The Patient Right to Participation: A Key Factor in Improving the Quality of Health Service Delivery in Uganda. A Case Study of Masaka District

ABSTRACT

The right to participation is one of the key human rights in the protection and promotion of human life. According to the United Nations General assembly as reflected in the Universal Declaration of Human Rights, the right to participation is one of the highest inspirations of common people. Healthcare world over has transformed from the medical approach of the first half of the 20th century, where a patient was considered only a passive user of health services and the doctor who was the expert knew all. Patients therefore had no right to question the services they received or took part in the decisions made on their lives. With the development of the human rights regime, the following Universal Declaration on Primary Healthcare (1976), the consumer is considered a significant partner in the delivery of health services. With the notion of primary healthcare and the right-based approach, patients are entitled to know and participate effectively in the management of their health system. The right to participation is therefore a key preliquist for the consumers to manage their own health and the delivery of quality services. When viewed from a more modern perspective, healthcare is increasingly becoming a commodity subjected to the Neo-Keynesian rules of demand and supply as consumers are paying for services they receive. It therefore becomes both a legal and moral imperative that patients who are buyers of health services have adequate participation and their efforts must be seen regarding the services they receive. Some countries like United Kingdom, France, and South Africa have gone ahead to provide legislation on the right to participation both in private and public sector. However, there is no legal framework for patients rights particularly right to participation at health facilities considering the wide spread outcry on the poor quality of services in the country. In absence of a clear legislation and adequate information one wonders how patients can claim for their rights about the services they receive and make informed decisions about services they receive. This research therefore was prompted to review the existing mechanisms and assess how the right to participation is promoted at health facilities in Uganda today and prompts policy intervention. The research was carried out in Masaka District and it covered Masaka Refferal hospital in the category of a public hospital, Kitovu hospital in the category of private not for profit and Kimwanyi Health Centre IV in the category of private for profit. It is hoped that the results presented in this report can become a useful tool in the implementation actions to empower patients right to participation and improve the quality of health care in Uganda. The research was designed to find out how the patients’ right to participation can improve the quality in the delivery of health services.