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厄瓜多尔保护遇险移民的健康权:法律承诺是否得到履行?

Protecting Distress Migrants' Right to Health in Ecuador: Are Legal Commitments Being Fulfilled?

作者信息

Pinto-Alvarez Mariana, Torres Irene, López-Cevallos Daniel F

机构信息

Physician and doctoral student in the Department of Health Promotion and Policy at the University of Massachusetts Amherst School of Public Health and Health Sciences, Amherst, United States.

Technical director of Fundación Octaedro and coordinator of the Observatory on the Implementation of the Health Information System, Quito, Ecuador.

出版信息

Health Hum Rights. 2024 Dec;26(2):121-132.

Abstract

Ecuador's legal framework promises equitable access to health care for all. However, gaps in coverage are being exacerbated by the nearly 500,000 Venezuelan distress migrants remaining in the country over the past decade. The purpose of our study was to examine how the Ecuadorian health system responds to the needs of migrant populations arriving in poor health conditions. We conducted 28 key informant interviews with government officials, health care providers, and representatives of international cooperation agencies and migrant organizations, and analyzed documents from a related Constitutional Court sentence. We find that despite Ecuador's commitments, significant gaps exist in the implementation of protection mechanisms for distress migrants. Systemic obstacles, such as documentation requirements and exclusion from benefits granted by law, remain. Discriminatory practices and concerns about the allocation of limited resources can further impede access. The Constitutional Court case underscores how the judicialization of health may prompt the government to address distress migrants' right to health and document its progress. Ultimately, more comprehensive approaches are needed to promote a more equitable health system that addresses the specific experiences and needs of distress migrants in Ecuador.

摘要

厄瓜多尔的法律框架承诺为所有人提供公平的医疗保健服务。然而,在过去十年中,该国仍有近50万委内瑞拉难民,这加剧了医保覆盖方面的差距。我们研究的目的是调查厄瓜多尔卫生系统如何应对健康状况不佳的移民群体的需求。我们对政府官员、医疗保健提供者、国际合作机构代表和移民组织进行了28次关键信息人访谈,并分析了宪法法院相关判决的文件。我们发现,尽管厄瓜多尔做出了承诺,但在为难民移民实施保护机制方面仍存在重大差距。系统性障碍依然存在,如文件要求以及被依法授予的福利排除在外。歧视性做法以及对有限资源分配的担忧可能会进一步阻碍医保获取。宪法法院的案件凸显了卫生问题的司法化如何促使政府解决难民移民的健康权问题并记录其进展。最终,需要采取更全面的方法来促进建立一个更公平的卫生系统,以解决厄瓜多尔难民移民的特殊经历和需求。

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