Everyday Political Economy of Human Rights to Health: Dignity and Respect as an Approach to Gendered Inequalities and Accountability

Sexual and reproductive health needs and rights are one of the bleakest examples of (racialised) gender health inequalities in Brazil. This is so despite legal and constitutional specificity recognising the right to health as right of citizenship. In this paper we argue that a ‘performance gap’ is revealed in contradictions between what the right to health as a normative framework encourages states to do, and institutional arrangements and power relations that underpin everyday gendered inequalities in health delivery. The contribution of this article is two-fold. First, it contributes to feminist political economy accounts of the neglect of sexual and reproductive rights by adding a perspective of human dignity as an approach to gender inequalities. Second, it explores ways in which health inequalities manifest in everyday practices, and how divergent expectations of what the right to health means for professionals and for disadvantaged black women limit the capacity of healthcare to make a difference to their well-being. The article also underlines the importance of complementing legal accountability in health with mechanisms that account for prerogatives of gender justice, equality and dignity.