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Integrating ethics, health policy and health systems in low and middle income countries : case studies from Malaysia and Pakistan.


Hyder, Adnan A and Meritt, Maria and Ali, Joseph and Tran, Nhan T and K.C Mani, Kulanthayan and Akhtar, Tasleem (2008) Integrating ethics, health policy and health systems in low and middle income countries : case studies from Malaysia and Pakistan. Bulletin of the World Health Organization, 86 (8). pp. 606-611. ISSN 0042-9686, ESSN: 1564-0604


Scientific progress is a significant basis for change in public-health policy and practice, but the field also invests in value-laden concepts and responds daily to sociopolitical, cultural and evaluative concerns. The concepts that drive much of public-health practice are shaped by the collective and individual mores that define social systems. This paper seeks to describe the ethics processes in play when public-health mechanisms are established in low- and middle-income countries, by focusing on two cases where ethics played a crucial role in producing positive institutional change in public-health policy. First, we introduce an overview of the relationship between ethics and public health; second, we provide a conceptual framework for the ethical analysis of health system events, noting how this approach might enhance the power of existing frameworks; and third, we demonstrate the interplay of these frameworks through the analysis of a programme to enhance road safety in Malaysia and an initiative to establish a national ethics committee in Pakistan. We conclude that, while ethics are gradually being integrated into public-health policy decisions in many developing health systems, ethical analysis is often implicit and undervalued. This paper highlights the need to analyse public-health decision-making from an ethical perspective.

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Additional Metadata

Item Type: Article
Divisions: Faculty of Medicine and Health Science
DOI Number: https://doi.org/10.1590/S0042
Publisher: World Health Organization
Keywords: Ethics; Health policy; Health systems; Low and middle income country; Pakistan; Malaysia.
Depositing User: Raja Norazlinda Raja Azenam
Date Deposited: 17 Oct 2013 03:17
Last Modified: 17 Sep 2015 00:33
Altmetrics: http://www.altmetric.com/details.php?domain=psasir.upm.edu.my&doi=10.1590/S0042
URI: http://psasir.upm.edu.my/id/eprint/15254
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