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社会团结、人权与集体行动:南非国家医疗保险实施中的考量

Social Solidarity, Human Rights, and Collective Action: Considerations in the Implementation of the National Health Insurance in South Africa.

作者信息

Douwes Renate, Stuttaford Maria, London Leslie

机构信息

Honorary research associate at the University of Cape Town, South Africa, and currently works for Simavi, a Dutch nongovernmental organization in the field of sexual and reproductive health and rights.

Honorary senior lecturer at the School of Public Health and Family Medicine, University of Cape Town, South Africa.

出版信息

Health Hum Rights. 2018 Dec;20(2):185-196.

Abstract

Participation is recognized as an important contribution to implementing the right to health. It features as a key element of the global movement to achieve universal health coverage. The mobilization of groups into collective action is central in this. In South Africa, universal health coverage has become a feature of health policies, with the country's new National Health Insurance (NHI) scheme in the process of being established. The NHI is considered an experiment in social solidarity. This paper provides insights into civil society's experiences in the pursuit of universal health coverage via the implementation of the NHI. It explores the interplay of trust, reciprocity, and altruism and how these individual actions can advance toward solidarity and collective action. Our research shows that the road to universal health coverage via the rollout of the NHI will be complex. However, opportunities for collective action exist, including shared learning about human rights, as well as local initiatives within trusted circles. A collective health commitment is based on trust between the government and citizens. Thus, one of the first steps in implementing the NHI should focus on rebuilding trust, which could be developed by establishing platforms for citizen participation.

摘要

参与被视为对实现健康权的一项重要贡献。它是实现全民健康覆盖全球运动的一个关键要素。将群体动员起来采取集体行动是其中的核心所在。在南非,全民健康覆盖已成为卫生政策的一个特点,该国新的国家医疗保险(NHI)计划正在建立过程中。NHI被视为一项社会团结的试验。本文深入探讨了民间社会在通过实施NHI追求全民健康覆盖方面的经验。它探讨了信任、互惠和利他主义之间的相互作用,以及这些个体行动如何能够朝着团结和集体行动迈进。我们的研究表明,通过推出NHI实现全民健康覆盖的道路将是复杂的。然而,集体行动的机会是存在的,包括关于人权的共同学习,以及在可信赖圈子内的地方倡议。集体健康承诺基于政府与公民之间的信任。因此,实施NHI的首要步骤之一应侧重于重建信任,这可以通过建立公民参与平台来实现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd58/6293357/1bbb47e86d2b/hhr-20-185-g001.jpg

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