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.

Keywords:

• human rights
• health systems
• policy
• equity
• accountability

Notes

This work was completed when all authors except JH were with the Program on International Health and Human Rights, Department of Global Health and Population, Harvard School of Public Health.

1. These results are based on the review of key documents noted in the methods. Findings about the WHO Framework are based on two references: WHO's Framework for Action Everybody's Business: Strengthening Health Systems to Improve Health Outcomes (WHO 2007) and the World Health Report 2000, Health Systems: Improving Performance (WHO 2000). Findings related to the Flagship Framework are based on the reference Roberts et al. Getting Health Reform Right: A Guide to Improving Performance and Equity (2004). Given this, in-text citations to these references are not included unless direct quotations are used.