Innu and Atikamekw women’s connection to the land through pregnancy and birthing practices

This paper focuses on a series of cookbooks published by Indigenous Australian groups. These cookbooks are typically produced with government funding, and are developed by nutritionists, dieticians, and health workers in consultation with local communities. They are designed to teach Indigenous Australians to cook healthy, nutritious, low-cost meals. In this paper, Fredericks and Anderson identify the value of these cookbooks as low-cost, public health interventions. However, they note that their value as health interventions has not been tested. Fredericks and Anderson question the value of these cookbooks within the broader context of the health disadvantage faced by Indigenous Australians. They argue that the cookbooks are developed from a Western perspective of health and nutrition that fails to recognise the value of traditional Indigenous foodways. They suggest that incorporating more Indigenous food knowledge and food-related traditions into cookbooks may be one way of improving health among Indigenous peoples and revitalising Indigenous knowledge.

Understanding Indigenous people’s experiences of acute health care with a focus on heart health

Review question/objective The objective of this review is to analyse and synthesise the best available evidence on the experiences of Indigenous people who engage in health care encounters in Western settings and contexts. The review question is: What are the experiences of Indigenous people engaged in health care encounters in Western settings and contexts? Inclusion Criteria Types of Participants Studies including two groups of participants, regardless of age or gender, will be considered for this systematic review. The first group is persons of Indigenous descent from the following countries and continents appearing most frequently in the literature: North America, South America, New Zealand, Australia, and Scandinavian countries. These countries include peoples such as First Nations, Native Americans, Metis, Inuit, North American Indians, South American Indians, Inca, Maori, Aboriginal and Torres Strait Islander peoples of Australia, and Sapmi. This list is not exhaustive, and any Indigenous population identified in a study will be included. Indigenous populations who immigrate to new countries will be excluded, given that immigrant status can confound Indigenous status. The second group of participants to be considered for inclusion is health care providers who work in Western settings and context, including, but not limited to, nurses, physicians, nutritionists, midwives, social workers, physiotherapists, occupational therapists, speech and language therapists, and respirologists. Phenomena of Interest The phenomenon of interest is the experience of Indigenous people in health care encounters in Western health care settings and context. Health care encounters refer to any interactions between an Indigenous person and a health care provider within the scope of Western health care services. All reasons for health encounters will be considered. Context The context will be Indigenous persons seeking health care services in Western settings and context. These services may be located within urban, rural, or remote health care settings where Western health care services are delivered.

NU01.05 Indigenous Population with Lung Cancer

This study aimed to evaluate indigenous peoples' access to medium and high-complexity health services in the municipality of Cuiabá, Mato Grosso State, Brazil, through the Casa de Saúde Indígena or Indigenous Peoples' Clinic (CASAI Cuiabá). A single case study with a qualitative approach was conducted at CASAI Cuiabá. Data were obtained from observation of the work routines at CASAI Cuiabá, semi-structured interviews with health professionals and administrators from the Cuiabá Special Indigenous Health District (DSEI) and CASAI Cuiabá, and document analysis. Data analysis used a matrix derived from the theoretical and logical model of accessibility, validated by the Delphi method with a group of experts on indigenous peoples' health. Despite advances achieved by CASAI in improving indigenous peoples' access, there are persistent social, organizational, cultural, and geographic barriers in access to medium and high-complexity health services in Cuiabá. The study highlights the need for specific strategies to improve access to health services by indigenous peoples in Mato Grosso State.

The influence of Identity, Roles and Expectations on Indigenous students studying at university which impacts on building the Indigenous health workforce

I am grateful for the financial contributions provided by the Canadian Indigenous of Health Research (CIHR), Institute of Indigenous Peoples Health and Gender and Health, with First Nations Health Authority, the Canadian Nurses Foundation, and the University of Victoria.

If the expression "Indian time" means anything, it should signify this history of temporal multiplicity.

Low back pain is a significant global public health issue affecting over half a billion people and contributing to disability worldwide. The impact of disability related to low back pain is growing, particularly in low- and middle-income countries. In contrast with previous research, current evidence shows Indigenous Peoples also experience low back pain's disabling effects. A clinical ethnographic can contribute by attempting to understand the data through the perspective of Indigenous Peoples. A clinical ethnographic study was conducted in Galibi, a Kalinya rural Indigenous village in Suriname, with support of the local traditional authority. The main objective was to explore the impact of low back pain and care-seeking behavior from the perspective of Indigenous Peoples with low back pain. The findings were that low back pain had a significant physical and emotional impact. Despite aggravating their low back pain, participants continued many of their activities of daily life since these were essential for their (economic) survival. Furthermore, participants expressed anxiousness, financial worries, and concerns about the cause and future of their low back pain. To address their low back pain, the Kalinya Indigenous Peoples used both western and traditional care. Visits to western healthcare practitioners were limited due to logistical challenges and travel costs, and the experience was often negative. The study highlights the experiences of Kalinya Indigenous Peoples dealing with low back pain. Low back pain is a burden within Indigenous Peoples of Galibi but accepted as an integral part of their life. When in pain, Indigenous Peoples face many barriers to access western health care and visits to healthcare practitioners were often unhelpful. This contributed to a long-lasting negative impact on the Indigenous people with low back pain. Further research is needed to develop strategies that improve health outcomes related to low back pain while reducing its associated disability in Indigenous Peoples.

Being and Becoming Ute: The Story of an American Indian People

Dear Editor, We want to manifest our concern about a recent original article published in your journal that cited one of our articles. Gabriela Minaya and Joel Roque have included our work about indigenous people and sexually transmitted infections (STIs) in the Peruvian Amazon (Zavaleta et al. 2007a) in their discussion about “Ethical problems in health research with Indigenous or originary peoples in Peru”(Minaya and Roque 2015). We have detected a number of serious discrepancies between their affirmations regarding what we did vs. what we have published in 2007. Minaya and Roque questioned if we provided education and treatment for our participants. In the introduction of the paper, we explain that the Ministry of Health (MoH) workers participated in this research and the MoH and Chayahuita community leaders approved of our study, which originally was motivated by the deep concern of a local Indigenous health promoter about an increasing number of fevers that were potentially STI associated. Once in the community, all procedures were realized in accordance with existing MoH guidelines, which included treatment for syphilis and individual pre- and post-test counselling for HIV. With the knowledge of the HIV positive results, as Peruvian health researchers and workers, we felt very concerned that highly active antiretroviral therapy was not available to this remote region, given the absence of appropriate facilities and staff for the frequent monitoring required. At that time, HAART was not being fully implemented in Peru, and it was only introduced around 2005, but only at tertiary hospitals with infectologists. Given that the local health personnel was aware of the lack of treatment availability for HIV, they prioritized preventive education for this ethnic group. Precisely because of this lack of treatment, the counselling process and a better understanding about the extension of the epidemics was critical as a public health strategy. Indeed, following our work, multiple initiatives have been undertaken to quantify the prevalence of STI, clarify their risk factors (Alva and Orellana 2012; Bartlett et al. 2008; Zavaleta et al. 2008; Ormaeche et al. 2012) and design an intercultural preventive strategy lead by the national Indigenous health authority (Zavaleta et al. 2007b). Although we agree that more work should be done to provide effective HIV treatment for remote Indigenous populations, our work has provided as much education and promoted access to health care. Minaya and Roque also implied that our findings serve to stigmatize the population studied. We do not consider that the attribution of AIDS dissemination to “absence of use of condoms, homosexual behaviour, early initiation of sexual relations and polygamy”, as we mentioned in our paper, promotes stigmatization. On the contrary, we believe that the recognition, knowledge and respectful understanding of multiple cultures are key to initiate effective preventive measures on the ground. We believe that the increase of information about Indigenous culture including acceptable sexual practices and traditional social institutions such as polygamy, rather than serving to stigmatize these populations, is a way to increase the voice of underrepresented people to create more cultural adapted health policies in our Peruvian society. Lastly, the authors wrote that our study results were generalized to the all Indigenous People of the region. We presented our results specifically for the community studied, although we made recommendations to take actions for preventing STIs among the Indigenous People living in the Amazon. We do not consider that extrapolating our preventive recommendations to more Indigenous People located in the Amazon was wrong. We felt that a strong call for attention was needed to mobilize the national and international public health community since the level of STIs was extremely high in a location with virtually absent health resources. Our work was instrumental in mobilizing local health authorities, international agencies and other groups to work towards stopping the spread of HIV among Chayahuita and other Amazon remote Indigenous People. Instead of visualizing our publication as an ‘ethical problem’, the complete description of our work proves an example of how health researchers in Peru are doing investigations by prioritizing Indigenous health concerns, adapting western methods and ethical approaches to work in a respectful manner with Amazon Indigenous People and to contribute with culturally appropriate public health initiatives for historically excluded minorities. The publication was an initial report and did not include all of our subsequent work in Indigenous health. Perhaps, if the work had ended with the content of the original report, we would be in agreement with some of the criticism; nonetheless, we consider the interpretation of our work to be inaccurate and believe that the context is important to tell the full story of our investigation.

Despite evidence documenting high prevalence of type 2 diabetes among several Indigenous populations, a comprehensive systematic review of type 2 diabetes among global Indigenous Peoples has not been recently conducted. Our aim was to report region-, time-, age- and sex-specific type 2 diabetes prevalence among Indigenous adult populations globally. MEDLINE, Embase and CINAHL were searched for English-language studies published between 1 January 1980 and 3 March 2023. Studies reporting type 2 diabetes prevalence and/or cases of diabetes among global Indigenous adult populations aged 18 years and older were included. Type 2 diabetes prevalence data were extracted for the overall Indigenous population, sex, age group and year. Summaries of extracted data were tabulated, and are presented using comprehensive tables and figures. A modified Newcastle-Ottawa quality assessment scale reflective of Indigenous-specific criteria was applied to assess paper quality. The search identified 2332 studies, of which 202 met the inclusion criteria. The included studies represented at least 187 Indigenous populations from 37 countries, although the exact number of populations is approximate, as some studies did not name specific Nations/Tribes/Groups for populations from different geographic regions. Diabetes prevalence ranged from 0 to 40%, with a mean of 73% of Indigenous populations reporting type 2 diabetes prevalence above the estimated global prevalences for every decade between 1980 and 2020. Prevalence increased over time and with age for many populations, with the highest reported prevalence (50.5%) in the 45-54 year age group. Type 2 diabetes prevalence was notably high among Indigenous women, with 73% of studies reporting higher prevalence for Indigenous women than for Indigenous men. Potential limitations include publication bias, which may have led to fewer studies being included in this review. Type 2 diabetes prevalence among Indigenous adult populations was markedly higher than the global averages in every decade from 1980 to 2020, with a mean of 73% of populations reporting higher prevalence. These findings underscore the persistent and disproportionate burden of diabetes experienced by many Indigenous communities over several decades. Future work should aim to generate representative data on type 2 diabetes prevalence across global Indigenous populations, investigate factors that contribute to alarmingly high and notably low diabetes prevalence, and support Indigenous-led, culturally safe, Indigenous population-specific health practices to prevent and manage type 2 diabetes and achieve equitable outcomes. There was no funding source for this study. PROSPERO registration no. CRD42021258623.

Introduction: Cancer prognosis for Indigenous peoples, who represented 6% of the world population, is largely unknown. The rights of indigenous people, including their right to equality in health, have become a focus of the U.N. and other agencies, but little attention has been given to their cancer burden. Data from countries such as Australia, New Zealand Canada, and the United States, which have relatively well resourced cancer registries, show that cancer is now the second leading cause of death among Indigenous people in those countries. Greater understanding of the burden of cancer among indigenous populations is of major importance to public health, given that poorer outcomes contribute to the lower life expectancies. Methods: We conducted an overview of the literature surrounding cancer burden, including screening, epidemiology, treatment and survivor-ship among indigenous people globally. Results: Globally, the research work has been piecemeal and focused on the colonized inhabitants of the four former British or French colonies with higher Human Development Indexes (HDI), namely Australia, New Zealand, Canada and the United States (U.S.). Overall, cancer incidence and mortality among Indigenous Australians is greater and survival is significantly poorer than among non-Indigenous Australians, as is the case among Maori in New Zealand. First Nations people in Ontario are reported to have poorer survival for breast, prostate, cervical, colorectal (male and female) and male lung cancers compared to their non-First Nations peers and cancer mortality is higher for both American Indian and Alaska Native than for U.S. Whites. Maori women and Indigenous Australian women are less likely to participate in National Screening Programs; the rate of mammography in the latter group are 36% for Indigenous women and 55% for non-Indigenous women and rates of cervical screening in Maori women are also lower. There has been a dearth of research into the cancer burden of Indigenous people in other regions. The dearth of information, and lack of international collaboration, highlighted the need for an international multidisciplinary meeting, inviting participation from researchers, public health practitioners, clinicians, nurses, advocacy groups, allied health professionals, and related professionals from around the globe. The World Indigenous Cancer Conference 2016 will provide opportunities to foster new collaboration, enhance capacity and increase knowledge about cancer and Indigenous people nationally and internationally. Networks and partnerships can bring together the combined expertise and efforts of many to focus on the critical challenge of cancer among Indigenous peoples. By enabling those who work in or are interested in this area to connect, communicate and collaborate, this conference will encourage high quality cancer research and partnerships across the spectrum of cancer among indigenous people: from prevention, to psycho-social and health services research aimed at improving the quality of life for survivors, their family and friends. The conference will contain a number of streams including ‘Screening and Prevention’, ‘Cancer Data’, ‘Health Services’, ‘Psycho-social/survivorship’ and ‘Advocacy and capacity building’ Conclusion: Establishing networks and partnerships is an important method to raising the profile and addressing cancer disparities. Our aim is to overcome inequalities in cancer care for Indigenous peoples through the establishment of international collaborations of researchers with experience in areas such as epidemiology of chronic disease, social determinants of health, and health systems research. Citation Format: Suzanne P. Moore, Bronwyn Morris, Joan Cunningham, Gail Garvey. The burden of cancer in indigenous people globally and the World Indigenous Cancer Conference 2016 (WICC16). [abstract]. In: Proceedings of the Eighth AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 13-16, 2015; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2016;25(3 Suppl):Abstract nr C18.

Whither the Aborigine

Purpose This article examines the contexts, challenges, and notion of women's entrepreneurship through an indigenous cultural and gender framework. The aim is to provide indigenous voices to the diversity of entrepreneurship research from non-Western perspectives. This approach enables us to highlight the experiences of indigenous women entrepreneurs in Nigeria. Design/methodology/approach This article uses a qualitative research approach to examine indigenous entrepreneurial practices. Data were collected through interviews with 15 Nigerian indigenous women entrepreneurs, who were purposively selected. In addition, focus groups were conducted to generate further data and validate participants' responses. Through thematic analysis, we developed an empirically derived framework for gender and indigenous entrepreneurship culture. Findings Inductive themes emerged from thematic analysis, revealing 7 Ms gender framework of indigenous women's entrepreneurship related to money, management, market, motherhood, meso-environment, macro-environment, and mobilisation of resources. Moreover, the findings reveal enabling elements of indigenous cultural entrepreneurship frameworks, such as the Ajo or Adeshe/Esusu traditional savings schemes, which promote “indigenous sources of capital,” and informal entrepreneurial learning that nurtures future entrepreneurial leaders. Research limitations/implications This study uses data from a single country, geographical area, and specific populations, which may limit the scope of the empirical findings. Future research could expand the parameters or combine qualitative and quantitative methods to provide a more in-depth analysis of different contexts and relationships. Originality/value Entrepreneurship research has been criticized for its non-inclusive theories, overreliance on Western philosophies, and failure to integrate indigenous knowledge from the Global South. This article makes an original contribution to knowledge by exploring the relationship among indigenous culture, gender, and entrepreneurship in a non-Western context.