indigenous representation and participation in decisionmaking with regards to health policies planning and evaluation at the national level and their right to participate in decisionmaking in local health facility management are critical to improving indigenous access to health services indigenous peoples seems to fall behind in all major health indicators employed by the existing mainstream health policies and programmes even when the state has made significant progress in economic growth and social development irrespective of the hdi of the country and growth rate indigenous peoples have a lower rate of life expectancy higher infant and child mortality poorer maternal health outcomes and lower levels of access to health services provided by the government including development of and access to information on indigenous health and health services