Conscientious Objection and Reproductive Health Service Delivery in Sub-Saharan Africa
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Abstract
Lack of access to quality reproductive health services is the main contributor to the high maternal mortality and morbidity in sub-Saharan Africa (SSA). This is partly due to a shortage of qualified and experienced health care providers. However conscientious objection amongst the available few is a hitherto undocumented potential factor influencing access to health care in SSA. Provision of certain reproductive health services goes counter to some individual’s religious and moral beliefs and practices. Health providers sometimes refuse to participate in or provide such services to clients/patients on moral and/or religious grounds. While the rights to do so are protected by the principles of freedom of religion, among other documents, their refusal exposes clients/patients to the risk of reproductive health morbidity as well as mortality. Such providers are required to refer the clients/patients to other equally qualified and experienced providers who do not hold similar conscientious objection. Access to high quality and evidence-based reproductive health services by all in need is critical to attaining MDG5. In addressing factors contributing to delay in attaining MDG5 in SSA it is instructive to consider the role of conscientious objection in influencing access to quality reproductive health care services and strategies to address it (Afr J Reprod Health 2012; 16[1]:15-21).
RésuméObjection de conscience et la dispensation des services de santé de la reproduction en Afrique subsaharienne : Le manque d’accès aux services de santé de la reproduction de bonne qualité contribue le plus à la mortalité et morbidité élevée en Afrique subsaharienne (ASS). Ceci est dû en partie à un manque de dispensateurs des services médicaux qualifiés et expérimentés. Néanmoins, une objection de conscience qui existe parmi les quelques-uns disponibles est un facteur potentiel non documenté qui influence l’accès aux services médicaux en ASS. La dispensation de quelques services de santé de la reproduction va à l’encontre des croyances et pratiques religieuses de certaines personnes. Les dispensateurs des services médicaux refusent parfois de participer à l’assurance de tels services aux clientes / patientes pour des raisons morales et /ou religieuses. Alors que les droits qui permettent de le faire sont protégés par les principes de la liberté de la région parmi d’autres documents, leur refus expose les clientes /patientes au risque de la morbidité de santé de la reproduction aussi bien qu’à la mortalité. Il faut de tels dispensateurs pour envoyer les clientes /patientes aux dispensateurs aussi qualifiés et expérimentés qui n’ont pas une objection de conscience pareille. L’accès aux services de santé de la reproduction qui sont basés sur les constatations pour tous ceux qui les désirent est crucial pour l’accomplissement de l’OMD-5. En s’occupant des facteurs qui contribuent au délai dans l’accomplissement de l’OMD -5 en ASS, il est instructif de considérer le rôle de l’objection de conscience dans l’influence de l’accès aux services de santé de la reproduction de qualité et les stratégies permettant de s’en occuper (Afr J Reprod Health 2012; 16[1]:15-21).
Keywords: Conscientious objection, reproductive health service delivery, impact, sub-Saharan Africa
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