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The Pretense of Inclusion: Contextualizing Sexual and Reproductive Health Policies in Lived Realities of Indigenous Youth


Adolescents and youth compose over a quarter of Mexico’s total population; and while the overall fertility rate among 15- to 19-year-olds has declined, there remains severe inequality across the country in fertility trends, contraceptive needs and health care access. Within this age group, Indigenous youth have a higher fertility rate than their non-Indigenous peers, at approximately 97 births per 1,000 women compared to 68 births per 1,000 in 2015. The sociocultural contexts of Mexico’s Indigenous populations are fundamental to explaining such disparities between these groups. Access to quality reproductive health care among Indigenous youth is influenced and affected by community and cultural contexts as well as cultural incompetence in health programs, as exemplified by health care actors and policymakers. 

Building on Observatorio de Mortalidad Materna en México’s findings and responding to an expressed concern among civil society that President López Obrador’s campaign promise will not reach the large Indigenous populations in the southern states, this report shares an exploration into the reproductive realities of young Indigenous people from Chiapas and Oaxaca and details how government and civil society representatives are working to ensure the sexual and reproductive health (SRH) needs of Indigenous youth are being met through the implementation of Estrategia Nacional para la Prevención del Embarazo en Adolescentes (National Strategy for Adolescent Pregnancy Prevention). 

Participants were engaged in conversations about how the interplay of institutional barriers and social norms affect access to SRH care and the realization of sexual and reproductive rights among Indigenous youth. Their responses will strengthen the collective understanding of whether and how their sexual and reproductive health and rights are being realized in order for civil society to better hold federal and state administrators accountable to their young Indigenous constituents. This inquiry will expand the knowledge base of specific SRH concerns, needs and desires of Indigenous youth in these communities. 

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