Chapter 24: Citizen monitoring: promoting health rights among socially excluded women in Andean Peru
This chapter explores the complexities of social inclusion and exclusion in health care. It presents a study of a group of indigenous women in Peru who act as ‘citizen monitors’ using a human rights-based approach to health. The monitors document and confront problems that indigenous health users face with discrimination, cultural insensitivity, poor treatment and illegal charges for services in public health care facilities. The study findings suggest that measures taken by the citizen monitors can help to address these problems. However, systemic deficiencies, including underfunding, poor management and neglect, are characteristic of the health system’s weakest segment which serves the monitors’ communities. These systemic issues underlie many of the problems identified by the monitors.
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