Protection of the right to health care of women living with HIV/AIDS (WLA) in Uganda: the case of Mbarara hospital

Abstract

The study examines factors that affect protection of the right to health care of Women Living with AIDS (WLA) in Uganda. It recognizes the critical role Anti-retroviral Therapy (ART) plays in the enjoyment of the rights to life and to health of WLA. Through human rights and gender perspectives, the study explores the major constraints to the protection of the right of WLA to access ART. The study does this in the first instance by analyzing the extent to which the legal and policy framework protects this right in Uganda, and delimits the scope, contours and content of the right, with a particular analysis of the situation of Mbarara Hospital in south-western Uganda. Also identified are the obligations of the state and other actors including private persons and the institutions of globalization. In theory, there is no doubt that WLA have a right of access to health care. However, the realization of this right is inhibited by both internal and external constraints. The first is that the existing legal and policy frameworks are largely antithetical to the protection of this right. Furthermore, there is inadequate attention to a Human Rights Based Approach (RBA) to policy design and implementation with respect to this right. Poverty and inequitable gender relations inhibit the promotion and protection of the right in question, and neither is adequately addressed by the policy framework. Against the above background, the study recommends several legislative, judicial, administrative and other measures for the enhanced protection of the right, including the following: 1. The right to health care should be explicitly recognized and incorporated into the Bill of Rights of the Constitution. 2. A health legislation that clearly spells out the relevant obligations and measurable benchmarks should be enacted. The legislation should expressly provide that the state is obliged to protect the right to health generally and the right to healthcare for vulnerable groups like WLA in particular. The legislation should provide for the active participation of the specific population for whom the policies are intended, such as WLA. 3. A Rights-based Approach (RBA) should be incorporated into the design and implementation of all legislation and policies relevant to the right in question. Free ART should be provided to all WLA in need of it, which ultimately necessitates increased funding to the health sector. 4. Inheritance and property laws and customs should be reformed to ensure that women inherit property. 5. There should be zero tolerance of sexual and domestic violence, and this should be incorporated into the legal and policy frameworks. 6. All necessary steps should be taken to eliminate or mitigate the stigma and discrimination against PLHA. 7. Home based or mobile care should be encouraged. 8. Both men and women should be targeted in any education, counseling and treatment strategies, while WLA should be provided with sustainable projects that enhance their vocational and business skills.