Prenatal care and human rights: Addressing the gap between medical and legal frameworks and the experience of women in Brazil.
Prenatal care and human rights: Addressing the gap between medical and legal frameworks and the experience of women in Brazil.
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DOI：
10.1371/journal.pone.0281581
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发表时间：
2023
期刊：
影响因子：
3.7
通讯作者：
中科院分区：
文献类型：
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获得高质量和负担得起的保健服务对于满足妇女的生殖健康和性健康需求和权利至关重要。为此，世界卫生组织宣布，在怀孕和分娩期间获得适当的保健服务是妇女的一项基本权利。正如1988年《宪法》和许多巴西政策所宣布的那样，在巴西，产前护理是一项公认的妇女健康人权。然而，在巴西落实健康权的过程中，生殖健康方面的法定权利与实现之间存在着根本的绩效差距。通过广泛的实地工作，包括焦点小组、对妇女的访谈和在巴西东北部两个城市的参与观察，本文探讨了这些问题，并探讨了妇女在产前保健方面获得和实现健康权的亲身经历。我们提供并叙述了妇女的经历，她们认为是践踏其健康权的障碍，即：a)人员和医疗设备有限，被视为被忽视；B)及时提供服务：时间对权利的感知和体验很重要；(C)妨碍行使健康权的错误信息；d)社会经济障碍。这些障碍特别影响到社会经济水平和受教育程度较低的农村社区妇女的权利，以及从交叉角度来看，已经面临更大健康风险和产前护理不足的棕色和黑人妇女的权利。因此，我们认为，在规范和法律框架鼓励卫生系统所做的事情与该系统在获取、平等、尊重和持续治疗某些社会群体方面的实际提供之间存在绩效差距，这些群体的健康权被剥夺，而其健康风险增加。
Access to quality and affordable healthcare is central to the fulfilment of women’s reproductive and sexual health needs and rights. For this reason, the World Health Organization declared access to appropriate healthcare services during pregnancy and childbirth a fundamental women’s right. Prenatal care is a recognized human right to women’s health in Brazil, as declared by the 1988 Constitution and many Brazilian policies. However, implementing the rights to health in Brazil presents a fundamental performance gap between legal rights and their delivery concerning reproductive health. Through extensive fieldwork including focus groups, interviews with women and participate observation in two municipalities in northeastern Brazil, this article addresses these issues and explores women’s lived experience of access to and their fulfilment of the right to health regarding prenatal healthcare. We offer and account of the experience of women regarding what they identified as barriers that trample their right to health, that is: a) limited personnel and medical equipment as a perception of neglect; b) timely delivery of services: time matters for perception and experience of rights; c) misinformation as a barrier to the exercise of health rights; and d) socioeconomic barriers. These barriers particularly affect the right of women in rural communities, with lower socioeconomic levels and education, as well as brown and black women, from an intersectionality perspective, who are already at greater health risk and inadequate prenatal care. As such, we argue there is a performance gap between what the normative and legal frameworks encourage the health system to do and what the system actually provides in terms of access, equality, respect and continuity of treatment amongst certain groups in society whose right to health are denied while their health risks increase.
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