Samuel Jeannie, Frisancho Ariel
Assistant Professor at the School of Health Studies, University of Western Ontario, Canada.
Country Director of the Catholic Medical Mission Board in Peru and former President of ForoSalud in Lima, Peru.
Health Hum Rights. 2015 Dec 10;17(2):123-34.
This paper discusses a human rights-based initiative developed in Puno, Peru, in which indigenous women seek to address problems with access and quality of care by monitoring their government-run health facilities. The evidence of impact presented here is based on a qualitative study of the rights-based monitoring initiative (53 key informant interviews in 2010-2011), corroborated by findings from a review of previous qualitative and quantitative assessments of the initiative. The research findings show that the citizen monitors are able to identify, document, and act on a set of persistent "everyday injustices" experienced by health care users. These can include illegal financial charges, abusive or dismissive treatment, extended wait times, and culturally insensitive care. These results suggest that citizen monitoring can lead to important changes at the health facility level, as well as in the lives of the volunteer monitors. It can also provide key information that can be used to put previously neglected concerns onto local and national health policy agendas. However, as this article explores, the citizen monitoring initiative faces several of its own challenges.
本文讨论了秘鲁普诺开展的一项基于人权的倡议，在该倡议中，土著妇女试图通过监测政府运营的医疗机构来解决医疗服务可及性和质量方面的问题。此处所呈现的影响证据基于对该基于权利的监测倡议的定性研究（2010 - 2011年进行了53次关键 informant访谈），并得到了对该倡议先前定性和定量评估结果的佐证。研究结果表明，公民监测员能够识别、记录医疗服务使用者所经历的一系列持续存在的“日常不公正现象”，并就此采取行动。这些现象可能包括非法收费、虐待或冷漠对待、长时间等待以及缺乏文化敏感性的护理。这些结果表明，公民监测能够在医疗机构层面以及志愿监测员的生活中带来重要改变。它还能提供关键信息，用于将先前被忽视的问题纳入地方和国家卫生政策议程。然而，正如本文所探讨的，公民监测倡议自身也面临若干挑战。
