title: [Interventions to improve access to health services by indigenous peoples in the Americas].
abstract: OBJECTIVE
  Synthesize evidence on effectiveness of interventions designed to improve access to health services by indigenous populations.
  
  
  METHODS
  Review of systematic reviews published as of July 2015, selecting and analyzing only studies in the Region of the Americas. The bibliographic search encompassed MEDLINE, Lilacs, SciELO, EMBASE, DARE, HTA, The Cochrane Library, and organization websites. Two independent reviewers selected studies and analyzed their methodological quality. A narrative summary of the results was produced.
  
  
  RESULTS
  Twenty-two reviews met the inclusion criteria. All selected studies were conducted in Canada and the United States of America. The majority of the interventions were preventive, to surmount geographical barriers, increase use of effective measures, develop human resources, and improve people's skills or willingness to seek care. Topics included pregnancy, cardiovascular risk factors, diabetes, substance abuse, child development, cancer, mental health, oral health, and injuries. Some interventions showed effectiveness with moderate or high quality studies: educational strategies to prevent depression, interventions to prevent childhood caries, and multicomponent programs to promote use of child safety seats. In general, results for chronic non-communicable diseases were negative or inconsistent.
  
  
  CONCLUSIONS
  Interventions do exist that have potential for producing positive effects on access to health services by indigenous populations in the Americas, but available studies are limited to Canada and the U.S. There is a significant research gap on the topic in Latin America and the Caribbean.
authors.affiliation: Clínica INDISA, Santiago, Chile.
authors.forename: Miguel
authors.initials: M
authors.lastname: Araujo
authors.affiliation: Ministerio de Salud, Santiago, Chile.
authors.forename: Cecilia
authors.initials: C
authors.lastname: Moraga
authors.affiliation: Organização Pan-Americana da Saúde, Brasília, Brasil.
authors.forename: Evelina
authors.initials: E
authors.lastname: Chapman
authors.affiliation: Fundação Oswaldo Cruz, Brasília, Brasil.
authors.forename: Jorge
authors.initials: J
authors.lastname: Barreto
authors.affiliation: Hospital Barros Luco Trudeau, Santiago, Chile.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Illanes
mesh_terms: D000569:Americas; D002318:Cardiovascular Diseases; D017691:Caribbean Region; D002648:Child; D005260:Female; D006297:Health Services Accessibility / Q000458:organization & administration*; D006303:Health Services, Indigenous; D006801:Humans; D011247:Pregnancy; D012196:Review Literature as Topic; D012307:Risk Factors