The role of legal framework in driving improvement in medical practices in Ghana: a case study of obstetric fistula.
There has been a marked surge in the discrimination faced by obstetric fistula patients, a phenomenon that not only perpetuates social marginalisation but also undermines healthcare practice in Ghana. Of greater concern is when such discriminatory conduct emanates from healthcare providers, exposing gaps in prevention and systemic response. These dynamics deter patients from seeking follow-up care, thereby worsening clinical outcomes. Furthermore, provider conduct constitutes a direct violation of core ethical principles, including respect, equity, and non-discrimination and contravenes Ghana's legal framework, which mandates the equitable treatment of all individuals accessing healthcare, including those with obstetric fistula. As such, this study sought to answer how international and domestic legal frameworks can be utilised to protect the rights of fistula patients and, further, use these frameworks together with public health interventions to improve medical practices in Ghana. To achieve this aim, the research critically reviews international, national and institutional frameworks governing women's healthcare and those providing healthcare in Ghana, Nigeria and Uganda, to identify best practices that Ghana could adopt to improve its medical practices governing women’s healthcare. Findings indicate that Ghana faces a failure to comply with ethical standards, non-ratification of international frameworks, insufficient resource availability and lack of clarity of legal stipulations, which cannot therefore be implemented or enforced adequately. Therefore, Ghana can consider prioritising the enforcement of existing legislation designed to comprehensively support women's healthcare and learn from comparators by adopting targeted policies and practical interventions, with greater focus on obstetric fistula policy failings that prevent real-life obstetric fistula care. This offers valuable insights that Ghana could integrate into its healthcare framework.
Obstetric fistulas, Patient rights, Legal and ethical framework, Ghana, Nigeria, Uganda, Women's health, Healthcare delivery, Healthcare access, Health care providers
Networked Digital Library of Theses and Dissertations