Social Determinants of Health Inequities in Indigenous Children in the Philippines

Oben et al. reported disparities in hospitalisation rates among indigenous peoples in New Zealand.1 They revealed that hospitalisation rates are higher in Maori than non-Maori non-Pacific groups. Although hospitalisation deprivation inequities have decreased for both groups, Maori experienced a slower decline. Indigenous children experience similar health inequities in the Philippines, a low- to middle-income country. We show that socio-economic factors heavily influence health disparities in the country. Indigenous peoples comprise about 13% (10–15 million) of the Filipino population and have worse health outcomes, seen in their high infant and maternal mortality rates.2 The prevalence of anaemia and iodine deficiency is high in indigenous communities, and the persistence of poliomyelitis, cholera outbreaks, and high soil-transmitted infections among indigenous children has been reported.2, 3 While 77.1% of indigenous peoples were aware of the national health insurance program in the Philippines, 46.2% were not members, implying a lack of financial protection for their dependent minors.4 Indigenous children were identified as among the most vulnerable to COVID-19 spread and complications in the country.5 Socio-economic factors influencing health inequities among Filipino indigenous communities puts the indigenous child at higher risk for disease morbidity and hospitalisation. Most of these communities are located in geographically isolated and disadvantaged areas where health-care access is difficult.6 Indigenous peoples belong to the poorest quintile, further limiting their health-care access due to financial reasons.4 Destruction of their ancestral lands by extractive industries (e.g. mining) and massive displacement from armed conflicts have caused massive food insecurity that particularly affected indigenous children.4, 7 Although the Philippines has had its Indigenous Peoples Rights Act since 1997, indigenous communities still face disadvantages, partly from difficulty in implementing this policy at the grassroots level.2 Protection of indigenous peoples from ancestral land deprivation, security conflicts, and socio-economic disenfranchisement is paramount to easing health disparities and securing quality health for the indigenous child. However, existing strategies in implementing social protection policies in the Philippines are insufficient to protect indigenous peoples from these social injustices. We call for increased collaboration among national and local leaders, policymakers, researchers, and community stakeholders to ensure that barriers to health care are properly identified and actively addressed. Strong commitment and political will among leaders are essential to ensure social justice and equity in health for indigenous children.