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Conversas com o movimento social negro sobre vulnerabilidades em relação às DSTs/Aids / Conversations with the black social movement about vulnerabilities in relation to STD / AIDSAna Lúcia Spiassi 16 March 2011 (has links)
A intensificação do debate sobre a epidemia de DST/aids na população negra, trazida por entidades da sociedade civil na última década, aparece na esteira da recente sistematização de políticas voltadas para a saúde desta população. O objetivo do presente estudo foi conhecer a avaliação que o movimento social negro do ABC paulista tem sobre as condições de vulnerabilidade em relação às DST/aids vividas pelos cidadãos negros da região. Trata-se de estudo qualitativo, construído com base em entrevistas individuais em profundidade com lideranças diversas deste movimento. A representatividade dos entrevistados foi ancorada no conceito de Luta por Reconhecimento e a estrutura das entrevistas foi organizada a partir do conceito teórico orientador de todo o trabalho que é o conceito de Vulnerabilidade. A construção e interpretação das entrevistas foram apoiadas em uma concepção de linguagem entendida como desveladora de processos de interação a partir do cotejo de duas tradições filosóficas principais: o materialismo histórico dialético e a hermenêutica. As avaliações dos entrevistados sobre as três dimensões de vulnerabilidades vivenciadas pelos negros em relação às DST/aids, produziram um quadro no qual diversas situações cotidianas são relatadas e discutidas. No plano institucional, três grupos centrais de problemas foram levantados: as condições de atendimento nos serviços de saúde; a atuação do Estado sobre as condições de iniquidade e a relação do Estado com o movimento social. Em relação às vulnerabilidades sociais, foram destacadas as desigualdades sócio-econômicas entre negros e não-negros e suas consequências, que incluem a persistência de baixa escolaridade, precarização das moradias, fixação da população negra para a periferia das áreas urbanas, barreiras à ascensão social, desigualdades sociais em saúde e a persistência da discriminação racial nas relações sociais. Em relação às vulnerabilidades individuais, os entrevistados relataram algumas de suas vivências pessoais e familiares em que sobressaem os sentimentos de insegurança e desrespeito trazidos pela tensão da discriminação racial, o que tem implicações não apenas morais, mas manifesta-se também no modo como os sujeitos vivenciam, apreendem e lidam com os aspectos dos demais planos de vulnerabilidade, acima citados. Os entrevistados apontaram, ainda, alternativas de reconstrução prática com potencial de redução do impacto da vulnerabilidade para a aids entre os brasileiros negros / The intensified discussion about the STD/AIDS epidemic among black population, brought about by civil society organizations in the last decade, appears in the wake of recent policies aimed at health of this population. The objective of this study was to explore the assessment that the black social movement in the ABC region (State of SP) make about vulnerability conditions regarding STD/AIDS experienced by black citizens from the region. This is a qualitative study, built on individual in-depth interviews with several leaders of this movement. Representativeness of respondents was based on the concept of \"Struggle for Recognition\", and the structure of the interviews on the theoretical concept of Vulnerability that guided the whole work. The structure and interpretation of interviews were backed by designing a language understood as unfolding processes of interaction based on confrontation of two major philosophical traditions: historical dialectical materialism and hermeneutics. The evaluations of the respondents about the three dimensions of vulnerability experienced by brazilian blacks in relation to STD/AIDS, resulted in a framework in which many daily situations are reported and discussed. At institutional level, three core groups of issues were raised: the conditions of care in health services, State action concerning inequity conditions and the relation between the State and social movements. As to social vulnerabilities, socioeconomic inequalities and their consequences were highlighted between blacks and non-blacks, including persistence of low schooling, precarious housing, setting the black population in the periphery of urban areas, barriers to social mobility, health inequalities and persistence of racial discrimination in social relations. In relation to individual vulnerabilities, respondents reported some of their personal and family experiences that stress feelings of lack of confidence and disrespect due to tension resulting from racial discrimination, which has moral implications and also manifests in how the subjects experience, perceive and deal with vulnerability aspects at other levels, as mentioned above. Yet, the interviewees pointed out practical reconstruction alternatives with potential to reduce the impact of vulnerability to AIDS among black Brazilians
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Impact d’un réseau national sur la prise en charge des tumeurs rares du péritoine / Impact of dedicated healthcare organization in the management of rare peritoneal surface malignanciesVilleneuve, Laurent 19 October 2017 (has links)
Les cancers primitifs du péritoine ont une incidence qui varie de 1 à 2 cas/an/1 000 000 d'habitants selon les types. Leur diagnostic et leur prise en charge sont complexes et exigent des spécificités de moyens et de compétences. Dans le cadre du plan cancer, le réseau national de prise en charge des tumeurs rares du péritoine (RENAPE) s'est structuré autour de centres experts et de missions transversales pour garantir à chaque patient, l'accès à l'expertise médicale et diagnostique. Après une revue de la littérature sur l'épidémiologie de ces cancers et leurs caractéristiques de prise en charge, l'objectif de ce travail est d'évaluer l'impact de l'organisation du réseau RENAPE, et de ses actions mises en œuvre, pour améliorer le parcours de soins des patients et favoriser l'évolution des pratiques dans la prise en charge de ces cancers. Une première étude, menée sur une cohorte de mésothéliomes péritonéaux, démontre l'apport de l'organisation RENAPE sur la diminution des délais de prise en charge thérapeutique. Une seconde étude rapporte les actions mises en œuvre par le réseau pour standardiser et homogénéiser les procédures chirurgicales et approches thérapeutiques. Une troisième étude présente les caractéristiques épidémiologiques de la population issue de l'observatoire mis en place au sein du réseau. Enfin, une quatrième étude analyse la distribution spatiale des patients pris en charge au sein du réseau et évalue l'impact de facteurs socio-économiques sur l'incidence des mésothéliomes péritonéaux. En s'appuyant sur une dynamique de réseau, l'organisation RENAPE a permis de structurer une filière de référence qui intègre une approche multidisciplinaire / Rare peritoneal malignancies (RPM) are extremely rare with annual incidence of 1 to 2 case/1,000,000 of the population per year depending types. Diagnostic and therapeutic management are complex and need specialized clinical skills associated to specific technical platforms. As part of the French cancer plan the national network for the treatment of rare peritoneal malignancies (RENAPE) has been organized including expert centres and cross-disciplinary healthcare issues to allow the patients to access to clinical expertise. After literature review of epidemiological data, the aim of this work is to evaluate the impact of the RENAPE healthcare organization on the clinical pathways of patients and to support the development of clinical practices in the management of RPM. A first study demonstrated the benefit of the RENAPE network to reduce the therapeutic management delays in cohort of peritoneal mesothelioma (PM). Then a second work reports the RENAPE initiative to standardize and homogenize the surgical procedures and therapeutic approach. A next study describes the epidemiological characteristic of the population from the RENAPE registry. Finally a fourth study analyzes the geographical distribution of RENAPE cohort and to evaluate the impact of the socioeconomic factors on the PM incidence. Based on the network approach, the RENAPE organization succeeded to structure a healthcare system with multidisciplinary integrated approach
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Factors that influence utilization of primary health facilities by adolescents in Tafelsig, Mitchells PlainGovender, Thashlin January 2012 (has links)
Magister Public Health - MPH / Promoting positive and healthy decision-making practices and encouraging the utilization of health care facilities amongst adolescents is an important public health priority given that the period of adolescence is characterized by experimentation and risk taking behaviour. In the Tafelsig area of Mitchell‟s Plain, a poor socio-economic community within the Cape Town metropole, adolescents are exposed to a range of social problems (such as alcohol and substance abuse) that can potentially be harmful to their health. Given this context there was some concern
raised by the sub-district health management team that adolescents are not making sufficient use of the local health facilities. The purpose of this study was to gain a greater understanding of the factors that contribute to, or hinder, the utilization by adolescents of the public health facilities in the Tafelsig area and in turn provide the Department of Health with information on adolescents‟
preferences concerning access to and use of the local primary-level health services in Mitchells Plain.An exploratory descriptive study was conducted to explore the topic using qualitative research methods. Permission to conduct the research was obtained from the Higher Degrees Committee of the University of the Western Cape and the School Principal. In-depth interviews were conducted with eight Grade 9 and seven Grade 10 male and female learners from the local secondary school - all of whom were randomly selected from a list of learners who indicated
their willingness to participate in the study and who had obtained the written consent from their parents or guardian to do so. Interviews with the learners explored the positive and negative experiences, perceptions and opinions they have of using – or contemplating the use of – the local health facilities. The data from these interviews were analyzed using thematic content analysis.The study demonstrated that even when public health services are available, adolescents are often not in a position themselves to choose for themselves: their parents or guardians invariably make the choice for them. At times they are also reluctant to use public health facilities for fear of being judged by health personnel for being sexually active. The idea of waiting for long periods of time to see a health professional, or being observed at the health facility by other members of their community, are also considered to be disincentives.Many of the learners interviewed expressed a need for more information about sexual and reproductive health issues and matters that affect their health. The findings of this study also
suggest that there is an urgent need for youth-friendly health services to be made available in the Mitchells Plain community. It is thus recommended that the Department of Health strategically assess whether an existing public health facility can be re-orientated to cater for the specific health needs of adolescents in Mitchells Plain.
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Health Status and Access Disparities Among the Uninsured Working-Age Population in a Safety-Net Healthcare Network in Tarrant County, TexasQueen, Courtney M. 12 1900 (has links)
The objective of this research was to determine if healthcare access disparities exist across race and gender in a publically funded safety-net healthcare system in Texas. Data were examined from a representative random sample of 1468 adults aged 18-64 who were patients in this safety-net system in July and August of 2000 and were analyzed using binary logistic regression and chi-square measures of significance. Major Findings: On measures of health status - overall health rating (p =.051), limited employment (p =.000), energy level (p =.001), and worry (p =.012) - Anglos reported the worst health; Mexican Americans, the best health; with African Americans intermediate. Mexican Americans were more likely to have never had health insurance, and to also have had insurance in the past year; Anglos were least likely to have ever had insurance (p =.015) or to have had insurance in the past year (p =.000). On use of EDs (p =.028), problems getting prescription medicines (p =.029), and foregoing other necessities of life to pay for healthcare, Mexican Americans were least disadvantaged with African Americans reporting greatest use of EDs among both men and women, and Anglos the most problems with prescription medicines and foregoing care, especially among women. Logistic regression revealed that health status was the strongest predictor of problems accessing healthcare in all groups; the poorer health status of safety-net patients, the more problems they had accessing care. Patterns of poor reported health status and greater problems accessing care among Anglos relative to other groups is discussed in terms of social drift and relative deprivation.
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Ethnic Identity as a Moderator for Perceived Access to Healthcare Among LMSMJanuary 2020 (has links)
abstract: The Centers for Disease Control and Prevention (2017) note that gay, bisexual, and other men who have sex with men (collectively referred to as MSM) face more barriers to accessing health care compared to other men. Such barriers include, lack of cultural- and sexual identity-appropriate medical and support services, concerns about confidentiality, and fear of discussing sexual practices or orientation in a medical setting. In comparison to other MSM populations, Latino MSM (LMSM) report having the least amount of access to health care (McKirnan et al., 2012). The purpose of the present study is to elucidate how individual- (i.e., age, education level, and income level), community- (i.e., social support and neighborhood collective efficacy), and sociocultural-level factors (i.e., immigration status, heterosexual self-presentation, sexual identity commitment, sexual identity exploration, and ethnic identity affirmation and belonging) may relate with perceived access to healthcare. It is hypothesized that ethnic identity affirmation and belonging will moderate relations between the aforementioned predictors and perceived access to health care based on increasing evidence that ethnic identity, or one’s sense of affirmation and belonging to one’s ethnic group, may be a health protective factor. Among a sample of 469 LMSM, this study found that there were several predictors across all three levels (i.e., individual, community, and sociocultural) of perceived access to healthcare. Additionally, data supported evidence that ethnic identity affirmation and belonging (Phinney, 2003) acts as a moderator of other predictors of perceived access to healthcare in this sample. These findings can inform outreach interventions of researchers and healthcare providers about psychosocial and cultural barriers and facilitators of access to healthcare. / Dissertation/Thesis / Masters Thesis Counseling Psychology 2020
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Des principes de responsabilité et de solidarité pour un accès équitable aux soins de santé : le cas des travailleurs de l'informel urbain du Cameroun en situation de vulnérabilitéMoubé, Moubé 09 1900 (has links)
La question de l’accès financier des personnes socialement défavorisées aux soins de santé est aujourd’hui un enjeu éthique de grande importance dans de nombreux pays à faible revenu ou en voie d’émergence. On peut se demander comment l’équité dans l’accès aux soins peut être rendue effective puisque l’égalité des chances pour tous et la santé sont des pré-requis aux choix de vie et à la réalisation de soi. Les soins de santé sont donc d’une importance éthique particulière du fait qu’ils contribuent à préserver notre statut comme citoyens pleinement fonctionnels.
Au Cameroun, bien que des efforts considérables soient consentis par les pouvoirs publics et leurs partenaires extérieurs pour favoriser l’accès aux soins des personnes défavorisées, le secteur de la santé reste encore très marqué par l’inégalité dans l’accès financier aux prestations sanitaires. Les médicaments les plus essentiels ne sont pas financièrement à la portée de tous et les coûts d’accès aux soins ambulatoires et hospitaliers dans les formations sanitaires sont manifestement prohibitifs pour une large frange de la population. Lors des épisodes de maladie, l’accès aux soins se fait par le paiement direct au point d’accès, et la pratique de l’automédication s’est répandue du fait de l’incapacité des personnes socialement défavorisées à payer leurs soins sans courir le risque de perdre l’essentiel de leur revenu. Les mesures de prise en charge sociale ou des systèmes de financement qui garantissent la réduction des inégalités entre les classes sociales sont fortement limitées par les faibles capacités d’une économie qui repose essentiellement sur l’informel.
Sur la base de cette réalité, cette thèse analyse à partir du cas des travailleurs vulnérables du secteur informel urbain, la pertinence du choix politique de la couverture universelle santé au Cameroun à travers les principes de responsabilité et de solidarité. La population d’étude choisie est celle des travailleurs vulnérables du secteur informel en considération des problématiques liées à leur accès aux soins de santé, de l’importance de leur apport dans l’économie du pays ( 90 % des travailleurs) et du rôle qu’elle pourrait jouer dans l’atteinte de l’objectif de la couverture universelle santé.
La thèse analyse donc, d’une part, les conditions et les modalités de répartition des biens sociaux qui répondent à la nécessaire redistribution équitable des ressources, en l’occurrence l’accès aux soins de qualité. Après avoir montré les préoccupations d’ordre politique, social, économique et éthique liées au problème d’accès universel aux soins, la thèse propose des stratégies opérationnelles susceptibles de conduire à l’amélioration de la qualité des soins et à un assainissement de la gestion du secteur des services de soins (éthique du care et éthique de bonne gouvernance).
Aussi, dans la perspective de la recherche d’un financement local soutenable et durable de l’accès de tous aux soins, la thèse propose une approche participative. L’exploration de cette perspective aboutit au résultat qu’une approche inclusive et intégrée de promotion de l’économie informelle (dynamisation de ses activités et potentialisation de ses acteurs) pourrait faire de ce secteur un véritable levier de développement économique et social. Un développement social et solidaire durable et susceptible, sur le long terme, de réaliser l’objectif de la couverture universelle santé. En d’autres termes, elle propose des stratégies de capabilisation et de responsabilisation des travailleurs du secteur informel, en vue d’une société plus impliquée, plus responsable et plus solidaire. Une approche susceptible de matérialiser le droit à la santé, de construire l’autonomie des travailleurs en situation de vulnérabilité et de renforcer leurs capacités contributives à travers une opérationnalisation adaptée au contexte des principes de responsabilité et de solidarité. / Financial access to health services for socially disadvantaged groups is an important ethical stake in many low-income countries or in process of emergence. Equity achievement in the healthcare system, equal opportunities and good health are prerequisite to wellbeing. Thus, access to healthcare represents a key ethical issue for people to keep their full functional citizens status.
In Cameroon, efforts have been made by public authorities and their foreign partners to favour access to healthcare for the disadvantaged groups. However the incentives fall short to guarantee a sufficient healthcare access level. Basics medicines still are not affordable. Furthermore, the high financial costs of ambulatory and hospitals care do not help. In case of sickness, access to health service occurs unless a cash payment before the service, leading to a situation of health care non-affordability. Hence, self-medication is a direct outcome. The economy is mostly informal in the country, so it is not have the capacity to finance welfare and social systems, which are tools usually used to reduce disparities.
This thesis analyzes the relevance of the political choice of universal health coverage in Cameroon through the principles of social responsibility and solidarity. The analysis was performed using the case of vulnerable urban workers of the informal sector, who represent 90% of all the workers in the country. The population of study is the vulnerable workers of the informal sector, who faced issues in accessing healthcare.
This thesis analyzes the conditions and modalities of distribution of social goods (access to quality care) in order to establish equity in resources redistribution. Lickewise, political, social, economic and ethical issues related to the universal problem of access to care have been assessed. The operational strategies that lead to improved quality of care and a better management of the healthcare services (good care and ethics of good governance in the system) come forward.
Furthermore, a participatory approach is advocated here under the form of the mobilisation of a sustainable local funding of universal access to care. The exploration of this perspective leads to the result that an inclusive and integrated approach to promoting the informal economy (boosting its activities and potentiating its actors) could make this sector a real social and economic development lever. A social and inclusive sustainable development over the long term, might lead to the goal of universal health coverage. This thesis recommends the accountability of the informal sector`s workers for a more involved, responsible and caring society. Hence, this approach is likely to materialize the right to health, to build the autonomy of workers in vulnerable situations and strengthen their ability to contribute through an adapted operationalization to the principles of responsibility and solidarity.
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Exploring the Association Among Provider-Patient Relationship, Communication, Accessibility and Convenience and Perceived Quality of Care from the Perspective of Patients Living with HIV Before and During SARS-CoV-2 PandemicCaldwell, Elisha 31 August 2021 (has links)
No description available.
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Moving from Daji towards Noma: Changing the perception of a spiritual towards a treatable disease : A case study of Hilfsaktion Noma e.V. in NigerDe Vriese, Shauni Denise January 2021 (has links)
Noma is a neglected non-contagious disease of the face and mouth affecting children living in extreme poverty. Due to the quick spread of the disease, the mortality rate is estimated at 90% when treatment is not started within two weeks of onset. Even though Hilfsaktion Noma e.V. (HAN) has been actively spreading awareness about the disease and offering treatment and reconstructive surgery, the mortality rate has not decreased. Moreover, patients reaching the noma centre often present severe sequela, affecting their speech, eating and drinking ability. Therefore, this study investigates the challenges faced by noma patients to seek medical care in Niger and how to overcome them. A mixed-method approach was performed; a survey among healthcare workers of HAN was supplemented with an interview with a key informant of the organisation in order to get a wider understanding of the possible challenges noma patients encounter. Accessibility to healthcare, as well as distance to the hospital and lack of transportation means were identified as the challenges with the highest impact on the health-seeking behaviour of noma patients. The lack of knowledge about noma and treatment costs were the second main challenge. This information gap is reflected in stigmatization, inadequate health care staff and seeking aid from traditional healers, which seriously endangers the life of patients. To overcome these challenges, a community-based surveillance system in combination with a multisectoral approach was proposed. This low-cost system can not only eliminate noma by facilitating the early detection of noma patients, but it can also contribute to sustainable health in Niger and other countries in the Noma belt.
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Universalidade e políticas públicas: a experiência dos imigrantes no acesso à saúdeFaleiros, Sarah Martins 27 February 2012 (has links)
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Previous issue date: 2012-02-27 / The right to health is already recognized at international level and, in most cases, at national level. However, it is still restricted to citizens in most countries. Even in the countries that recognize immigrants’ right to health, there are still many barriers, specially to the undocumented. This dissertation aims to understand how immigrants access health care services, focusing on the implementation process of public policies and its potential barriers. In order to achieve these objectives we studied two cases that guarantee immigrants’ access to health based on different mechanisms: the one of bolivian immigrants that live in the city of São Paulo, Brazil, and the brazilian immigrants that live in the metropolitan area of Boston, USA. A qualitative research has been conducted with 46 immigrants in both countries. Moreover, we interviewed 16 experts, bureaucrats and street level bureaucrats: people that work directly with immigrants in the health services, or that research and work with the issues we raise in this dissertation. The interviews were based on a semi structured script, then transcripted and analyzed. The analyses showed that both systems present distinct barriers to immigrant’s access to health. In São Paulo’s case study, the restrictions occurred by the fixation of the quantity of offered services, and by lack of training of the professionals that work directly with this public. In the metropolitan area of Boston, it occurred by the imposition of costs and service’s allocation for different classes of clients (LIPSKY, 1980). These barriers could be overcome by governments and their implementing agencies’ actions. Among these, we highlight multicultural policies and government programs that aims to actively promote preventive health, such as Programa Saúde da Família, in Brazil. We could observe the important role played by street level bureaucrats in this process, facilitating the access, creating creative solutions, or raising difficulties to immigrants’ access to health. We suggest further research that deepens the analysis on these actors role regarding the implementation process of the right to health. / O direito à saúde já é reconhecido no plano internacional e, em muitos casos, nacional. No entanto, ele ainda está restrito apenas aos cidadãos na maior parte dos países do mundo e, mesmo naqueles países que o reconhecem, ainda existem muitas barreiras para que os imigrantes, especialmente os indocumentados, usufruam dos serviços de saúde. Esta dissertação tem como objetivo entender como acontece o acesso dos imigrantes à saúde, focando no processo de implementação das políticas públicas e nas barreiras que se formam a partir desse. Para isso estudamos dois casos que garantem o acesso à saúde, mas por meio de mecanismos diferentes: o dos imigrantes bolivianos que vivem na cidade de São Paulo (SP – Brasil) e dos imigrantes brasileiros que vivem na zona metropolitana de Boston (MA – EUA). Realizou-se uma pesquisa qualitativa com 46 imigrantes nos dois países. Além disso, entrevistamos 16 especialistas e burocratas de nível de rua, pessoas que atuam diretamente com os imigrantes na ponta dos serviços de saúde, ou que pesquisam e trabalham nestas questões. As entrevistas foram realizadas a partir de um roteiro semi-estruturado, transcritas e analisadas. A análise mostrou que ambos os sistemas apresentam barreiras distintas, no caso de São Paulo pela fixação da quantidade de serviços oferecidos e no segundo caso pela imposição de custos e pela alocação de serviços por classes de clientes diferenciados (LIPSKY, 1980). Essas barreiras puderam ser contornadas por ações promovidas pelos governos e suas agências implementadoras. Entre essas destacamos políticas multiculturais e programas que buscam promover a saúde preventiva de forma ativa, como é o caso do Saúde da Família. Pudemos observar também o importante papel desempenhado pelos burocratas de nível de rua nesse processo, seja facilitando o acesso, por meio da criação de soluções criativas, seja o dificultando. Sugerimos que estudos futuros aprofundem a análise do papel desses atores no processo de implementação do direito à saúde.
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Le problème de l'accès aux soins en Afrique francophone subsaharienne : le cas de la république du Congo / The problem of access to care in sub-Saharan francophone Africa : the case of the Republic of CongoBoukoulou, Phares 15 December 2017 (has links)
Le Congo a signé bon nombre d'accords internationaux relatifs à la protection du droit à la santé. Cependant, en dépit de la signature et la ratification de ces accords, le droit à la santé n'est pas encore devenu un droit protégé stricto sensu et la population congolaise connait toujours de grands écueils dans l'accès aux soins. D'aucuns affirment que cette notion "d'accès aux soins" n'est qu'un slogan au Congo. Que la santé ne fait pas partie des priorités de politiques publiques et que le manque de volonté des autorités publiques comme en témoigne l'absence d'assurance maladie ne rendent pas possible le recours effectif aux soins. D'autres nuancent par contre ces affirmations et considèrent que même si,des difficultés existent dans l'accès aux soins au Congo, ces difficultés ne sont pas spécifiques à ce pays. Dans bon nombre de pays africains, voire occidentaux, des obstacles existent également dans l'accès aux soins. Par ailleurs, le Congo a essayé tout de même d'entreprendre des actions pour améliorer l'accès aux soins de sa population. Que ces actions menées ont été appuyées par le soutien des Organisations internationales comme l'OMS et aussi par des ONG. / Congo has signed a number of international agreements on the protection of the right to health. Despite the signing and ratification of these agreements, however, the right to health has not yet become a protected right stricto sensu, and the Congolese population still faces great pitfalls in access to care. Some say that this notion of "access to care" is only a slogan in the Congo. That health is not part of public policy priorities and that the lack of will of the public authorities as evidenced by the lack of health insurance do not make effective use of the care possible. Others, on the other hand, qualify these assertions and consider that even if difficulties exist in access to care in the Congo, these difficulties are not specific to this country. In many African and even western countries there are barriers to access to care. On the other hand, Congo has tried to take action to improve access to health care for its population. That these actions were supported by the support of International Organizations such as WHO and also by NGOs. Ac
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