urgent to overcome the narrow limits of sectorial approaches, emphasizing the legitimacy and need to work within a framework of theories and practices that take into account and assimilate the knowledge and experience of multiple actors and sectors…to work contextually, in a participatory manner and between and among various institutions from a human rights and equity and gender perspective approach that takes into account the integrity of the life cycle of specific human beings”.

UNICEF and the Tulane University Collaboration Group developed the study presented on Friday for Equity in Health in Latin America and the Caribbean within the framework of A Promise Renewed for the Americas and Caribbean movement. It is based on more than 700 statistical sources, including a review of the results of household surveys (demographic and health, multiple cluster indicators, reproductive health and other national surveys) conducted between 2008 and 2014.