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Submitted by Robert Oelrichs on

Great post, Susan. It was remarkably telling that the mother you met would rather risk her child’s serious ongoing illness than return to a clinic where she had felt alienated and devalued. This may well have been a rational choice – the technical quality of health care surely correlates with such “softer” indices. But how often does an individual fail to access services that might have been beneficial, because they fall outside the mainstream as individuals, or because the concerns of their entire community are not included in nationally tailored plans? Parents may be reluctant to immunize their children because they mistrust the intentions of a government which does not acknowledge them. Homosexual men and sex workers may shun effective HIV prevention and treatment services, rather than visit a clinic where they have been ridiculed or vilified. We indeed need to do much better across the spectrum of health to understand and measure the impact of exclusion – and to learn how to address it. I’m very much looking forward to seeing your report.

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