CPH LEC MIDTERM EXAMINATION

• Maintenance of good health is not limited to an individual and separate act. Many times, it involves a collective effort from the whole community.
• The health of one person may affect the rest; this is particularly true in infectious diseases.
• Health is a basic human right. As the World Health Organization declared, "the enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition".
• Regardless of a person's membership in the population, he/she must have access to quality health care.
• Ethnicity


  A subcultural group within a multicultural society. Membership in an ethnic group is usually based on a common national or tribal heritage.
• Definition of an ethnic group (Hutchinson and Smith)


  • A common proper name
  • A myth of common ancestry
  • Shared historical memories
  • One or more elements of common culture
  • A link with a homeland
  • A sense of solidarity
• Ethnicity in the Philippines

  A primary sense of belonging to an ethnic group, which is consanguine in nature (traced through the family tree)
• Race


  The categorization of parts of a population based on physical appearance due to particular historical, social and political forces
• Majority


  Characteristics found in more than 50% of a population
• Minority group


  Fewer than 50% of the population
• Related terminologies


  • Diversity
  • Race
  • Acculturation
  • Refugee
  • Health disparities
• Due to colonization, most ethnic groups had their cultures extrinsically and substantially modified. Nonetheless, there are some who were able to maintain their core culture – the Indigenous Cultural Communities/Indigenous People (ICC/IP).
• Indigenous Cultural Communities/Indigenous People (ICC/IP)


  A group of people or homogenous societies identified by self-ascription and ascription by others, who have continuously lived as organized community on communally bounded and defined territory, and who have, under claims of ownership since time immemorial, occupied, possessed and utilized such territories, sharing common bonds of language, customs, traditions and other distinctive cultural traits, or who have, through resistance to political, social and cultural inroads of colonization, non-indigenous religions and cultures, became historically differentiated from the majority of Filipinos.
• The Philippines has an estimated 14- 17 million Indigenous Peoples (IPs) belonging to 110 ethno-linguistic groups; they are mainly concentrated in Northern Luzon (Cordillera Administrative Region, 33%) and Mindanao (61%), with some groups in the Visayas area.
• The Philippine Constitution, in recognition of this diversity and under the framework of national unity and development, mandates state recognition, protection, promotion, and fulfillment of the rights of Indigenous Peoples.
• One current disadvantage is that there is a lack of established references regarding their health status and existing health disparities as compared to other countries who have organizations and government programs specifically protecting and promoting the health of minority groups.
• Minority groups in the Philippines

  • Northern Luzon: The Igorot Community
  • Northern Luzon: The Aeta/Ayta/Agta Community
  • Mindanao: The Lumad Community
• Igorot Community


  • Ten upland tribal groups on Luzon who have retained much of their traditional, pre-colonial culture, social institutions and living practices
  • They live in geographically isolated areas with limited access to basic social services
  • Their main forms of work are wet-rice farming, dry-rice growing techniques, and shifting cultivation
• "Abat" and "Senga"


  An indigenous community practice in Tabuk, Kalinga for diseases or illness, involving a traditional priest or medium, butchering of animals, gongs and other materials in a ritual done with complete reverence and solemnity
• Threats to community health among Igorot people

  • Land-grabbing
  • Discrimination and inequalities
  • Destructive socio-economic projects such as megadams, large-scale mines and megatourism
  • Commercialization of indigenous culture
  • Institutionalized discrimination
  • Violation and non-recognition of indigenous socio-political systems and processes
  • Government neglect of basic social services to indigenous people
• Aeta/Ayta/Agta Community


  • A group of people termed as Negrito during the Spanish colonial rule, thought to be descendants of the earliest settlers to the Philippines
  • They are mainly skilled in hunting, gathering and jungle survival
  • They practice herbal medicine and are considered to be nomadic, monotheistic, peace and non-violent
  • They are highly respectful of their environment and have their own rituals to address prolonged diseases or those associated with spiritual interference
• Threats to community health of the Aeta people

  • Dispossession, poverty and political discrimination through decades of protracted land rights processes
  • Little recognition and support from the local government
  • Marginalization and displacement due to land grabbers, illegal logging, mining and slash-burn farming
  • Racial discrimination
• Lumad


  A Bisayan term meaning "indigenous", "native"
• Aeta people


  • They resisted colonization which resulted into their communities' retention of their own traditions, customs, identity and language known as "sambal"
  • They are highly respectful of their environment since they believe that any type of exploitation or wasting of resources would be offensive to the spirits
  • Women healers often use medicinal plants and have their own rituals to address spiritual interference and prolonged diseases
• Lumad


  A bisayan term meaning "indigenous", "native" or "born of the earth"
• Lumad tribal groupings


  • Ata
  • Bagobo
  • Mamanwa
  • Mandaya
  • Manobo
  • Subanon
  • Tiruray
• The Lumad only comprise 5% of the total Mindanaoan population
• The current socio-political context of the Lumad is burdened with violence and oppression, and among this population, the most vulnerable are still women and children
• A report from the University of the Philippines described the poor living conditions of Lumad families during the Christmas season
• The first-ever Report on the State of the World of Indigenous Peoples, issued by the United Nations Permanent Forum on Indigenous Issues in January 2010, revealed that IPs make up fully one-third of the world's poorest peoples, suffer disproportionately in areas like health, education, and human rights, and regularly face systemic discrimination and exclusion
• The reporting of accurate and complete race and ethnicity data provides essential information to target and evaluate public health interventions aimed at under-represented populations
• Self-reported data regarding race and ethnicity is unreliable due to the fact that individuals of varied cultures and heritage or of multiple races can have difficulty in classifying their identities
• Many health systems as well do not have robust and well-established health data systems that reports minority data and their health status, just like in the Philippines
• The translation of the western model of medicine and its definition of health to the definition of indigenous health status may only partly capture different Indigenous understanding and conceptions of health
• Indigenous health (as defined by WHO)

  Health was both a collective and an individual intergenerational continuum encompassing a holistic perspective incorporating four distinct shared dimensions of life: the spiritual, the intellectual, physical and emotional. Linking these four fundamental dimensions, health and survival manifests itself on multiple levels where the past, present and future co-exist simultaneously
• Indigenous peoples have generally have markedly poorer health and social outcomes relative to non-indigenous peoples
• Explanatory frameworks for indigenous health disparities

  • Racial differences
  • Health behaviors
  • Socioeconomic disadvantage
  • Historical processes of colonization
  • Urbanization and globalization
• Strategies for improving indigenous health policy


  • Health system development and financing
  • Capacity building for human resources
  • Community participation in policy and program delivery
  • Health care, health promotion and disease prevention programs development and delivery
  • Comprehensive integration of Western and traditional health systems
  • National health information, monitoring and evaluation systems
  • Addressing issues on land reform
  • Political recognition of indigenous peoples
  • Support for the retention of indigenous languages and culture
  • Address poverty, educational reform and programs to improve housing quality
• National Commission on Indigenous Peoples (NCIP)

  Government body responsible of protecting the rights of ICCs/IPs through governmental programs
• R.A. 8371: The Indigenous Peoples Rights Act of 1997


  Declares that the State shall recognize and promote all the rights of Indigenous Cultural Communities/Indigenous Peoples (ICCs/IPs) to government basic services health. This also addresses the social, economic and cultural well-being of IPs