在新自由主义全球化和保守势力反弹的时代推进孕产妇健康权利的五个教训。
Five Lessons for Advancing Maternal Health Rights in an Age of Neoliberal Globalization and Conservative Backlash.
机构信息
Lecturer on law and senior fellow on global health and rights at the Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics at Harvard Law School; adjunct senior lecturer on health policy and management at Harvard T.H. Chan School of Public Health; and senior advisor on health policy and human rights at Partners In Health, Boston, United States.
出版信息
Health Hum Rights. 2023 Jun;25(1):185-194.
After considerable progress in recent decades, maternal mortality and morbidity (MMM) either stagnated or worsened in most regions of the globe between 2016 and 2020. The world should be outraged given that we have known the key interventions necessary for preventing MMM for over three-quarters of a century. Since the 1990s, human rights advocacy on MMM has gained crucial ground, demonstrating that entitlements related to maternal health are judicially enforceable and delineating rights-based approaches to health in the context of MMM. Nonetheless, evident retrogressions, coupled with ballooning social inequalities, redoubled austerity post-pandemic, and a conservative populist backlash against reproductive rights, underscore the steep challenges we face. This paper offers five lessons gleaned from what we have achieved during the past 30 years of human rights advocacy on maternal health, and where we have fallen short: (1) maternal health is not a technical challenge alone and is inseparable from reproductive justice; (2) reproductive justice requires strengthening health system infrastructures; (3) we must center the political economy of global health in our advocacy, not just national policies; (4) litigation is part of a larger advocacy toolkit, not a go-it-alone strategy; and (5) we must use metrics that tell us women are dying and what to do.
尽管在过去几十年中取得了相当大的进展,但在 2016 年至 2020 年期间,全球大多数地区的孕产妇死亡率和发病率(MMM)要么停滞不前,要么恶化。鉴于我们已经了解预防 MMM 所需的关键干预措施超过四分之三个世纪,这是令人愤怒的。自 20 世纪 90 年代以来,孕产妇死亡率的人权倡导已取得重大进展,证明与孕产妇健康相关的权益在司法上是可执行的,并在 MMM 背景下界定了基于权利的健康方法。然而,明显的倒退,加上不断扩大的社会不平等,大流行后的紧缩政策,以及对生殖权利的保守民粹主义反弹,突显了我们面临的严峻挑战。本文从过去 30 年孕产妇健康人权倡导中取得的成就以及不足之处中汲取了五个教训:(1)孕产妇健康不仅仅是一个技术挑战,与生殖正义是不可分割的;(2)生殖正义需要加强卫生系统基础设施;(3)我们必须将全球卫生的政治经济学纳入我们的倡导工作,而不仅仅是国家政策;(4)诉讼是更大的倡导工具包的一部分,而不是单独行动的策略;(5)我们必须使用可以告诉我们妇女正在死亡以及应该采取什么措施的指标。
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