Description:

Inadequate sexual and reproductive health service provision has been linked to unintended pregnancies, early and forced marriage, sexual and gender-based violence, increases in sexually-transmitted infections, and higher incidence of mental health distress and disorders. Securing strong sexual and reproductive and mental health outcomes is premised on women and girls having the agency to exercise their rights, access knowledge, and make decisions to improve their health and well-being. However, there is a critical knowledge gap on how to improve sexual, reproductive, maternal, and mental health outcomes among adolescent and Indigenous populations in Latin America. A history of colonialism and marginalization has had long-standing negative impacts on Indigenous populations' development trajectories, as research systems have historically valued and supported Western approaches over traditional Indigenous ways of knowing. Recognition of this legacy and how it has impacted the visibility and opportunities of Indigenous peoples in research, remains lacking. Similarly lagging is the degree to which data collection with Indigenous peoples has been done in collaborative, rather than extractive ways, ensuring Indigenous communities are at the helm of knowledge creation and policy change. The aim of this session is to discuss the approaches and opportunities in co-creating research with adolescents and Indigenous populations as the primary beneficiaries, to improving access to health services and policy implementation, as well as to promote greater recognition and uptake of Indigenous knowledge in health systems research. Research teams funded by Canada's International Development Research Centre (IDRC) working in Guatemala, Mexico and Peru, will share their experiences, achievements and policy challenges integrating Indigenous knowledge, people-centeredness, local leadership and diplomacy into health policies and solutions and in reflecting the perspectives of adolescents and Indigenous peoples in health research.

• To learn about the approaches and opportunities in co-creating research with adolescent and Indigenous populations as the primary beneficiaries in Guatemala, Mexico and Peru • To gain greater understanding of Indigenous knowledge in health systems research. • To learn about the experiences, achievements and policy challenges integrating adolescent perspectives, Indigenous knowledge, people-centeredness, local leadership and diplomacy into health research and in reflecting the perspectives of Indigenous peoples in health research.

1. Exploring the nexus between maternal and mental health in climate change-affected Indigenous communities in Guatemala • Discussing participatory action research in Guatemala to develop a community-informed understanding of the nexus between maternal health and mental health needs in 20 rural Indigenous communities in two of the poorest departments in Guatemala also impacted by climate-change-driven extreme weather events. 2. Deconstructing sexual and reproductive health with Mayan Indigenous-Afro-descendant adolescents: perspective of intersectional gender and decolonizing mental health in Mexico • Learning from and documenting the ethnic, sexual and gender intersectional identity of Mayan and Afro-descendant adolescent and youth, and the meanings they give to sexual and reproductive health, in order to understand what their information and care needs are, as well as the social repercussions related to their physical and mental well-being. • Describing the use of mixed methods and the research outcomes aim to inform and result in comprehensive and respectful health services to help promote adolescent participation with local health systems to make the latter more inclusive and equitable. 3. Identifying policy implementation gaps to address the intersecting burdens of mental health challenges and adolescent pregnancy in Peru • Discussing the extent to which public policies designed to address the sexual and reproductive health and mental health needs of adolescent girls are achieving their goals and to validate an intervention to improve these policies. • Describing how this project is including adolescents' voices in research, ethical considerations, and how this intersects with other issues, such as ethnicity and migration status. • Reflecting on the ethics review, what the concerns are in working with adolescent populations, the extent to which local realities are taken into consideration, and how to aim for more respectful research. 4. Upscaling access to quality health-care services for priority populations in Guatemala through public policy co-creation • Discussing how government and civil society work in collaboration to design and implement health programs that integrate ancestral (indigenous) and institutional medicine; to recognize and integrate the work of traditional birth attendants; and to implement a model of family care which integrates all priority care services and intersectoral interventions to improve health. • Outlining participatory methods and techniques that are used to facilitate policy co-creation with users of services, civil society organizations, frontline providers and the authorities. 5. Improving access to menstrual health for girls and adolescents in Peru: A school-based and health-system-based implementation research study • Presenting the assessment of whether the implementation of the law responds to the needs of the populations served, and what factors, including gender, stigma and intersectionality, influence its effectiveness. • Describe the knowledge generated to close gaps in the sexual, reproductive and mental health needs of girls and adolescents in vulnerable situations in Peru by co-designing and piloting a national plan for menstrual health management across schools and health centres in Lima (coast), Ayacucho (highlands) and Ucayali (jungle).

• Diverse approaches and opportunities in research co-creation, in a different number of contexts across Latin America, promote greater recognition and uptake of Indigenous knowledge in health systems research. • Research co-creation with adolescent and Indigenous populations can improve policy implementation and access to health services and helps to fill critical knowledge gaps on how to improve sexual, reproductive, maternal, and mental health outcomes among adolescent and Indigenous populations in Latin America.

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