Can the right to health inform public health planning in developing countries? A case study for maternal healthcare from Indonesia

Lucia D'Ambruoso, Peter Byass, Siti Nurul Qomariyah

Research output: Contribution to journalArticle

7 Citations (Scopus)

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 rights-based 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. The 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. The cause of death was acute infection. The woman encountered a range of barriers to access; behavioural, socio-cultural, geographic and economic. Several serious health system failures were also apparent. The theoretical framework derived from the right to health identified that none of the essential elements of the right were upheld. CONCLUSION: The 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.
Original languageEnglish
Number of pages10
JournalGlobal Health Action
Volume1
DOIs
Publication statusPublished - 9 Sep 2008

Fingerprint

Health Planning
Indonesia
Developing Countries
Public Health
Mothers
Delivery of Health Care
Health
Maternal Death
Maternal Mortality
Quality of Health Care
Social Justice
Signs and Symptoms
Cause of Death
Autopsy
Fever
Referral and Consultation
Economics
Pregnancy
Infection

Keywords

  • human rights
  • maternal mortality
  • developing countries
  • Indonesia

Cite this

Can the right to health inform public health planning in developing countries? A case study for maternal healthcare from Indonesia. / D'Ambruoso, Lucia; Byass, Peter; Qomariyah, Siti Nurul.

In: Global Health Action, Vol. 1, 09.09.2008.

Research output: Contribution to journalArticle

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