8 October, 2015
Pictures published in the national press. Source: article by Ana Raquel Matos http://www.scielo.br/pdf/sausoc/v20n3/07.pdf
in the article The controversy over the restructuring of perinatal emergency services in Portugal, Ana Raquel Matos, researcher at the University of Coimbra explores the controversial decision made by the Ministry of Health which resulted in the closure of several maternity wards in 2006.
The researcher also explores the protests held across the country against these measures, with particular emphasis to the importance of citizen participation in the formulation of health policies.
In order to study this case, Ana Raquel used interviews with key informants, documents, reports and articles selected from the Diário de Notícias, Jornal de Notícias, and Expresso newspapers.
Maternal and child health policies in Portugal before and after 2006 – a brief overview
It was only in the 1970s that the Portuguese government acknowledged responsibility for health policy and took important actions which included universal access to healthcare and investment in primary care.
After 1989, attempts were made to create larger maternity units based on the assumption that the quality of services depended on the number of deliveries performed at the facility each year.
In 2006 a group of experts wrote a report reiterating the recommendations regarding concentration of births in larger health units. Some days later the minister signed a directive providing for the closure of maternity wards which performed less than 1,500 births per year.
The protests
Criticism and suspicion of the measures were voiced soon after the ministerial decision in 2006. According to some interviews, the controversy arose mainly due the lack of public participation in the decision-making process.
Outdoor in one of the towns where the protests were held. Source: article by Ana Raquel Matos. http://www.scielo.br/pdf/sausoc/v20n3/07.pdf
Those who felt affected by the decision to close the wards claimed that there was no room for dialogue. Most of the actors against the resolution felt that they were given no opportunity to engage in dialogue with the decision-makers and present their arguments.
During the 2006 and 2007 protests, opponents of the measure objected to the adoption of “purely economic criteria,” accusing the government of using “terror tactics” and emphasizing that the arguments against closure outweighed those in favor. Another issue at stake was the lack of transparency and consultation during the decision-making process.
Conclusions
The article concludes that the Portuguese government neglected the protests and decided to close maternity wards without informing or consulting the respective local authorities and populations.
It states that policy makers do not “give due weight” to protests as a valid form of participation in decision-making processes. Although the protests were generally unsuccessful, they led the government to consider the problems raised and make certain modifications.
Read the full article:
Matos, Ana Raquel. The controversy over the restructuring of perinatal emergency services in Portugal and the importance of citizen participation in health care decision-making processes. Hist. cienc. saude-Manguinhos, Sept 2015, vol.22, no.3, p.705-722. ISSN 0104-5970
Related articles already published in HCS-Manguinhos:
Biernat, Carolina and Ramacciotti, Karina La protección a la maternidad de las trabajadoras en Argentina: aspectos legales y administrativos en la primera mitad del siglo XX. Hist. cienc. saude-Manguinhos, Dic 2011, vol.18, suppl.1, p.153-177. ISSN 0104-5970
Castejón, Ramón, Perdiguero, Enrique and Ballester, Rosa. Los medios de comunicación al servicio de la lucha antivenérea y la protección de la salud materno-infantil (1900-50). Hist. cienc. saude-Manguinhos, Jun 2006, vol.13, no.2, p.411-437. ISSN 0104-5970
Di Liscia, María Silvia. Hijos sanos y legítimos: sobre matrimonio y asistencia social en Argentina (1935-1948). Hist. cienc. saude-Manguinhos, 2002, vol.9, p.209-232. ISSN 0104-5970
Franzoni, Juliana Martínez. ¿Presión o legitimación? Poder y alternativas en el diseño y adopción de la reforma de salud en Costa Rica, 1988-1998. Hist. cienc. saude-Manguinhos, Set 2006, vol.13, no.3, p.591-622. ISSN 0104-5970
