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Building Demand for Health Services
Increasingly, public health, including reproductive
health care provision, is being seen as a system — a changing
dynamic of entitlement and obligations between people, communities,
providers and governments.
Within this new lens, community participation, health promotion,
social support and empowerment of individuals (especially of women)
are seen as critical to achieving sustainable improvements in reproductive
health care.
 In other words, good reproductive health requires
partnership. While governments are obliged to make quality reproductive
services
and information widely accessible, users should be encouraged to
articulate what they need and expect in terms of services. Users
can also provide valuable input into monitoring and evaluation
efforts that can improve quality of care. In this way, users can
provide a feedback mechanism to support services appropriate to
their needs.
The health care system can be seen as
an interaction between supply (trained personnel, equipment and
services) and
demand
(active participation from individuals, groups and communities
for quality services). Interaction between these two parts
of the system can improve the reproductive health needs of users.
The idea
of human rights underpins this whole
model. The rights of individuals to exert control over their own
lives and their reproductive and sexual health needs have been acknowledged
by the international community. But people need information, as
well as affirmation and support, in articulating and exercising
their rights and in creating demand for the services they need.
That’s why UNFPA works on many levels.
In addition to supporting reproductive health services, the Fund
also promotes
behaviour
change communications, advocacy, education and empowerment of women.
These kinds of interventions can encourage individuals and communities
to increase demand and support for quality reproductive health
services.
A UNFPA-supported programme, Stronger
Voices for Reproductive Health exemplifies how
programming can
strengthen reproductive health services through a focus on the
interaction between supply and demand.
As an example of how this systematic approach
can work, consider the goal of reducing maternal mortality, one
of the priorities
selected by the international community for inclusion in the
Millennium Development Goals. Reducing maternal mortality will
require specific
inputs, such as the availability of skilled birth attendants
and access to emergency obstetric care. But progress can be accelerated
if pregnant women are empowered to make informed decisions about
childbirth. In many parts of the world, male relatives or in-laws
decide where a woman will give birth, or when she should get
emergency
care.
Educating women, and giving them more opportunities,
can help change this power balance. Communities that are fully
informed
about the needs and vulnerabilities of pregnant women can be
a part of this as well. For example, they can work to build awareness
of the danger signs of pregnancy, pool resources to help out
in
an emergency, or find ways to safely transport women in labour
to an appropriate facility if complications develop.
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