Indigenous Peoples

Greater Mekong Subregion (GMS) Regional Communicable Diseases Control (CDC) Project
Cambodia, Lao PDR, Viet Nam

The overall anticipated impact of the Project is to contain the spread of epidemic diseases at local level and reduce the burden of common endemic diseases in the countries by about 15% in the targeted provinces, and more for certain specific infections.

One of the expected project outcomes is improved coverage of prevention and care of communicable diseases in vulnerable populations. In line with this, The Project is specifically targeting ethnic groups in the selection of provinces, types of interventions, and planning and monitoring arrangements. Priority will be given to CDC in remote areas including border provinces where many ethnic groups and the poorest reside.

The Summary Poverty Reduction and Social Strategy (SPRSS) [ PDF ] indicates that impact on ethnic minorities (EMs) is significant. EMs constitute a major proportion of the population in the three countries, and often reside in relatively remote hills and forests where living conditions are difficult. They are particularly vulnerable because:

• infant and child mortality rates and maternal mortality ratios are generally higher in the provinces with a high proportion of EMs
• EMs suffer more often from common infectious diseases than the majority ethnic groups
• EMs are at special risk of infection with the human immunodeficiency virus (HIV) because of lack of access to education, poverty, lack of culturally appropriate information in their own languages, cultural and social breakdown within some communities, nontraditional drug use, and a relatively high involvement in the sex trade and other forms of exploited labor

An Ethnic Minority Development Plan (EMDP) [ PDF ] was prepared to ensure that EMs included in the Project will benefit fully from the proposed CDC activities. Three subcomponents of the Project provide special focus on vulnerable groups including ethnic minorities:

• a community-based surveillance and response system that will aim to reach remote living populations, to achieve timely control of epidemics like malaria and measles, but also avian influenza, encephalitis, and other epidemics
• improved CDC in these populations as a result of better access to promotive, preventive, and basic curative interventions through village health workers
• HIV/AIDS control through behavioral change and communication among high-risk groups, including ethnic minorities, in "hot spots."

The EMDP proposes two avenues for improving CDC for vulnerable populations:

• Village-Based Health Care. To give remote communities better access to health care, the Project will improve village-based health care by training village workers from ethnic minorities. For each ethnic group, specific cultural issues will be identified at the local level and incorporated in the local design to make services more acceptable. Materials and training programs will be designed to take into account the level of education and language of the target groups. Revolving funds for drugs will be set up at the village level, where this is feasible. These funds could also be used to improve water and sanitation coverage and other locally identified activities for disease prevention and control.
• Community-Based Action for CDC. The Project will also explore community mobilization for CDC. It will develop a participation strategy appropriate for ethnic minorities to improve surveillance and response at the community level, and to improve control of endemic diseases, by mobilizing leadership and mass organization, and providing demonstration models.

Location:
Cambodia, Lao PDR, and Viet Nam. (Project Map)

Learn more about the project:

• Report and Recommendation of the President [ PDF ]