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Public Health Ethics and Rights in Healthcare Programmes

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African Perspectives on Ethics for Healthcare Professionals

Part of the book series: Advancing Global Bioethics ((AGBIO,volume 13))

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Abstract

The chapter explains the nature of public health in Africa and discusses the development of public health ethics as an academic discipline. Also, it introduces the reader to basic theoretical frameworks for public health interventions, including the most important ethical principles of public health (e.g. necessity, proportionality, reciprocity, beneficence, consideration, community engagement, common good, common sense, solidarity). Lastly, it describes the context of public health ethics in Africa and discusses the challenges of ethics in the implementation of research and health programmes that affect the public – like quarantine for infectious diseases and the public health concerns of mass immunisation. It is critically important to apply the mentioned principles and to balance between personal rights and choices, and public safety and well-being while only choosing necessary, effective, appropriate and proportional means.

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References

  • African Union. n.d. Agenda 2063 – First ten years implementation plan, 8. Retrieved from www.un.org/en/africa/osaa/pdf/au/agenda2063-first10yearimplementation.pdf.

  • Banjul Charter. 1981. African Charter on Human and Peoples’ rights, Banjul Charter, 27 June 1981. Retrieved from www.achpr.org/instruments/achpr/.

  • Beauchamp, T.L., and J.F. Childress. 2001. Principles of biomedical ethics. 5th ed. Oxford University Press: New York.

    Google Scholar 

  • Belmont Report. 1978. Belmont report. Washington, DC. Retrieved from https://www.hhs.gov/ohrp/regulations-and-policy/belmont-report/index.htm.

  • Berger, G. 2012. Theorising African communications: The bad news signalled by broadcast digital migration policy. Communication 38 (2): 135–146.

    Google Scholar 

  • Blacksher, E. 2014. Public health ethics. Retrieved from https://depts.washington.edu/bioethx/topics/public.html.

  • Bolu, O.O., V. Allread, T. Creek, E. Stringer, F. Forna, M. Bulterys, and N. Shaffer. 2007. Approaches for scaling up human immunodeficiency virus testing and counselling in prevention of mother-to-child human immunodeficiency virus transmission settings in resource-limited countries. American Journal of Obstetrics and Gynecology 197 (3 Suppl): 83–89.

    Article  Google Scholar 

  • Braveman, P., and S. Gruskin. 2003. Defining equity in health. Journal of Epidemiology & Community Health 57: 254–258.

    Article  Google Scholar 

  • Brownson, R.C., J.E. Fielding, and C.M. Maylahn. 2013. Evidence-based decision making to improve public health practice. Frontiers in public health services & systems research 2 (2): 1–9.

    Google Scholar 

  • Center for Disease Control. 2016. Ebola (Ebola Virus Disease). Retrieved from https://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/index.html.

  • Center for Economic and Social Rights. n.d. The OPERA framework. Retrieved from www.cesr.org/sites/default/files/the.opera_.framework.pdf.

  • Chirwa, D.M. 2002. Non-state actors’ responsibility for socio-economic rights: The nature of their obligations under the South African constitution. ESR Review: Economic and Social Rights in South Africa 3 (3): 2–6.

    Google Scholar 

  • Cohen, M.S., C. Holmes, N. Padian, M. Wolf, G. Hirnschall, Y.R. Lo, and E. Goosby. 2012. HIV treatment as prevention: How scientific discovery occurred and translated rapidly into policy for the global response. Health Affairs (Millwood) 31 (7): 1439–1449.

    Article  Google Scholar 

  • Cook, J.G. 2009. Public health in Africa. Retrieved from: https://www.csis.org/analysis/public-health-africa.

  • Dawson, A., and M. Verweij. 2012. Solidarity: A moral concept in need of clarification. Public Health Ethics 5 (1): 1–5.

    Article  Google Scholar 

  • Declaration of Doha. 2001. Declaration on the TRIPS agreement and public health, Doha. Retrieved from https://www.wto.org/english/thewto_e/minist_e/min01_e/mindecl_trips_e.htm.

  • Drake, A.L., A. Wagner, B. Richardson, and G. John-Stewart. 2014. Incident HIV during pregnancy and postpartum and risk of mother-to-child HIV transmission: A systematic review and meta-analysis. PLoS Medicine 11 (2): e1001608.

    Article  Google Scholar 

  • Fabiani, M., S. Accorsi, R. Aleni, G. Rizzardini, B. Nattabi, A. Gabrielli, C. Opira, and S. Declich. 2003. Estimating HIV prevalence and the impact of HIV/AIDS on a Ugandan hospital by combining zero survey data and hospital discharge records. Journal of Acquired Immune Deficiency Syndrome 34 (1): 62–66.

    Article  Google Scholar 

  • Forman, L., C. Beiersmann, C.E. Brolan, M. McKee, R. Hammonds, and G. Ooms. 2016. What do core obligations under the right to health bring to universal health coverage? Health and Human Rights 18 (2): 23–34.

    Google Scholar 

  • Frazer, K., J.E. Callinan, J. McHugh, S. Van Baarsel, A. Clarke, K. Doherty, and C. Kelleher. 2016. Legislative smoking bans for reducing harms from secondhand smoke exposure, smoking prevalence and tobacco consumption. The Cochrane Database of Systemic Reviews 2: CD005992.

    Google Scholar 

  • Freeman, E., A. Semeere, M. Wenger, M. Bwana, F.C. Asirwa, N. Busakhala, E. Oga, E. Jedy-Agba, V. Kwaghe, K. Iregbu, A. Jaquet, F. Dabis, H.A. Yumo, J.C. Dusingize, D. Bangsberg, K. Anastos, S. Phiri, J. Bohlius, M. Egger, C. Yiannoutsos, K. Wools-Kaloustian, and J. Martin. 2016. Pitfalls of practising cancer epidemiology in resource-limited settings: The case of survival and loss to follow-up after a diagnosis of Kaposi’s sarcoma in five countries across sub-Saharan Africa. BMC Cancer 16: 65.

    Article  Google Scholar 

  • Frieden, T.R. 2010. A framework for public health action: The health impact pyramid. American Journal of Public Health 100 (4): 590–595.

    Article  Google Scholar 

  • Friedland, B.A., L. Apicella, K.D. Schenk, M. Sheehy, and P.C. Hewett. 2013. How informed are clients who consent? A mixed-method evaluation of comprehension among clients of male circumcision services in Zambia and Swaziland. AIDS and Behavior 17 (6): 2269–2282.

    Article  Google Scholar 

  • Gear, J. 2013. Public health in South Africa 1975–89: Reflections on a momentous past. Global Health Action 6 (1): 20095.

    Article  Google Scholar 

  • Gilks, C.F., K. Floyd, L.S. Otieno, A.M. Adam, S.M. Bhatt, and D.A. Warrell. 1998. Some effects of the rising case load of adult HIV-related disease on a hospital in Nairobi. Journal of Acquired Immune Deficiency Syndrome and Human Retrovirology. 18 (3): 234–240.

    Article  Google Scholar 

  • Glanz, E. n.d. E-Source behaviour and science research. Retrieved from http://www.esourceresearch.org/tabid/724/Default.aspx.

  • Gostin, L.O. 2015. Law, ethics, and public health in the vaccination debates: Politics of the measles outbreak. JAMA 313 (11): 1099–1100.

    Article  Google Scholar 

  • Green, L., and M. Kreuter. 2005. Health program planning: An educational and ecological approach. 4th ed. New York: McGraw Hill.

    Google Scholar 

  • Hankins, C., R. Macklin, and M. Warren. 2015. Translating PrEP effectiveness into public health impact: Key considerations for decision-makers on cost-effectiveness, price, regulatory issues, distributive justice and advocacy for access. Journal of the International AIDS Society 18 (4 Suppl 3): 19973.

    Google Scholar 

  • Ibrahim, A.M. 2012. Evaluating a decade of the African Union’s protection of human rights and democracy: A post-Tahrir assessment. African Human Rights Law Journal 12 (1): 30–68.

    Google Scholar 

  • IJsselmuiden, C.B., T.C. Nchinda, S. Duale, N.M. Tumwesigye, and D. Serwadda. 2007. Mapping Africa's advanced public health education capacity: The AfriHealth project. Bulletin of the World Health Organization 85 (12): 914–922.

    Article  Google Scholar 

  • Institute of Medicine. 1988. The future of public health. Washington, DC: The National Academies Press.

    Google Scholar 

  • International Conference on Primary Health Care. 1978. Declaration of Alma-Ata. Retrieved from www.who.int/publications/almaata_declaration_en.pdf.

  • International Covenant on Economic, Social and Cultural Rights. 1966. Retrieved from http://www.ohchr.org/EN/ProfessionalInterest/Pages/CESCR.aspx.

  • Kass, N.E. 2001. An ethics framework for public health. American Journal of Public Health 91 (11): 1776–1782.

    Article  Google Scholar 

  • Kengne, A.P., Z. McHiza, A.G. Amoah, and J.C. Mbanya. 2013. Cardiovascular diseases and diabetes as economic and developmental challenges in Africa. Progress in Cardiovascular Disease 56 (3): 302–313.

    Article  Google Scholar 

  • Kompala, T., S.V. Shenoi, and G. Friedland. 2013. Transmission of tuberculosis in resource-limited settings. Current HIV/AIDS Reports 10 (3): 264–272.

    Article  Google Scholar 

  • Lygizos, M., S.V. Shenoi, R.P. Brooks, A. Bhushan, J.C. Brust, D. Zelterman, Y. Deng, V. Northrup, A.P. Moll, and G.H. Friedland. 2013. Natural ventilation reduces high TB transmission risk in traditional homes in rural KwaZulu-Natal, South Africa. BMC Infectious Disease 13: 300.

    Article  Google Scholar 

  • Macha, J., B. Harris, B. Garshong, J.E. Ataguba, J. Akazili, A. Kuwawenaruwa, and J. Borghi. 2012. Factors influencing the burden of health care financing and the distribution of health care benefits in Ghana, Tanzania and South Africa. Health Policy and Planning 27 (Suppl 1): 46–54.

    Article  Google Scholar 

  • Magnusson, R. 2017. Advancing the right to health: The vital role of law. World Health Organisation. Retrieved from http://www.who.int/healthsystems/topics/health-law/health_law-report/en/.

  • Mfutso-Bengo, J.M., and F. Masiye. 2011. Toward an African Ubuntuology/umunthuology bioethics in Malawi in the context of globalization. In Bioethics around the globe, ed. C. Myser. New York: Oxford University Press.

    Google Scholar 

  • Mfutso-Bengo, J., F. Masiye, M. Molyneux, P. Ndebele, and A. Chilungo. 2008. Why do people refuse to take part in biomedical research studies? Evidence from a resource-poor area. Malawi Medical Journal 20 (2): 57–63.

    Google Scholar 

  • Ndiyaye, K. 2016. Contributions of African perspectives to a global theory of health communication. Retrieved from http://www.comminit.com/global/content/contributions-african-perspectives-global-theory-health-communication.

  • Nsubuga, P. 2014. The Ebola outbreak in West Africa: A story of related public health challenges and a pointer to solutions to mitigate the inevitable next outbreak. Pan African Medical Journal 19: 48.

    Article  Google Scholar 

  • Nunn, P., S. Gathua, D. Kibuga, R. Binge, R. Brindle, J. Odhiambo, and K. McAdam. 1993. The impact of HIV on resource utilization by patients with tuberculosis in a tertiary referral hospital, Nairobi, Kenya. Tuberculosis 74 (4): 273–279.

    Google Scholar 

  • Nutbeam, D. 2000. Health literacy as a public health goal: A challenge for contemporary health education and communication strategies into the 21st century. Health Promotion International 15 (3): 1259–1267.

    Google Scholar 

  • O’Hare, B.A.M., D. Devakumar, and S. Allen. 2016. Using international human rights law to improve child health in low-income countries: A framework for healthcare professionals. BMC international health and human rights 16 (1): 11.

    Article  Google Scholar 

  • Phillips-Howard, P.A., K.F. Laserson, N. Amek, C.M. Beynon, S.Y. Angell, S. Khagayi, P. Byass, M.J. Hamel, A.M. Van Eijk, E. Zielinski-Gutierrez, L. Slutsker, K.M. De Cock, J. Vulule, and F.O. Odhiambo. 2014. Deaths ascribed to non-communicable diseases among rural Kenyan adults are proportionately increasing: Evidence from a health and demographic surveillance system, 2003-2010. PLoS One 9 (11): e114010.

    Article  Google Scholar 

  • Ports, K.A., F. Haffejee, M. Mosavel, and A. Rameshbabu. 2015. Integrating cervical cancer prevention initiatives with HIV care in resource-constrained settings: A formative study in Durban, South Africa. Global Public Health 10 (10): 1238–1251.

    Article  Google Scholar 

  • Reed, J.B., E. Njeuhmeli, A.G. Thomas, M.C. Bacon, R. Bailey, P. Cherutich, K. Curran, K. Dickson, T. Farley, C. Hankins, K. Hatzold, J. Justman, Z. Mwandi, L. Nkinsi, R. Ridzon, C. Ryan, and N. Bock. 2012. Voluntary medical male circumcision: An HIV prevention priority for PEPFAR. Journal of Acquired Immune Deficiency Syndromes 60 (Suppl 3): 88–95.

    Article  Google Scholar 

  • Ruger, J.P. 2004. Health and social justice. Lancet 364 (9439): 1075–1080.

    Article  Google Scholar 

  • Streatfield, P.K., W.A. Khan, A. Bhuiya, S.M. Hanifi, N. Alam, C.H. Bagagnan, A. Sié, P. Zabré, B. Lankoandé, C. Rossier, A.B. Soura, B. Bonfoh, S. Kone, E.K. Ngoran, J. Utzinger, F. Haile, Y.A. Melaku, B. Weldearegawi, P. Gomez, M. Jasseh, P. Ansah, C. Debpuur, A. Oduro, G. Wak, A. Adjei, M. Gyapong, D. Sarpong, S. Kant, P. Misra, S.K. Rai, S. Juvekar, P. Lele, E. Bauni, G. Mochamah, C. Ndila, T.N. Williams, K.F. Laserson, A. Nyaguara, F.O. Odhiambo, P. Phillips-Howard, A. Ezeh, C. Kyobutungi, S. Oti, A. Crampin, M. Nyirenda, A. Price, V. Delaunay, A. Diallo, L. Douillot, C. Sokhna, F.X. Gómez-Olivé, K. Kahn, S.M. Tollman, K. Herbst, J. Mossong, N.T. Chuc, M. Bangha, O.A. Sankoh, and P. Byass. 2014. Adult non-communicable disease mortality in Africa and Asia: Evidence from INDEPTH Health and Demographic Surveillance System sites. Global Health Action 29 (7): 25365.

    Article  Google Scholar 

  • Sylla, B.S., and C.P. Wild. 2012. A million Africans a year dying from cancer by 2030: What can cancer research and control offer to the continent? International Journal of Cancer 130 (2): 245–250.

    Article  Google Scholar 

  • Talbot, L. 2012. Fat tax as an alternative tax in South Africa. Dissertation. Pretoria: University of Pretoria. Retrieved from: https://repository.up.ac.za/dspace/bitstream/handle/2263/30671/Talbot_Fat_2012.pdf?sequence=3.

    Article  Google Scholar 

  • The Nuffield Council on Bioethics. 2007. Public health: Ethical issues. Report 2007, 6. Retrieved from http://nuffieldbioethics.org/wp-content/uploads/2014/07/Public-health-ethical-issues.pdf.

  • The Rockefeller Foundation. n.d. The rockefeller foundation – A digital history. Retrieved from https://rockfound.rockarch.org/public-health-at-johns-hopkins.

  • Turan, J.M., E.A. Bukusi, M. Onono, W.L. Holzemer, S. Miller, and C.R. Cohen. 2011. HIV/AIDS stigma and refusal of HIV testing among pregnant women in rural Kenya: Results from the MAMAS study. AIDS and Behavior 15 (6): 1111–1120.

    Article  Google Scholar 

  • Ugboajah, F. 1982. “Oramedia” or traditional media as effective communication options for rural development in Africa. Communicatio Socialis 15 (3): 211–221. Retrieved from http://ejournal.communicatio-socialis.de/index.php/cc/article/viewFile/1449/1444.

    Article  Google Scholar 

  • UN Commission on Human Rights. 1984. The Siracusa principles on the limitation and derogation provisions in the international covenant on civil and political rights. E/CN.4/1985/4. Available: http://www.refworld.org/docid/4672bc122.html. Accessed 11 Nov 2017.

  • UN Committee on Economic, Social and Cultural Rights (CESCR). 2000. General comment No. 14: The right to the highest attainable standard of health (Art. 12 of the Covenant). E/C.12/2000/4. Retrieved from http://www.refworld.org/docid/4538838d0.html para 30–36.

  • Universal Declaration of Human Rights. 1948. Retrieved from www.un.org/en/universal-declaration-human-rights/index.html

  • Wachira, T.D., G.G. Wairire, and S.W. Mwangi. 2014. Socio-economic hazards of plastic paper bags litter in peri-urban centres of Kenya; a case study conducted at Ongata Rongai Township of Kajiado. International Journal of Scientific Research and Innovative Technology 1 (5): 24.

    Google Scholar 

  • World Health Organisation. 2005. International health regulations (2005). Retrieved from http://www1.umn.edu/humanrts/instree/healthpromotion.html.

  • Yamin, A.E., and S. Gloppen. 2011. Litigating health rights: Can courts bring more justice to health? Cambridge, MA: Harvard University Press.

    Google Scholar 

Further Reading

  • Childress, F.F., R.R. Faden, R.D. Gaare, L.O. Gostin, J. Kahn, F.J. Bonnie, et al. 2002. Public health ethics: Mapping the terrain. The Journal of Law, Medicine and Ethics 30 (2): 170–178.

    Article  Google Scholar 

  • Gear, J. 2013. Public health in South Africa 1975–1989: Reflections on a momentous past. Global Health Action 6 (1): 20095.

    Article  Google Scholar 

  • Magnusson, R. 2017. Advancing the right to health: The vital role of law. World Health Organisation. Retrieved from http://www.who.int/healthsystems/topics/health-law/health_law-report/en/.

  • Mann, J.M. 1997. Medicine and public health, ethics and human rights. Hastings Center Report 27 (3): 6–13.

    Article  Google Scholar 

  • Mfutso-Bengo, J.M., and F. Masiye. 2011. Toward an African Ubuntuology/umunthuology bioethics in Malawi in the context of globalization. In Bioethics around the globe, ed. C. Myser. New York: Oxford University Press.

    Google Scholar 

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Author information

Authors and Affiliations

  1. Center of Bioethics for Eastern and Southern Africa (CEBESA), School of Public Health and Family Medicine, College of Medicine, University of Malawi, Blantyre, Malawi

    Joseph Mfutso-Bengo

  2. Centre for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya

    Elizabeth Bukusi

  3. Departments of Global Health and Obstetrics and Gynecology, University of Washington, Seattle, WA, USA

    Elizabeth Bukusi

  4. Faculty of Commerce, Polytechnic University of Malawi, Blantyre, Malawi

    Eva Mfutso-Bengo

  5. Fernuniversität, Hagen, Germany

    Eva Mfutso-Bengo

Authors
  1. Joseph Mfutso-Bengo
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  2. Elizabeth Bukusi
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  3. Eva Mfutso-Bengo
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Corresponding author

Correspondence to Elizabeth Bukusi .

Editor information

Editors and Affiliations

  1. University of Texas, MD Anderson Cancer Center, Houston, TX, USA

    Nico Nortjé

  2. University of the Western Cape, Bellville, South Africa

    Jo-Celene De Jongh

  3. Tshwane University of Technology, Pretoria, South Africa

    Willem A. Hoffmann

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Mfutso-Bengo, J., Bukusi, E., Mfutso-Bengo, E. (2018). Public Health Ethics and Rights in Healthcare Programmes. In: Nortjé, N., De Jongh, JC., Hoffmann, W. (eds) African Perspectives on Ethics for Healthcare Professionals. Advancing Global Bioethics, vol 13. Springer, Cham. https://doi.org/10.1007/978-3-319-93230-9_16

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