Integration of the Human Rights Based Approach into healthcare delivery in selected health facilities in Uganda
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The Center for Health, Human Rights and Development (CEHURD), part- nered with the Uganda National Commission for UNESCO to undertake an assessment on the application of the HRBA principles in the delivery of health care in 40 selected public and private not for profit facilities in central and northern Uganda.
The purpose of the assessment was to provide a baseline and an under- standing of the current situation of health care delivery through the lens of HRBA principles.
This study interrogated existing literature on International, Regional and National Human Rights standards for a HBRA for health care delivery; ser- vice delivery standards to identify their levels of compliance with the Human Rights Based Principles ; document any case studies as evidence of use of the HBRA to health care delivery and recommend some model approaches for integrating the HBRA in health servicedelivery.
According to the findings of the study, legal and policy review shows that several International and regional human rights instruments provide guid- ance for the integration of Human Rights Based approaches to health care delivery.
The instruments have informed Uganda’s legal and health policy frameworks such as the Patient Charter developed by the Ministry of Health to guide health care delivery. However, gaps in the implementation of HRBA were noted in the sampled health facilities.
The study also inter alia documented challenges relating to accessibility . Over 92.5% (37 out of the 40 facilities) lacked ramps to ease access for people with physical impairment. Ambulance services are still a major chal- lenge in many facilities while underlying determinants of health are also a challenge in some facilities. Specifically, 40% lacked clean water and 22.5% (9 out of the 40 facilities) lacked alternative sources of power.
In a few facilities, patients had to pay to use to the toilets. Economic access is also a problem as 52.6% of health facility clients who were asked to pay, expressed hardship to meet the costs.