Inequalities across ethnic groups
Authors: Walter Mendoza, Nancy Hidalgo, Martín Benavides
Journal: The Lancet Global Health (2018)

The cross-sectional analyses by Marilia Mesenburg and colleagues (August, 2018)1Mesenburg MA Restrepo-Mendez MC Amigo H et al.Ethnic group inequalities in coverage with reproductive, maternal and child health interventions: cross-national analysis of national surveys in 16 Latin American and Caribbean countries.Lancet Glob Health. 2018; 6: e902-e913Summary Full Text Full Text PDF PubMed Scopus (39) Google Scholar represent a welcome contribution to the UN Sustainable Development Goals and the Countdown to 2030 agenda. In culturally and ethnically diverse countries such as Peru, the statistical invisibility of some excluded populations might lead to violation of their human rights, representing a major challenge for national statistical systems. In Peru, the Demographic and Health Survey (DHS) has become one of the main methods of monitoring major national and subnational development goals. Between 2000 and 2015, the annual DHS in Peru included specific questions about mother tongue, but from 2016, the survey also included specific questions on ethnic self-identification. Other household surveys, such as the annual household survey, have followed a similar pattern, thus ethnic self-identification is already mainstreamed. Since 2013, following publication of the 2012 DHS results used by Mesenburg and colleagues,1Mesenburg MA Restrepo-Mendez MC Amigo H et al.Ethnic group inequalities in coverage with reproductive, maternal and child health interventions: cross-national analysis of national surveys in 16 Latin American and Caribbean countries.Lancet Glob Health. 2018; 6: e902-e913Summary Full Text Full Text PDF PubMed Scopus (39) Google Scholar the National Institute of Statistics convened a technical committee to mainstream self-identification as a new variable in its main surveys,2Instituto Nacional de Estadísitica e InformáticaMemoria Institucional. Comité técnico insterinstitucional sobre estadíticas de etnicidad.https://www.inei.gob.pe/media/MenuRecursivo/publicaciones_digitales/Est/Lib1460/libro.pdfDate: 2013–2016Date accessed: November 20, 2018Google Scholar including the annual DHS, in preparation for the 2017 Population and Housing Census.3Instituto Nacional de Estadísitica e InformáticaPerú: encuesta demográfica y de salud familiar.https://www.inei.gob.pe/media/MenuRecursivo/publicaciones_digitales/Est/Lib1525/index.htmlDate: 2017Date accessed: November 20, 2018Google Scholar Thus, in their analysis, Mesenburg and colleagues reported no data for afro-descendants since the data used were based on the 2012 DHS in Peru. However, by 2017, 8·6% of female DHS respondents self-identified as afro-descendant, which was three times higher than former estimates from household surveys. This increase might be explained by the fact that an individual's mother tongue was used as the ethnicity identifier in the 2012 surveys. The analysis by Mesenburg and colleagues provides a valuable reference to monitor access to reproductive rights by ethnicity; thus future iterations will indicate how ethnicity-driven inequalities explain exclusion of the populations most left behind and how well these inequalities are addressed. This analysis shows how statistical visibility can lead to improved human rights. WM is Programme Analyst at the United Nations Population Fund (UNFPA) Peru Country Office, and the views expressed in this publication are those of the author and not necessarily those of the UNFPA. NH is a technical director of Demography and Social Indicators at the National Institute of Statistics and Informatics. MB is principal researcher of the Group for the Analysis of Development (GRADE), and the views expressed in this publication are those of the author and not necessarily those of GRADE. All authors were members of the National Technical Committee for the inclusion of ethnic self-identification questions in surveys and censuses (2013–17), convened by the National Institute of Statistics and Informatics. Ethnic group inequalities in coverage with reproductive, maternal and child health interventions: cross-sectional analyses of national surveys in 16 Latin American and Caribbean countriesThe lower coverage levels for indigenous women are pervasive, and cannot be explained solely by differences in wealth, education, or residence. Interventions delivered at community level—such as vaccines—show less inequality than those requiring access to services, such as birth attendance. Regular monitoring of ethnic inequalities is essential to evaluate existing initiatives aimed at the inclusion of minorities and to plan effective multisectoral policies and programmes. Full-Text PDF Open Access