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In-Depth Reading Time: 12 minutes

Recap: Responding to the SRHR Needs of Indigenous Women and Girls

Measuring Sexual and Reproductive Health and Rights in a Global Context


Earlier this year, Communities, Alliances & Networks (CAAN) and The World Health Organization’s (WHO) IBP Network partnered on a series of seven webinars on advancing the SRHR of Indigenous women living with HIV. Each webinar featured rich discussions, highlighting national plans and the status of Indigenous women living with HIV and other sexually transmitted infections in each country.

Did you miss any or all of these seven webinars? Now is your chance to get caught up! Below, we’ve provided a recap of each country’s webinar, with highlighted quotes and links to specific segments.

The Communities, Alliances & Networks (CAAN) Research Initiative

The Communities, Alliances & Networks (CAAN) was established in 1997 and is a crucial platform for Indigenous people living with HIV and other sexually transmitted infections. 

In 2017, the World Health Organization released a consolidated guideline on the sexual and reproductive health and rights (SRHR) of women living with HIV. Using this guideline, CAAN designed a five-year research project. Its goal was to address evidence that highlighted inequitable access to quality health services for Indigenous women. Living with HIV, they face extreme vulnerability to gender-based violence and SRHR violations.

Read more about the research project

The purpose of the research project—called Measuring Sexual and Reproductive Health and Rights: Responding to the Needs of Indigenous Women and Girls in a Global Context—is to develop an Indigenous framework that promotes and improves well-being. Through scoping reviews, focus group discussions, and surveys, the project aims to create an Indigenous women-specific, culturally appropriate toolkit on SRHR. The project is being implemented simultaneously alongside local Indigenous organizations in seven countries, including:

  • Canada.
  • Guatemala.
  • India.
  • Nepal.
  • New Zealand.
  • Nigeria.
  • Peru. 

The project has three specific aims:

  1. Improved understanding of barriers affecting data collection, analysis, utilization, and communications related to SRHR of Indigenous women and girls living with HIV.
  2. Increased partnerships to inform SRHR care programming, planning, and learning.
  3. Enhanced capacity of future Indigenous and allied researchers, civil society professionals, and in-country leaders to collect, analyze, communicate, and use data effectively.

In March and April of 2022, CAAN and The World Health Organization’s (WHO) IBP Network collaborated on a series of seven webinars (one per country). Each webinar included:

  • An introduction to the research project.
  • Featured Indigenous speakers who presented on context-specific challenges and opportunities in advancing SRHR of Indigenous women living with HIV.
  • A discussion about ways to implement the guidelines to support SRHR of Indigenous women living with HIV.

Each webinar was unique, with speakers highlighting national plans, the status of Indigenous women living with HIV in the particular country, and rich discussions. 

Introduction to the CAAN Research Initiative

Each webinar began with an introduction to the CAAN research initiative by either Dr. Patricia Mahecha, global research manager, or Carrie Martin, Indigenous women’s research coordinator at CAAN, and the nominated principal knowledge user of the project.

Highlights

“Throughout this project, Indigenous knowledge will be integrated from the design, development, dissemination, and evaluation, and we will work to defend the principles of equity, gender equality, and sustainable development among all the populations we will interact with. Therefore, it is paramount that Indigenous ceremonies and traditional activities are honored throughout the project to help guide safe and healthy relationships.”

Dr. Patricia Mahecha, Global Research Manager
  • CAAN is implementing a five-year research project to develop an Indigenous framework that promotes and improves well-being. The project is working to strengthen a global network while also building local capacity in evidence-based and culturally relevant SRHR.
  • The project centers Indigenous women and girls. It ensures they are equipped with the knowledge to make the best decisions about their sexual and reproductive lives. They also seek to enhance the ability of Indigenous women and girls to engage in all levels of research while strengthening global Indigenous and allied partnerships.
  • The project’s research questions are:
    • What are the underlying cultural and structural issues Indigenous women and girls face in accessing safe and effective SRHR?
    • What are some cultural and structural opportunities that could increase Indigenous women and girls’ access to safe and effective SRHR?
    • What are appropriate, culturally responsive solutions to advance Indigenous women and girls’ SRHR?
    • How do we build Indigenous men’s capacity to advocate for optimizing the SRHR of Indigenous women and girls?
  • The team’s overall goal is to develop an Indigenous framework that promotes and improves well-being. It plans to investigate:
    • Underlying barriers to SRHR.
    • Develop culturally informed solutions.
    • Mentor and train Indigenous women.
    • Support capacity strengthening among Indigenous self-identified men and boys as advocates for and change agents for SRHR.
  • Project activities and deliverables include:
    • A scoping review specific to SRHR among Indigenous Women living with HIV.
    • Focus group discussions.
    • A survey administered by Indigenous women living with, or impacted by, HIV.
    • An Indigenous-appropriate toolkit on SRHR for Indigenous women living with HIV.
    • An evaluation of the impact of the project and the toolkit.

Listen to a recording of this segment from the first webinar (India):

Overview of the WHO Guidelines on SRHR of Women Living with HIV

Each webinar also included an overview of the WHO Guidelines on SRHR of women living with HIV by either Dr. Rodolfo Gomez, regional advisor for Sexual and Reproductive Health Pan American Health Organization (PAHO), or Manjulaa Narasimhan, scientist with the Department of Sexual and Reproductive Health and Research at WHO.

Highlights

“First and foremost, this guideline adopted an approach that is centered on the needs and rights of women, girls, and gender-diverse individuals living with HIV. It sees them as active participants as well as beneficiaries of trusted health systems that can respond to their needs, to their rights, to their preferences in holistic ways. This guideline emphasizes the promotion of gender equality as central to the achievement of their SRHR.”

Manjulaa Narasimhan, Scientist with the Department of Sexual and Reproductive Health and Research at WHO
  • The WHO published the consolidated guideline on the sexual and reproductive health and rights of women living with HIV in 2017. It is the outcome of a broad consultative process, involving many national, regional, and global experts—including individuals and networks of people living with HIV (as well as Indigenous women living with HIV).
  • This guideline was developed because, in many contexts, women living with HIV do not have equitable access to good quality health services. They are faced with multiple and intersecting forms of stigma and discrimination.
  • The guideline is meant to help countries more effectively and efficiently monitor programs and services. This ensures that they are appropriate for women living with HIV.
  • The guideline is grounded in the following guiding principles: women-people-centered approaches, human rights, gender equality, meaningful community engagement, and health and well-being.
  • The development began with a global survey, which was conducted by and for women living with HIV. It assessed their priorities ahead of the expert working groups.
  • The need for quality and respectful care within health facilities was highlighted and recommendations support a safe and supportive enabling environment. Effective implementation of the guideline needs to be context-specific, responding to the needs of local communities.
  • The participatory approach used in the guideline led to the establishment of a WHO advisory group of women living with HIV. It includes representation from Indigenous communities.

Listen to a recording of this segment from the first webinar (India):

Canada

Sexual and Reproductive Health and Rights of Indigenous Women, Girls, and Gender-Diverse Communities Living with HIV in Canada

Highlights

“We have skills to pass on. Don’t think you’re not worthy of being in these positions. Because we have to be in order for the work to get done in a proper way to really enforce these guidelines.”

Claudette Cardinal (traditional name Wâpakwaniy), Indigenous Peer Research Associate at the British Columbia Centre for Excellence in HIV/AIDS

The webinar took place on March 25, 2022, and included the following:

Session Speaker, Title Link to Recording
Introduction Sugandhi del Canto, co-founder of the City Centre Food Cooperative 0:00–0:54
Welcome Sharp Dopler, Elder 0:54–6:15
National Action Plan on the SRHR of women living with HIV in Canada Angela Kaida, Associate Professor and Canada Research Chair at Simon Fraser University

Jasmine Cotnam, Project Coordinator at Women’s College Research Institute and case worker at Elevate NWO

30:25–40:50
Stats on Indigenous women living with HIV from the Canadian HIV Women’s Sexual and Reproductive Health Cohort Study (CHIWOS) Laura Warren, Research Coordinator ​​Women’s College Hospital 41:50–49:12
My Story Claudette Cardinal (traditional name Wâpakwaniy), Indigenous Peer Research Associate at the British Columbia Centre for Excellence in HIV/AIDS 49:12– 57:20
Challenges & Opportunities in Advancing SRHR of Indigenous Women Living with HIV at Local Level and How to Operationalize the Guideline to Support SRHR of Indigenous Women Living with HIV Renée Masching, Director of Research, CAAN 57:35–1:19:24
Discussion Sugandhi del Canto, co-founder, City Centre Food Cooperative and Moderator 1:19:30–1:33:20
Closing Sharp Dopler, elder 1:33:23–1:35:43

Highlights from the discussion

If someone at the [International AIDS] conference asked you what are Canada’s top three HIV issues among Indigenous women, what would you say to them?

  • “Talking about SRHR and bringing forward the rights of women to be wholly and fully sexual beings and to have that respect…” —Renée Masching
  • “I want to put a call out there for all of us at how much there is to learn and benefit at understanding Indigenous approaches and ways of knowing. Research as ceremony is transformative for all of us engaged in research in the HIV space and I really hope that is something that emerges from AIDS 2022 in Montreal.” —Angela Kaida
  • “The involvement of women at the table is forefront. We have to be in every little nook and cranny in order for that work to be represented in the right way.” —Claudette Cardinal
  • “The importance of continued research. For us at WHO, we are dependent on that things should be based on the evidence … having that published and available to others continues to be so important.” —Manjulaa Narasimhan

Guatemala

Panorama de los Derechos Sexuales y Reproductivos Desde la Perspectiva de las Comunidades Indígenas en Guatemala

Highlights

“It’s important to guarantee that government programs, plans, and policies have high community participation. Consult communities. Consult Indigenous women. Ask what their primary needs are in order to address them.”

Dora Alonso, Maya Kiché, President of the Indigenous Organization Naleb' and Activist on SRHR in Indigenous Women

This webinar took place on March 17, 2022. It was conducted in Spanish and included the following:

Session Speaker, Title Link to Recording
Welcome Jose Yac, director, IDEI Association

 

0:00–2:00
Invocation María Graciela Velásquez Chuc, Midwife Association of the West Community Leader 2:00–6:17
Approach from the Institutional Framework of the State of Guatemala Marcela Perez, director, Interculturality Unit of the Ministry of Health 35:04–49:05
Approaches in the ICA Clinic on SRHR and HIV in IDEI Juana López, HIV Educator, IDEI Association 50:00–1:00:50
How to Operationalize the Guideline to Support SRHR of Indigenous Women Living with HIV Dora Alonso, Maya Kiché, president of the Indigenous Organization Naleb’ and activist on SRHR in Indigenous women 1:01:22–1:16:24
Discussion Dali Angel, responsible for the Indigenous Youth and SDG program, Fund for the Development of Indigenous Peoples of Latin America and the Caribbean (FILAC)

Patricia Rodriguez, Dali Angel

1:17:27–1:24:001:24:47–1:27:31
Closing Jose Yac, director, IDEI Association

María Graciela Velásquez Chuc, Midwife Association of the West Community Leader

1:27:31–1:28:30

1:28:35–1:32:21

India

Sexual and Reproductive Health and Rights of Indigenous Women, Girls, and Gender-Diverse Communities Living with HIV in India

Highlights

“While we design guidelines and implement them, we need to ensure that the people find it attractive enough to get to a [service delivery] place. And that happens only when we have a system that is equitable, non-judgemental, and totally free of any bias.”

G.S. Shreenivas, Technical Director, UW I-TECH India

The webinar took place on March 10, 2022. It included the following:

Session Speaker, Title Link to Recording
Opening Sanjeeta Gawri, manager at Sexual Reproductive Health Matters (SRHM) and an advisor, Maldhari Rural Action Group (MARAG) 0:00–04:13
Welcome by Spiritual Leader Deepa Pawar, trainer and member, Anubhuti team 4:13–30:20
Challenges & Opportunities in Advancing SRHR of Indigenous Women Living with HIV at Local Level G.S Shreenivas, technical director, UW I-TECH India 31:45–47:45
How to Operationalize the Guideline to Support SRHR of Indigenous Women Living with HIV [Presented in Hindi] Munni Kumari, activist and member, Jawala Shakti Samuh 48:50–1:15:12
Discussion Sanjeeta Gawri, manager, SRHM and advisor, MARAG 1:15:15–1:27:12
Closing Nisha Rani, coordinator, MARAG 1:28:15–1:30:45

Highlights from the discussion

Many of the faith-based organizations are not pro-women and [have their] own biases. What would be the most influential factor for breaking these biases?

“It’s not that we have found any of our partners who are faith-based organizations in any way biased in terms of gender. But one of the biggest problems comes when the issues of morals [come] in … what we do is we offer them a bouquet of choices: Either they just talk about preventive approaches or they act as secondary service provision points or they act as counselors … we tell them, “You decide what your congregation likes to do’ and then give them the choice to take it forward.” —G.S. Shreenivas

Nepal

Sexual and Reproductive Health and Rights of Indigenous Women, Girls, and Gender-Diverse Communities Living with HIV in Nepal

Highlights

“Now is the right time to work on this issue … we have to focus on reducing the disempowerment and discrimination due to this inattention in our public policies … we have to overcome the challenges.”

Bhagwan Aryal, Assistant Professor of Health Education, Tribhuvan University, Kathmandu

The webinar took place on April 4, 2022. It included the following:

Session Speaker, Title Link to Recording
Welcome Anup Adhikari, research coordinator, SURUWAT

 

0:00–1:37
Welcome by an Elder Yogi Adesh, spiritual practitioner and yoga Instructor

 

1:37–9:00
Challenges & Opportunities in Advancing SRHR of Indigenous Women Living with HIV at Local Level Bhagwan Aryal, assistant professor, Health Education, Tribhuvan University, Kathmandu 31:40–41:30
Status of Sexual and Reproductive Health of Indigenous People with Disabilities Maheshwar Ghimire, treasurer, Nepal Family Development Foundation (NFDF)

 

42:00–50:43
Maternal Health for Indigenous PLHIV Gyanu Maharjan, lecturer, Kathmandu Model Hospital, School of Nursing

 

51:25–57:48
How to Operationalize the Guideline to Support SRHR of Indigenous Women Living with HIV Rajesh Didiya, director, SURUWAT

 

58:30–1:08:43
Discussion Anup Adhikari, research coordinator, SURUWAT 1:08:43–1:22:55
Closing Rajan K C, co-researcher, SURUWAT 1:22:55–1:29:37

Aotearoa/New Zealand

He Whānau Kotahi Tātou: Achieving Good Sexual and Reproductive Health and Rights (SRHR) for Māori Living with HIV and Their Whānau in Aotearoa New Zealand

Highlights

“My overriding message is that we deal with stigma and discrimination so that people with HIV no longer experience stigma and discrimination … It’s very sobering and distressing to think that not much has changed in the 40 years that we’ve been living through this pandemic. That it’s still a factor in people’s lives. Let’s see what we can do as a powerful consortium of seven countries to break down some of these barriers.”

Clive Aspin, Associate Dean Māori and Senior Lecturer in Health at Te Herenga Waka, Victoria University of Wellington

This webinar took place on April 1, 2022. It included the following:

Session Speaker, Title Link to Recording
Karanga (Call to Gather) Milly Stewart, CE and founder, Toitu te Ao

Alison Green, professor, Te Whāriki Takapou

0:00–1:48
Ngā Whakariterite (Briefing) Kevin Haunui, researcher, Te Whāriki Takapou 1:48–4:33
Formal Welcome to Aotearoa and Whakatau Geoff Rua’ine, health promoter, Zealand AIDS Foundation, Toitu te Ao 4:33–7:55
Kauhau: Overview of the History of Maori Living with HIV and the CAAN Research Initiative Clive Aspin, associate dean Māori and senior lecturer in Health, Te Herenga Waka, Victoria University of Wellington

 

7:55–13:16
He Whānau Kotahi Tātou (Introduction) Milly Stewart, CE and founder, Toitu te Ao 29:22–30:40
SRHR of Maori People Living with HIV (PLHIV) and Their Whānau at Local and National Levels Marguerite Kawana, Toitu te Ao

Ben Black, co-founder, Toitu te Ao)

Milly Stewart, CE and founder, Toitu te Ao

Geoff Rua’ine, health promoter, New Zealand AIDS Foundation, Toitu te Ao

30:46–1:00:52

 

Challenges & opportunities: How to operationalize the guideline to support SRHR of Indigenous women living with HIV at the local level Jillian Tipene, researcher and translator, Te Whāriki Takapou

Alison Green, professor, Te Whāriki Takapou

1:00:52– 1:19:28
Discussion Kevin Haunui, researcher, Te Whāriki Takapou 1:19:33–1:29:29
Closing Remarks Milly Stewart, CE & Founder of Toitu te Ao

Clive Aspin, Associate Dean Māori and Senior Lecturer in Health at Te Herenga Waka, Victoria University of Wellington

Kevin Haunui, Researcher, Te Whāriki Takapou

1:29:29–1:35:09

Highlights from the discussion

Why is it important for the voices of Maori people living with HIV to not only be heard but how do you see it in a way that you actually see changes being made?

  • “[I] think the approach needs to come from those that know and that understand those that are going through it … knowing how they are feeling. Knowing what they are needing … having a holistic approach, a cultural approach and understanding that we are not just dealing with the individual.” —Milly Stewart, CE and founder of Toitu te Ao

Stories really matter and come easy to us as Maori. How do we make stories also occurrent in the data so [they’re] meaningful to the people with lived experience?

  • “We need the stories and we also need the statistics in order to move forward. In our communities, stories are an effective way of providing information about services that are needed. But also the success stories … those stories are uplifting, positive, and very useful. But for health services, we need the health statistics to change the funds that are allocated and we need a rights-based approach.” —Alison Green, professor, Te Whāriki Takapou

Nigeria

Sexual and Reproductive Health and Rights of Indigenous Women, Girls, and Gender-Diverse Communities Living with HIV in Nigeria

Highlights

“I’m kindly asking all of us that we should share the information, post this information, and disseminate this information to our communities and our fellow civil society organizations. We are never going to get tired. We are going to keep talking about it. We will keep shouting it. We will keep taking advocacy to everywhere it needs to be until we have an end to HIV and AIDS … Let’s change the story. Let’s change the narrative and let all of us have an improved life.”

Walter Ugwuocha, CiSHAN

This webinar took place on March 18, 2022, and included the following:

Session Speaker, Title Link to Recording
Welcome Ogochukwu Iwuora, senior programme officer, FHI360 0:00–2:17
Welcome Chief Dr. Emma Enemuo, vice chairman, Oru-Nzenino Traditional Parliamentary Council 2:17–8:33
Challenges & Opportunities in Advancing SRHR of Indigenous Women Living with HIV at Local Level Dr. Dorcas Magbadelo, Caritas Nigeria and state team lead and incident commander, Delta State ART Response 30:45–42:43
How to Operationalize the Guideline to Support SRHR of Indigenous Women Living with HIV Walter Ugwuocha, CiSHAN 42:43–59:48
Discussion Ogochukwu Iwuora, senior programme officer, FHI360 1:00:00–1:23:18
Closing OnyekaOkafor, community leader, human rights activist, and publicity secretary, Ikenga-Nri Development Union

 

1:23:18–1:28:04

“So many of these challenges have been there for decades. Unless we can collectively get together, not just for community engagement but to ensure other pieces—like budget for women-led organizations, commitment at the political level, evidence-based information and tools are not only made available but we ensure the uptake of these tools—we aren’t going to be able to see the kind of progress we’d like.”

Manjulaa Narasimhan, scientist with the Department of Sexual and Reproductive Health and Research at WHO

Peru

Derechos a la Salud Sexual y Reproductiva de Mujeres, Niñas y Diversidades de Género en los Pueblos Indígenas que Viven con el VIH en Perú

Highlights

“Indigenous populations have resources. They are not strangers to health. They are not strangers to [health] services. There’s wisdom, knowledge, ancestral practices, health workers, and natural resources…”

Dr. Pilar Montalvo, Senior Program Officer, Planned Parenthood

This webinar took place on March 9, 2022. It was conducted in Spanish and included the following:

Session Speaker, Title Link to Recording
Opening Eliana Jacobo, National Federation of Peasant, Artisan, Indigenous, Native and Wage-earning Women of Peru (FENMUCARINAP)

 

0:18–4:36
Welcome by Spiritual Leader Lourdes Huanca, national leader and current president, FENMUCARINAP 4:38–7:25
Challenges & Opportunities in Promoting SRHR of Indigenous Women Living with HIV at the Local Level Dr. Daniel Aspilcueta, member of the Directorate of Sexual and Reproductive Health, Peruvian Ministry of Health 33:35–44:53
How to Operationalize the Guideline to Support SRHR of Indigenous Women Living with HIV Dr. Pilar Montalvo, senior program officer, Planned Parenthood

 

45:00–1:02:28
 Discussion & Closing Eliana Jacobo, FENMUCARINAP 1:02:30–1:21:23

Highlights from the discussion

In your experience how do we apply and institutionalize culturally relevant public health policies?

  • “It requires dialogue, training, the creation of working groups, and it requires time.” —Daniel Aspilcueta, member of the Directorate of Sexual and Reproductive Health at the Peruvian Ministry of Health
  • “All health services, including sexual and reproductive health, should be jointly developed through intercultural discussions, agreements, and consultations with the community.” —Pilar Montalvo, senior program officer at Planned Parenthood

Interested in recapping your webinar? Read our tips for writing and sharing webinar recaps on your website.

Anne Ballard Sara, MPH

Senior Program Officer, Johns Hopkins Center for Communication Programs

Anne Ballard Sara is a Program Officer II at the Johns Hopkins Center for Communication Programs, where she supports knowledge management research activities, field programs, and communications. Her background in public health includes behavior change communication, family planning, women’s empowerment, and research. Anne served as a health volunteer in the Peace Corps in Guatemala and holds a Master of Public Health from George Washington University.

Sarah V. Harlan

Partnerships Team Lead, Knowledge SUCCESS, Johns Hopkins Center for Communication Programs

Sarah V. Harlan, MPH, has been a champion of global reproductive health and family planning for more than two decades. She is currently the partnerships team lead for the Knowledge SUCCESS project at the Johns Hopkins Center for Communication Programs. Her particular technical interests include Population, Health, and Environment (PHE) and increasing access to longer-acting contraceptive methods. She leads the Inside the FP Story podcast and was a co-founder of the Family Planning Voices storytelling initiative (2015-2020). She is also a co-author of several how-to guides, including Building Better Programs: A Step-by-Step Guide to Using Knowledge Management in Global Health.