Can the right to health inform public health planning in developing countries? A case study for maternal healthcare from Indonesia.
Abstract
Background: Maternal mortality remains unacceptably high in developing countries despite international advocacy, development targets, and simple, affordable and effective interventions. In recent years, regard for maternal mortality as a human rights issue as well as one that pertains to health, has emerged. Objective: We study a case of maternal death using a theoretical framework derived from the right to health to examine access to and quality of maternal healthcare. Our objective was to explore the potential of rightsbased frameworks to inform public health planning from a human rights perspective. Design: Information was elicited as part of a verbal autopsy survey investigating maternal deaths in rural settings in Indonesia. 皇冠体育app deceased's relatives were interviewed to collect information on medical signs, symptoms and the social, cultural and health systems circumstances surrounding the death. Results: In this case, a prolonged, severe fever and a complicated series of referrals culminated in the death of a 19-year-old primagravida at 7 months gestation. 皇冠体育app cause of death was acute infection. 皇冠体育app woman encountered a range of barriers to access; behavioural, socio-cultural, geographic and economic. Several serious health system failures were also apparent. 皇冠体育app theoretical framework derived from the right to health identified that none of the essential elements of the right were upheld. Conclusion: 皇冠体育app rights-based approach could identify how and where to improve services. However, there are fundamental and inherent conflicts between the public health tradition (collective and preventative) and the right to health (individualistic and curative). As a result, and in practice, the right to health is likely to be ineffective for public health planning from a human rights perspective. Collective rights such as the right to development may provide a more suitable means to achieve equity and social justice in health planning.
Citation
Global Health Action, 2008, Vol. 1 [doi:10.3402/gha.v1i0.1828]