The purpose of the Rights Based Approach (RBA) as well as of Universal Health Coverage (UHC) is to ensure social protection for the most vulnerable groups in society so that there are equitable service delivery and accountability for the available resources. Understanding the different roles and responsibilities by citizens through the RBA, and working towards attaining social accountability would enable citizens to influence prioritisation of health for all as an investment, not just a cost. The RBA is a process of empowering people to know and claim their rights responsibly, and of increasing their ability and accountability for respecting, protecting and fulfilling their rights. The World Health Organisation (WHO) underpins the process of assessing and addressing the human rights implications of any health policy, programme or legislation.
While the Government of Uganda (Ministry of Health) adopted the patient’s charter in 2009 and followed-up with clients’ charters to clearly spell out patients’ rights and responsibilities, they remain unenforceable. The missing link is the availability of a platform that brings health providers, policy makers, and users together to define the local needs and aspirations of health care. A crucial principle of RBA is “PANEL”, standing for Participation, Accountability, Non-discrimination (against services and ensuring equity), Empowerment and Legal environment for enforcing the entitlements. In the perspective of the PANEL principle, can the RBA deliver better malaria control outcome?
Recent research has indicated misuse of insecticide-treated nets by citizens and exorbitant costs for implementing indoor residual spraying (IRS) while case management is dodged by stock-outs and fragmentation of Integrated Community Case Management (ICCM) among others. All these indicate limited or lack of involvement of citizens in planning for malaria control interventions.
Demand generation should start with what individuals, families, and communities know and believe in. Integrating rights-based principles into the malaria control interventions will position citizens at the centre of their own health to practice prevention, behaviour change and address the high burden of malaria in Uganda. It will promote meaningful interactions and engagements among patients, health service providers and policy makers to create realistic and effective opportunities for involvement in decision-making. Provision of information, knowledge, and mobilisation of citizens will further enhance citizen’s participation and initiatives for environmental and vector control measures such as planting mosquito repellent trees and ensuring household sanitation and hygiene.
Empowering clients with knowledge and information on their rights and responsibilities will contribute to behaviour change and prevention of malaria. Citizens become more accountable on malaria preventive tools are given to them, monitor implementing agencies in their communities and consequently transform the malaria control costs into investment initiatives.
The writer is a Programs Officer at Uganda National Health Consumers Organisation (UNHCO) and a Focal person for SPEED Project at MakSPH.