Building reproductive justice with indigenous women in the Northeast of Brazil

与巴西东北部土著妇女一起建立生殖正义

• 批准号: AH/X008118/1
• 负责人: Atina Krajewska
• 金额: $ 39.91万
• 依托单位: University of Birmingham
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2023
• 资助国家: 英国
• 起止时间: 2023 至 无数据
• 项目状态: 未结题
• 来源: https://gtr.ukri.org/projects?ref=AH%2FX008118%2F1
• 关键词: Building; reproductive; justice; indigenous; women

How do we create a healthcare system that respects and protects ethnic, cultural, and religious differences in an intensely pluralist society? How do we create a healthcare system that guarantees decision-making power in matters of sexual and reproductive health (SRH) for women from Indigenous communities in a society in which both sexual and reproductive rights (SRR) and Indigenous rights are subject to increasing political pressure? What is the role of traditional healing practices in the construction of reproductive justice?The project addresses these questions in response to and in collaboration with researchers and activists from the Pankararu and Xukuru communities in the Northeast of Brazil. While Indigenous people have their own healthcare system and there are separate national policies concerning respectively Indigenous- and women's health care, Indigenous women remain almost invisible to Brazilian indigenismo and face persistent and structural inequalities in the area of SRH. Studies have shown that maternal mortality rates among Indigenous women in Northern Brazil are 2-4 times higher than among non-Indigenous populations. Importantly, Xukuru and Pankararu women frequently give birth outside Indigenous territories and experience rates of caesarean sections far above those recommended by the WHO. This suggests serious problems with access to healthcare services, which additionally fail to prevent STD/HIV/AIDS and cervical cancer, but data remains scarce. These problems have been exacerbated in recent years by the increased violence against Indigenous people perpetuated by Temer's and Bolsonaro's governments and the outbreak of Covid19. The existential threat to Indigenous communities was recognised by the Federal Supreme Court, which in 2020 affirmed for the first time the right to health of Indigenous people and 'the indispensability of intercultural dialogue' in any question involving their rights.Against this background, the project aims to consolidate reproductive justice by enhancing access to SRH care of Indigenous women in accordance with their cultural practices. It does so by empirically examining Indigenous conceptions of SRH and the ways in which they are accommodated in Brazilian law, policy, and medical practice. It examines violations of SRR and their effects by analysing national and regional laws and policies and conducting interviews with Indigenous leaders, activists and policy makers. The project pays particular attention to the role of healthcare professionals and traditional healers in the construction of reproductive justice and how their relationships shape the provision of culturally sensitive SRH services. It does so by organising interviews and participant observation involving doctors and shamans. All findings will be shared with members of the Indigenous communities, policy makers and healthcare professionals through 2 feed-forward Workshops, 2 training sessions, the production of a Final Report, and educational materials produced in collaboration with a local artist. The project will also produce 3 high quality academic publications, a special edition of a journal, and several conference papers. The project is co-produced with members of Indigenous communities and will first and foremost benefit those seeking SRH care. While the Xukuru and Pankararu communities have approximately 20000 members, in Brazil there are nearly 900000 Indigenous people from 305 ethnic groups. Second, the project will benefit policy-makers and Indigenous activists involved in the field of healthcare in the Northeast of Brazil and beyond. Third, it will benefit healthcare professionals who provide services within and outside the special Indigenous healthcare system. The impact of the project will be facilitated by the support of the regional Public Prosecutor's Office tasked with the protection of Indigenous rights, and the Representation of Indigenous People and Organisations in Northeast Brazil.

我们如何在一个高度多元化的社会中建立一个尊重和保护种族、文化和宗教差异的医疗保健系统？在一个性权利和生殖权利以及土著权利都受到越来越大的政治压力的社会中，我们如何建立一个医疗保健系统，保障土著社区妇女在性健康和生殖健康问题上的决策权？传统治疗方法在构建生殖正义中的作用是什么？该项目针对巴西东北部Pankararu和Xukuru社区的研究人员和活动家并与他们合作，解决了这些问题。虽然土著人民有自己的医疗保健系统，而且在土著和妇女的医疗保健方面也有不同的国家政策，但土著妇女在巴西土著民族中仍然几乎不为人所知，在性健康和生殖健康领域面临着持续的结构性不平等。研究表明，巴西北方土著妇女的孕产妇死亡率比非土著人口高2-4倍。重要的是，Xukuru和Pankararu妇女经常在土著领土外分娩，剖腹产率远远高于世卫组织建议的水平。这表明在获得医疗保健服务方面存在严重问题，而且无法预防性传播疾病/艾滋病毒/艾滋病和宫颈癌，但数据仍然很少。近年来，由于特梅尔和博尔索纳罗政府对土著人民的暴力行为增加以及Covid 19的爆发，这些问题进一步加剧。联邦最高法院认识到土著社区面临的生存威胁，并于2020年首次确认土著人民的健康权以及在涉及其权利的任何问题上“文化间对话的不可或缺性”。它通过实证研究土著人的性健康和生殖健康概念以及巴西法律、政策和医疗实践中如何容纳这些概念来做到这一点。它通过分析国家和区域法律和政策，并与土著领导人、活动家和决策者进行访谈，审查侵犯性权利权利的行为及其影响。该项目特别关注保健专业人员和传统治疗师在建设生殖公正方面的作用，以及他们之间的关系如何影响对文化敏感的性健康和生殖健康服务的提供。它通过组织医生和萨满的访谈和参与观察来做到这一点。所有调查结果将通过2个前馈研讨会，2个培训课程，最终报告的制作以及与当地艺术家合作制作的教育材料与土著社区成员，决策者和医疗保健专业人员分享。该项目还将产生3个高质量的学术出版物，一个期刊的特刊，和几个会议论文。该项目是与土著社区成员共同制作的，将首先使那些寻求性健康和生殖健康护理的人受益。虽然Xukuru和Pankararu社区约有20000名成员，但在巴西，有来自305个种族群体的近900000名土著人。其次，该项目将使巴西东北部及其他地区参与医疗保健领域的政策制定者和土著活动家受益。第三，它将使在特别土著保健系统内外提供服务的保健专业人员受益。负责保护土著权利的地区检察官办公室以及巴西东北部土著人民和组织代表处的支持将促进该项目的影响。