Human rights in health systems frameworks: What is there, what is missing and why does it matter?

Abstract

Global initiatives and recent G8 commitments to health systems strengthening have brought increased attention to factors affecting health system performance. While equity concerns and human rights language appear often in the global health discourse, their inclusion in health systems efforts beyond rhetorical pronouncements is limited. Building on recent work assessing the extent to which features compatible with the right to health are incorporated into national health systems, we examine how health systems frameworks have thus far integrated human rights concepts and human rights-based approaches to health in their conceptualisation. Findings point to the potential value of the inclusion of human rights in these articulations to increase the participation or involvement of clients in health systems, to broaden the concept of equity, to bring attention to laws and policies beyond regulation and to strengthen accountability mechanisms.

Service user involvement in mental health system strengthening in a rural African setting: qualitative study

“…There is a need to address the stigmatizing and discriminatory practices that hinder the involvement of service users and caregivers in the mental health system, as well as in their full participation in social life and realization of their civic rights [50, 51]. This approach is focused on redressing the unfair distribution of power and discriminatory practices, with an emphasis on empowering service users and caregivers to know and claim their rights, and building the capacity and accountability of individuals, organizations and professionals to promote respect, protection and fulfillment of responsibilities [33, 50, 51].…”

“…This approach is focused on redressing the unfair distribution of power and discriminatory practices, with an emphasis on empowering service users and caregivers to know and claim their rights, and building the capacity and accountability of individuals, organizations and professionals to promote respect, protection and fulfillment of responsibilities [33, 50, 51]. The human right-based approach is guided by core values and principles of participation, accountability, non-discrimination, empowerment and legality and requires health facilities, goods and services to be available, accessible and acceptable services that help service users and caregivers to exercise their rights to health [50, 51]. …”

Implementing community participation through legislative reform: a study of the policy framework for community participation in the Western Cape province of South Africa

“…When communities are well informed on health issues, their active participation in a transparent system can serve to hold service providers and government officials accountable for their actions [13]. Creating a public sphere for dialogue in the health system, such collective deliberation is seen to improve both community development and health system management, resulting in more reasoned, informed, and public-oriented decisions [14]. Through this public deliberation, community members can create avenues to exert influence on policy makers, holding providers accountable for ensuring that funds are allocated equitably and efficiently and assuring that health practitioners and community members continue to interact in respectful and constructive ways [8,15].…”

Implementing Community Participation Through Legislative Reform: A Study of the Policy Framework for Community Participation in the Western Cape Province of South Africa

“…When communities are well informed on health issues, their active participation in a transparent system can serve to hold service providers and government officials accountable for their actions [13]. Creating a public sphere for dialogue in the health system, such collective deliberation is seen to improve both community development and health system management, resulting in more reasoned, informed, and public-oriented decisions [14]. Through this public deliberation, community members can create avenues to exert influence on policy makers, holding providers accountable for ensuring that funds are allocated equitably and efficiently and assuring that health practitioners and community members continue to interact in respectful and constructive ways [8,15].…”