Specific actions under the Action Plan
A. Government and Ministry of Health actions (as prime duty-bearers):
A1. Enactment of a National-Public-Health-Services-Act that recognizes and delineates the Health Rights of citizens (claim holders), the duties of the Public health system, the public health obligations of private health care providers (duty bearers) and the specifying broad legal and organisational mechanisms to operationalise these rights. [The Act is to make the actions under this Action Plan mandatory, and is to make more accountable/ justiciable the denial of health care. It will also include special sections recognising and legally protecting the health rights of various sectors of the population with special health needs, i.e., women, children, persons affected by HIV-AIDS, persons with mental health problems, disabled persons, persons in conflict situations, persons facing displacement, workers in various hazardous occupations including unorganised and migrant workers].
A2. Definition of packages-of-essential-health-services at different levels (village/dispensary/community health center/district and provincial hospital) to be made public to all citizens as their right.
A3. Substantial increase-in-central-budgetary-provisions-for-public-health [to be increased to 2-3% of the GDP in the next three to four years].
A4. Setting up a Central-Council-on-the-Right-to-Health to develop a consensus among various state agencies and civil society towards operationalizing the Right to Health Care across the country.
A5. Enacting a National–Clinical-Establishments-Regulation-Act that ensures citizen’s health rights concerning the private health sector and includes the right to emergency services, as well as ensuring minimum quality of care standards, adherence to standard treatment protocols and ceilings on diagnostic tests and essential health services prices.
A6. Issuing of a Health-Services-and-Drugs-Price-Control-Order, as well as the formulation of a Charter-of-Patients-Rights.
A7. Setting up a Health-Services-Regulatory-Authority that will broadly define and sanction what constitutes rational and ethical practice, as well as set and monitor quality standards and prices of services. [This is not to be a representative body of doctors alone, but is to include representatives of health care providers, public health experts, legal experts, representatives of consumers, health and human rights groups and elected public representatives].
A8. Issuing of National-Operational-Guidelines-on-Essential-Drugs that specify: a) the right of all citizens to access good quality essential drugs at all levels in the public and private health system; b) the promotion of generic drugs over brand name drugs; c) the inclusion of all essential drugs under the Drug Price Control Order; and, d) the elimination of irrational formulations and combinations. [The Government is also to take steps to publish and consolidate a National Drug Formulary based on the morbidity pattern of the people in the country].
A9. Taking measures to integrate-national-health-programmes-with-the-Primary-Health-Care-system in a way that decentralizes planning, decision-making and implementation. [Focus to be shifted from bio-medical and individual-based measures to social-, ecological- and community-based measures that will, among other, include the compulsory health impact assessment of all development projects, as well as a decentralized and effective compulsory surveillance system of notification of prevalent diseases by all health care providers, including private practitioners].
A10. Reversal of all coercive-population-control-measures that violate basic human rights, are not effective in stabilizing population, and draw away significant resources and energies of the health system from public health priorities. [Steps to be taken to eliminate and prevent all forms of coercive population control measures which target the most vulnerable and marginalized sectors of society].
A11. Setting up by the Ministry of Health of a-functioning-national-mechanism-of-health-services-monitoring that periodically reviews the implementation of health rights and the respective underlying structural and policy issues responsible for health rights violations. [Health sector civil society organizations to be involved].
(contd)
Claudio Schuftan, Ho Chi Minh City