A/HRC/12/34/Add.2 page 19 64. The Government has made some noteworthy efforts to improve indigenous health services more generally and adapt them to the particular needs of indigenous communities, including the creation of 34 Special Indigenous Health Districts (DSEI), administered by FUNASA, which provide a network of services either directly or through agreements with indigenous organizations or NGOs. FUNASA has made attempts to increase indigenous participation in the DSEI programmes, through the creation of local indigenous health committees to participate in all phases of the planning and execution of the health programmes, and a presidential decree of 18 June 2009 will make the DSEIs administratively autonomous.9 Additionally, FUNASA has put in place a nutritional monitoring system for some indigenous communities and worked in partnership with the Ministry of Social Development and Hunger Alleviation to distribute food and vitamins in the most critical areas such as Mato Grosso do Sul. The Government has also established indigenous health posts, which are located in urban centres near indigenous-populated areas and are intended to provide secondary or tertiary health services to indigenous peoples. 65. Of ongoing concern, nonetheless, is that FUNASA has been hamstrung by financial limitations, as well as by severe management problems, resulting in persistent shortcomings in the delivery of the health services to indigenous peoples. According to one study, even with significant increases in Government funding for indigenous health between 2003 and 2006, the delivery of services worsened in most areas and infant mortality rose among the indigenous population.10 The Government reports initiatives to develop pilot programmes for selected DSEIs and the formation of a working group within the Ministry of Health to advance in a new management model for indigenous health-care policy and services. Indigenous peoples and organizations, however, have pressed for deeper reforms, advocating for a special secretariat within the Ministry of Health to take over indigenous health-care responsibilities from FUNASA and for further measures to increase indigenous participation at all levels of health services, including the training of indigenous health providers. C. Education 66. The Constitution of Brazil of 1988 affirms the right of indigenous peoples to their native languages and their own methods of learning (art. 210.2). To that end, a series of Government initiatives beginning in 1991 provided for a model of “indigenous education” that sought to transform the existing system of “indigenous schools” (escolas indígenas) operating in indigenous communities into a vehicle of intercultural and bilingual education respectful of local indigenous cultural specificities. The Government reports that between 2002 and 2007 the total number of indigenous schools rose 45.4 per cent, from 1,706 to 2,480, and that the public resources designated for indigenous education have progressively increased. There has been a 9 10 Decreto No. 6.878. P.D. Moraes, “Avia cursis da saúde indígena no Brasil”, in Conselho Indigenista Missionário 2008, Violencia contra os povos indígenas no Brasil, Relatório 2006-2007, CIMI, 2008, pp. 23-24.

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