¿Políticas de salud y salud politizada? Un análisis de las políticas de salud sexual y reproductiva en Perú desde la perspectiva de la ética médica, calidad de atención y derechos humanos

Abstract

La ética médica es considerada entre los profesionales de salud como la disciplina que proporciona las bases para brindar una atención adecuada a los pacientes. En los últimos años, los conceptos de calidad de atención y derechos humanos - así como sus diversos discursos acompañantes - se han sumado al concepto de ética médica entre los paradigmas a tener en cuenta en la atención de las personas, tanto a nivel individual, así como a nivel de políticas de salud. El presente trabajo busca analizar tales paradigmas, utilizando como estudio de caso las políticas de salud sexual y reproductiva que se dieron en Perú en los últimos 10 años.

Sexual and reproductive health and rights in Latin America: an analysis of trends, commitments and achievements

“…23 Great disparities exist between states and cities in the same countries, between urban and rural areas, between those who have and do not have access to education, and along ethnic lines. 20,[24][25][26] For example, E Richardson, A-E Birn / Reproductive Health Matters 2011;19 (38):183-196 total fertility rates in the region persist in being 20-80% higher in rural compared to urban areas, and most deaths from cervical cancer are concentrated in women from lower socioeconomic groups. 12,27 In Guatemala, indigenous women are twice as likely as non-indigenous women to die due to pregnancy-related causes.…”

“…For example, Fujimori's government in Peru embarked on an aggressive programme between 1995 and 2000 in which 250,000 women, mostly poor and indigenous women from rural areas, were sterilized without their full and informed consent. 26 A case relating to this policy was presented against the state of Peru to the Inter-American Commission on Human Rights in 1999. The Commission found the Peruvian government to be in breach of the right to life of María Mamérita Mestanza Chavez after she was forced to undergo sterilization in 1996 and then died after post-operative complications were ignored.…”

“…27,41 Structural adjustment programmes in the 1980s-90s had debilitating effects on the health sector in many Latin American countries, as governments were pressured by international financial institutions to lower public expenditure at all costs. 26 The common trend of health sector reform in the region, often part of these structural adjustment packages, has had mixed results in terms of promoting sexual and reproductive health services. 27 An emphasis on efficiency and revenue generation was translated into the contracting out of services and the introduction of user fees, further segmenting access to services along socioeconomic lines.…”

Integrated health service delivery networks and tuberculosis avoidable hospitalizations: is there a relation between them in Brazil?

“…The introduction of a Logistic System is part of a rational and honest organization of flows and counterflows of information, products and people at the HCNs, thereby favouring a system which is effective with regard to reference and counterreference throughout the health care points and Support Systems [ 10 , 46 , 51 , 52 , 54 – 56 ].…”

La planificación familiar como herramienta básica para el desarrollo

“…Un ejemplo claro, que se recoge en una reciente publicación, señala que desde que Alejandro Toledo asumió la presidencia de la república el Ministerio de Salud fue dominado por elementos conservadores religiosos, que se reflejó en un bloqueo al acceso a los métodos anticonceptivos, dicha posición fue asumida como respuesta a las políticas del gobierno de Fujimori (17) .…”