E/2018/43 E/C.19/2018/11 50. Despite this critical role, community-regulated indigenous midwifery is often undermined and actively criminalized, to the detriment of the health of indigenous peoples. To close the gap between indigenous and non-indigenous health outcomes, the practice of indigenous midwifery must be supported by state health policy and integration. The right of indigenous peoples to self-determination extends to their reproductive health, and States should put an end to the criminalization of indigenous midwifery and make the necessary legislative and regulatory amendments to legitimize indigenous midwives who are recognized by their communities as health care providers. States should also support the education of new traditional indigenous midwives via multiple routes of education, including apprenticeship s and the oral transmission of knowledge. 51. The Permanent Forum reiterates previous recommendations that WHO, the United Nations Children’s Fund (UNICEF) and UNFPA, as well as regional health organizations and Governments, fully incorporate a cultural perspective into health policies and programmes and reproductive health services aimed at providing indigenous women with quality health care, including emergency obstetric care, voluntary family planning and skilled attendance at birth. The roles of tradi tional midwives should be re-evaluated and expanded so that they may assist indigenous women during their reproductive health processes and act as cultural brokers between health systems and indigenous peoples. 52. The Permanent Forum recommends that the WHO End TB Strategy and the Global Partnership to Stop Tuberculosis, in collaboration with UNFPA, PAHO and the Inter-Agency Support Group on Indigenous Peoples’ Issues, organize an expert group meeting on tuberculosis by 2020 to analyse the sociocultural an d economic determinants of health for the prevention, care and treatment of tuberculosis in indigenous communities, with the cooperation of the Forum, in order to ensure the realization of target 3 of Sustainable Development Goal 3. The Forum also recommends the review of the Moscow Declaration to End TB, which considers indigenous peoples to be disproportionately affected by tuberculosis. 53. The Permanent Forum appreciates the steps taken by the Joint United Nations Programme on HIV/AIDS, UNFPA and the Inter-Agency Support Group on Indigenous Peoples’ Issues for the organization of an international workshop on indigenous peoples and HIV/AIDS, and calls on Member States and United Nations entities to contribute to the workshop. 54. The Permanent Forum is concerned that, across the globe, indigenous women and adolescents face persistent inequalities and stigma, especially in relation to maternal health and maternal mortality, yet the lack of data in this area renders them invisible and presents a major barrier to efforts to address the issue. Indigenous women are overwhelmingly less likely to have received health-care services. Indigenous women are three times more likely to have had no antenatal care and twice as likely to give birth without a skilled birth attendant, and have a significantly higher adolescent birth rate. This is directly related to the poverty, discrimination and marginalization that indigenous women frequently face. 55. The Permanent Forum welcomes the study presented by UNFPA, in collaboration with CHIRAPAQ (Centro de Culturas Indígenas del Perú), entitled “Progress and challenges regarding the recommendations of the Forum on sexual and reproductive health and rights and gender-based violence”. 56. The Permanent Forum invites UNFPA to make efforts to disseminate the findings of the study at the global, regional and country levels among Member States, United Nations mechanisms and indigenous organizations. The Forum also invites UNFPA to engage in concerted dialogue with the nine Member States that were part 12/26 18-07701