Discrimination in Maternal Healthcare for Indigenous Women: INSP

A recent study by the National Institute of Public Health (INSP) highlights significant disparities in maternal healthcare access for indigenous women in Mexico. From 2009 to 2023, effective maternal health coverage for indigenous women was only 18.3%, compared to 25.3% for non-indigenous women. These findings underscore the urgent need for the Mexican government to implement targeted anti-discrimination health policies that specifically address systemic inequalities and improve health outcomes for marginalized communities.

The study analyzed data from over 69,000 women aged 12 to 54 collected through the National Surveys of Demographic Dynamics (ENADID) from 2009 to 2023. Coverage rates peaked between 2013 and 2018, with non-indigenous women experiencing coverage of 28.8% and indigenous women at 21.2%. However, coverage began to decline in 2019, falling to 25.7% for non-indigenous women and 18.7% for indigenous women. During the COVID-19 pandemic, access to care deteriorated further, dropping to 24.0% for non-indigenous women and 17.4% for indigenous women.

According to Think Global Health, the transition from Seguro Popular to the Institute of Health for Wellbeing (INSABI) in 2020 disrupted maternal coverage, particularly impacting indigenous women who often live in remote areas with limited healthcare infrastructure. This group of women, who rely heavily on public health programs, faced significant barriers to accessing essential maternal healthcare services. 

Prior to this transition, Seguro Popular, introduced in 2003, played a crucial role in expanding healthcare access for marginalized populations, achieving universal coverage by 2012. This expansion contributed to a decline in maternal and infant mortality rates. However, after 2018, funding adjustments failed to keep pace with population growth, leading to a decline in the program’s effectiveness and, ultimately, its cessation.

The World Health Organization (WHO) emphasizes that maternal mortality often reflects inequities in access to quality health services. It states that addressing these disparities through equitable healthcare can substantially reduce preventable maternal complications—such as severe bleeding, infections, and high blood pressure during pregnancy—which account for nearly 75% of maternal deaths.

For indigenous women, these challenges are further compounded by "triple discrimination," which arises from biases related to their gender, ethnicity, and socioeconomic status, highlights the INSP study. This discriminatory attitude restricts access to essential health services and is often manifested in various forms of mistreatment, including language barriers, neglect, and instances of verbal or physical abuse. Many indigenous women reported being blamed for their health issues, creating a hostile environment that further deters them from seeking necessary maternal care.

To effectively address these multifaceted discriminatory practices, a comprehensive approach is needed, as highlighted by the INSP study. The study recommends that this approach should not only improve access to healthcare but also address the lived experiences of discrimination that indigenous women face. Central to this effort is the involvement of affected communities in identifying the challenges they encounter and in developing effective solutions. 

According to the INSP study, the health system must implement anti-discrimination measures at every level—clinical, administrative, and regulatory—while ensuring that care is both patient-centered and culturally sensitive. Additionally, the study suggests that strategies should actively counter negative stereotypes that deter the use of health services and promote access to preventive care from preconception through the postpartum stages. Ultimately, the INSP study stresses that healthcare access must be grounded in the principles of citizenship, cultural diversity, and equality.