Title

Partnerships for empowerment in a post-Soviet society: Patients rights and responsibilities in Uzbekistan

Date of Award

2007

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Social Sciences

Advisor(s)

Susan S. Wadley

Keywords

Health reforms, Partnerships, Empowerment, Post-Soviet, Society, Patients rights

Subject Categories

Anthropology | Social and Behavioral Sciences | Social and Cultural Anthropology

Abstract

Patient rights are gaining attention worldwide. 'Patients' exist within the health care system. In Uzbekistan, the health system was inherited from the Soviet Union and is now undergoing reforms. This research was conducted as part of a USAID-funded health reform project in rural Uzbekistan, as part of their work to 'redefine patient rights and responsibilities'. For patients to be afforded rights, they must also be active in their own health care. Under the Soviet system, the State was held responsible for its citizens' health. Uzbekistan now struggles to balance between the State's responsibility, with the health care provider and the patient. Data were collected through clinic observations, exit interviews, focus group discussions, and a review of Uzbekistan health laws (which does outline patient rights). Issues that impinge on patient rights and responsibilities are reviewed, including health reforms, the role of the body and the individual within health care, doctor-patient interactions, and power relationships and empowerment within health care. Data analyses showed that a 'patient' is an extension of his/her family. Although patients were objectified, most health care providers knew their patients as their neighbors, which moved helped to personify the patient within the clinical setting. Most health care providers establish a positive relationship with their patients through conversations and consultations; however, health care providers were paternalistic towards their patients. The common belief was that the doctor 'knows best'. Currently, power within the health care system is shared between the State and the medical profession. For patients to become empowered, power needs to extend to include the patents too, especially within the doctor-patient relationship. Only through this partnership can patient rights truly be operationalized.

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