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. 2023 Nov 16;38(Supplement_2):ii36-ii50.
doi: 10.1093/heapol/czad051.

Justice implications of health and food security policies for Indigenous peoples facing COVID-19: a qualitative study and policy analysis in Peru

Victoria Chicmana-Zapata  1 , Ingrid Arotoma-Rojas  2 , Cecilia Anza-Ramírez  3 , James Ford  2 , Eranga K Galappaththi  4 , Kerrie Pickering  5 , Emma Sacks  6 , Cecil Togarepi  7 , Chrishma D Perera  4 , Bianca van Bavel  8 , Keith Hyams  9 , Francis A Akugre  10 , Jonathan Nkalubo  11 , Indunil Dharmasiri  4 , Olivia Nakwafila  12 , Adelina Mensah  10 , Jaime J Miranda  13 , Carol Zavaleta-Cortijo  14
Affiliations

Justice implications of health and food security policies for Indigenous peoples facing COVID-19: a qualitative study and policy analysis in Peru

Victoria Chicmana-Zapata et al. Health Policy Plan. .

Erratum in

Abstract

The spread of COVID-19 in Peru resulted in the declaration of a national health emergency, in which Indigenous peoples were identified as being particularly vulnerable due to their pre-existing poor health indicators and disadvantaged social conditions. The aim of this paper is to examine how the Peruvian government responded to the health and food needs of the Shawi and Ashaninka Indigenous peoples of Peru during the first 18 months of the pandemic (March 2020-August 2021). This study uses both official policy documents and real-world experiences to evaluate policy responses in terms of their immediate impact and their longer-term sustainability and contribution to the improvement of health, well-being and justice for Indigenous communities. Four health and food security responses were evaluated: the Amazon Health Plan and Indigenous Command; food aid; cash aid; and COVID-19 vaccination. We employed the Multidimensional Injustice Framework to analyse the justice implications of the design and implementation of responses. Data collection included 71 interviews with government officials (n = 7), Indigenous leaders (n = 31) and community members (n = 33). The results show how national and regional governments released policies to address the health and food needs of Indigenous peoples directly or indirectly, as part of a broader focus on vulnerable people. However, justice implications were not sufficiently addressed in the design or implementation of the responses. On the distributive dimension, Indigenous communities were prioritized to receive health goods and services, nevertheless, the distribution had shortcomings that impeded their collection and Indigenous food systems and livelihoods were largely overlooked. On the procedural dimension, Indigenous representatives were included to provide culturally sensitive feedback on health interventions, but without funding, and furthermore, the community members had only passive participation. This paper points out the importance of considering and addressing justice implications for more effective and fairer health and food policy responses to current and future health crises.

Keywords: COVID-19; Indigenous; food; health; justice.

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Conflict of interest statement

We have no conflicts of interest to declare.

Figures

Figure 1.
Figure 1.
Multidimensional Injustice Framework adopted from Byskov et al. (2021) and modified by the authors for this research
Figure 2.
Figure 2.
Map of the location of the Ashaninka community participating in this study, made by Engler Puente with ArcGis 10.8 software. Source: National Institute of Statistics and Informatics
Figure 3.
Figure 3.
Map of the district of the Shawi community participating in this study, made by Engler Puente with ArcGis 10.8 software. Source: National Institute of Statistics and Informatics
Figure 4.
Figure 4.
Epidemiological graphics of daily COVID-19 cases and deaths in Peru during the study period (March 2020–August 2021), provided by the co-author Cecilia Anza-Ramirez. Source: Peruvian Ministry of Health
See this image and copyright information in PMC

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