Democracy, Human Rights and Women's Health

Towards a Feminist Global Health Policy: Power, intersectionality, and transformation

In the realm of global health policy, the intricacies of power dynamics and intersectionality have become increasingly evident. Structurally embedded power hierarchies constitute a significant concern in achieving health for all and demand transformational change. Adopting intersectional feminist approaches potentially mitigates health inequities through more inclusive and responsive health policies. While feminist approaches to foreign and development policies are receiving increasing attention, they are not accorded the importance they deserve in global health policy. This article presents a framework for a Feminist Global Health Policy (FGHP), outlines the objectives and underlying principles and identifies the actors responsible for its meaningful implementation. Recognising that power hierarchies and societal contexts inherently shape research, the proposed framework was developed via a participatory research approach that aligns with feminist principles. Three independent online focus groups were conducted between August and September 2022 with 11 participants affiliated to the global-academic or local-activist level and covering all WHO regions. The qualitative content analysis revealed that a FGHP must be centred on considerations of intersectionality, power and knowledge paradigms to present meaningful alternatives to the current structures. By balancing guiding principles with sensitivity for context-specific adaptations, the framework is designed to be applicable locally and globally, whilst its adoption is intended to advance health equity and reproductive justice, with communities and policymakers identified as the main actors. This study underscores the importance of dismantling power structures by fostering intersectional and participatory approaches for a more equitable global health landscape. The FGHP framework is intended to initiate debate among global health practitioners, policymakers, researchers and communities. Whilst an undeniably intricate and time-consuming process, continuous and collaborative work towards health equity is imperative to translate this vision into practice.

Healthcare professionals' experiences and perceptions regarding health care of indigenous pregnant women in Ecuador

BACKGROUND

Pregnancy is an important life experience that requires uniquely tailored approach to health care. The socio-cultural care practices of indigenous pregnant women (IPW) are passed along the maternal line with respect to identity, worldview and nature. The cultural differences between non-indigenous healthcare professionals (HPs) and IPW could present a great challenge in women's health care. This article presents an analysis from a human rights and gender perspective of this potential cultural divide that could affect the health of the IPW in an Andean region of Ecuador with the objective of describing the health challenges of IPWs as rights holders through the experiences and perceptions of HP as guarantors of rights.

METHODS

We conducted 15 in-depth interviews with HPs who care for IPW in Chimborazo, Pichincha provinces of Ecuador. We utilized a semi-structured interview guide including questions about the experiences and perceptions of HPs in delivering health care to IPW. The interviews were recorded, transcribed and subjected to thematic analysis in Spanish and translated for reporting.

RESULTS

We found disagreements and discrepancies in the Ecuadorian health service that led to the ignorance of indigenous cultural values. Common characteristics among the indigenous population such as illiteracy, low income and the age of pregnancy are important challenges for the health system. The gender approach highlights the enormous challenges: machismo, gender stereotypes and communication problems that IPWs face in accessing quality healthcare.

CONCLUSIONS

Understanding the diverse perspectives of IPW, acknowledging their human rights particularly those related to gender, has the potential to lead to more comprehensive and respectful health care delivery in Ecuador. Further, recognizing there is a gender and power differential between the provider and the IPW can lead to improvements in the quality of health care delivery and reproductive, maternal and child health outcomes.

Correlation between human rights promotion and health protection: a cross country analysis

Purpose

The purpose of this paper is to explore the correlation among health outcomes, and civil and political rights (CPR) and also economic, social and cultural rights.

Design/methodology/approach

The study uses cross-sectional data from 161 countries. The authors use health outcomes and human rights variables in the model. In order to combine dimensions of human rights, this paper uses factor analysis and obtains proxy variables that measure economic, social and cultural rights and CPR. The two proxy variables are used as independent variables to explain variations in health in a regression model. The paper then classifies countries by cluster analysis and explores the patterns of different components of human rights and health outcomes across country clusters.

Findings

The regression model demonstrates that the economic, social and cultural rights variables explain variations in all health outcomes. The relationship between CPR and health is weaker than that of the economic, social and cultural rights. Cluster analysis further reveals that despite the country’s commitment to CPR, those that highly respect economic, social and cultural rights lead to superior health outcomes. The more respect a country has for economic, social and cultural rights, the better the health outcomes for the citizens of that country.

Practical implications

National policies should consider equal emphasis on all dimensions of human rights for further improvements in health.

Originality/value

The sole promotion of CPR such as democracy and empowerment, absence of adequate support of economic, social and cultural rights such as rights to housing, education, food and work can only contribute partially to health.