Cultural aspects related to the health of Andean women in Latin America: a key issue for progress toward the attainment of the Millennium Development Goals.

International declarations have affirmed that health is a universal right. In order for people to exercise their right to health, their social and cultural contexts need to be acknowledged. However, due to a number of barriers encountered at different levels of society and geographically this right is not yet fully exercised by a considerable number of women in Latin America. During the last decade progress has been made in the development of public health policies and programs that integrate and recognize the differences in culture that should be considered when addressing indigenous women's health issues. However, a biomedical health model, which discounts cultural influences, prevails globally over a more integrated approach. This leads to a lack of access and use of quality reproductive health services and care among indigenous people and is one of several important factors contributing to high levels of maternal mortality and poor reproductive health among indigenous women. It is important to ensure that an intercultural approach is included in health policies, programs and services. An intercultural strategy fosters dialogue and respect among women, men, and decision-makers and can contribute to the realization of reproductive health rights and improvement of health outcomes. The debate continues on how to accelerate progress in public policies, health programs and health services. An intercultural approach to assure the health of indigenous women should be a key part of this discussion. Specific efforts are critical for obtaining better health outcomes for indigenous women and other vulnerable populations, if not progress will stagnate in the middle of the 21st century, jeopardizing the attainment of the Millennium Development Goal (MDGs).