Right to health for undocumented migrants in Mexico: from theory to practice in the context of the health system reform

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Philippe Stoesslé ◽  
Francisco Gonzalez-Salazar
Keyword(s):  
Health System ◽  
Health Program ◽  
Legal Framework ◽  
Right To Health ◽  
System Reform ◽  
Undocumented Migrants ◽  
Structural Vulnerability ◽  
Migration Process ◽  
Human Right ◽  
Content Type

Purpose Undocumented Central American migrants in Mexico are legally eligible for free access to the public health system through the new Instituto para la Salud y el Bienestar (INSABI) health program, but many experience structural vulnerability and stigmatization that prevent them from accessing health-care facilities. The purpose of this study is to investigate the discrepancy between the migrants’ Human Right to health, proclaimed by the Mexican Government and supposedly guaranteed by law, and the reality of the migration process. Design/methodology/approach This study reviewed relevant literature on the health risk factors, social and structural vulnerability, stigmatization and structural violence experienced by undocumented migrants as obstacles to their Human Right to health. It also reviews the current legal framework in Mexico and internationally. Findings This review demonstrates the lack of implementation of the current legal framework in Mexico and identifies a set of complex obstacles to effective access to health for undocumented migrants. Although the migration process itself was not found to be directly associated with major health issues, the social conditions of the migratory journey expose the migrants to serious threats, especially sexually transmitted diseases and tuberculosis. Practical implications This paper makes 10 practical recommendations for interventions collectively involving the state, international and civil organizations and the migrant community. These are especially relevant since the implementation of the INSABI health program in 2020. Social implications The paper lays the basis for influencing Mexican health system stakeholders to improve the health of migrants. Originality/value The sociological barriers to health access for undocumented populations in Mexico have not been fully explored. In addition, this paper provides a unique reflection on opportunities and challenges linked to the 2020 health system reform.

A network of networks

2017 ◽  
Vol 31 (2) ◽  
pp. 223-236 ◽  
Author(s):  
Rick Iedema ◽  
Raj Verma ◽  
Sonia Wutzke ◽  
Nigel Lyons ◽  
Brian McCaughan
Keyword(s):  
Health Service ◽  
Health System ◽  
Network Governance ◽  
System Reform ◽  
System Transformation ◽  
Content Type ◽  
Multiple Networks ◽  
Network Of Networks

Purpose To further our insight into the role of networks in health system reform, the purpose of this paper is to investigate how one agency, the NSW Agency for Clinical Innovation (ACI), and the multiple networks and enabling resources that it encompasses, govern, manage and extend the potential of networks for healthcare practice improvement. Design/methodology/approach This is a case study investigation which took place over ten months through the first author’s participation in network activities and discussions with the agency’s staff about their main objectives, challenges and achievements, and with selected services around the state of New South Wales to understand the agency’s implementation and large system transformation activities. Findings The paper demonstrates that ACI accommodates multiple networks whose oversight structures, self-organisation and systems change approaches combined in dynamic ways, effectively yield a diversity of network governances. Further, ACI bears out a paradox of “centralised decentralisation”, co-locating agents of innovation with networks of implementation and evaluation expertise. This arrangement strengthens and legitimates the role of the strategic hybrid – the healthcare professional in pursuit of change and improvement, and enhances their influence and impact on the wider system. Research limitations/implications While focussing the case study on one agency only, this study is unique as it highlights inter-network connections. Contributing to the literature on network governance, this paper identifies ACI as a “network of networks” through which resources, expectations and stakeholder dynamics are dynamically and flexibly mediated and enhanced. Practical implications The co-location of and dynamic interaction among clinical networks may create synergies among networks, nurture “strategic hybrids”, and enhance the impact of network activities on health system reform. Social implications Network governance requires more from network members than participation in a single network, as it involves health service professionals and consumers in a multi-network dynamic. This dynamic requires deliberations and collaborations to be flexible, and it increasingly positions members as “strategic hybrids” – people who have moved on from singular taken-as-given stances and identities, towards hybrid positionings and flexible perspectives. Originality/value This paper is novel in that it identifies a critical feature of health service reform and large system transformation: network governance is empowered through the dynamic co-location of and collaboration among healthcare networks, particularly when complemented with “enabler” teams of people specialising in programme implementation and evaluation.

Recovery college features and context: advancing a recovery and well-being policy agenda

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Amadene Woolsey ◽  
Gillian Mulvale
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Health System ◽  
Mental Health System ◽  
Well Being ◽  
System Reform ◽  
Educational Approach ◽  
Content Type ◽  
Policy Objectives ◽  
Mental Health Association

Purpose Internationally, there has been a move towards more recovery-oriented mental health policies for people living with mental illness, and some countries have included well-being as a population-level objective. In practice, these policy objectives can be difficult to achieve because of deeply rooted policy legacies, including a biomedical approach to care and the stigma associated with mental illness. The purpose of this paper is to investigate how interventions that operate outside the formal mental health system, such as recovery colleges (RCs), may advance these policy objectives more easily than efforts at broader system reform. Design/methodology/approach This study conducted a scoping review to explore the features and context of RCs that make the model an attractive and feasible opportunity to advance a recovery and well-being agenda. Our research is motivated by the initial and growing adoption of RCs by the Canadian Mental Health Association. This paper applies the consolidated framework for implementation research to analyse features of the model and the context of its implementation in Canada. Findings The RC’s educational approach, adaptability, coproduced nature and positioning outside the formal mental health system are key features that facilitate implementation without disrupting deeply entrenched policy legacies. Other facilitators in the Canadian context include the implementing organisation’s independence from government, its federated structure and the model’s alignment with national policy objectives. Originality/value This paper highlights how interventions outside the formal mental healthcare system can promote stated recovery and well-being policy goals.

scholarly journals Legal Exploration of Right to Health

2021 ◽  
Vol 29 (S2) ◽  
Author(s):  
Tengku Noor Azira Tengku Zainudin ◽  
Mohd Zamre Mohd Zahir ◽  
Ahmad Azam Mohd Shariff ◽  
Ramalinggam Rajamanickam ◽  
Ong Tze Chin ◽  
...  
Keyword(s):  
Legal Status ◽  
World Health Organisation ◽  
Legal Framework ◽  
Right To Health ◽  
World Health ◽  
Health It ◽  
Physical And Mental Health ◽  
Human Right ◽  
The Right ◽  
Legal Mechanism

The right to health is recognised as a fundamental human right in the World Health Organisation (WHO) Constitution. In Malaysia, the enjoyment of the highest attainable standard of physical and mental health is a fundamental human right without discrimination for every human being. Consequently, the principle of the “right to health,” regardless of the legal status of an individual, is the driving force in creating acceptable standards of health care for all citizens. Even for individual who suffers from Covid-19, he still has a fundamental right to health. The issue of the right to health is whether the patients have any rights of their health? If they do have the right to health, the next issue is whether the hospitals are legally bound to follow such right, i.e. the right to health of the patients. Therefore, this paper aims to analyse and discuss the issues regarding the rights to health of the patients. Without the legal mechanism in recognising the right to health, it pointed out that is no such right. The method employed in this paper is qualitative based. The paper finds that although Malaysia does not have any specific legal framework about the right to health, the application of international legal mechanism can be referred to a guideline. Thus, it is important to have a specific legal framework by applying international legal mechanism in order to address this issue.

Rights of access to healthcare for undocumented migrants: understanding the Italian and British national health systems

2018 ◽  
Vol 11 (4) ◽  
pp. 232-243 ◽  
Author(s):  
Danielle da Costa Leite Borges ◽  
Caterina Francesca Guidi
Keyword(s):  
Health System ◽  
Health Systems ◽  
National Health ◽  
Universal Access ◽  
Research Question ◽  
Access To Healthcare ◽  
Health Policies ◽  
Undocumented Migrants ◽  
Content Type ◽  
British Health

Purpose The purpose of this paper is to analyse the levels of access to healthcare available to undocumented migrants in the Italian and British health systems through a comparative analysis of health policies for this population in these two national health systems. Design/methodology/approach It builds on textual and legal analysis to explore the different meanings that the principle of universal access to healthcare might have according to literature and legal documents in the field, especially those from the human rights domain. Then, the concept of universal access, in theory, is contrasted with actual health policies in each of the selected countries to establish its meaning in practice and according to the social context. The analysis relies on policy papers, data on health expenditure, legal statutes and administrative regulations and is informed by one research question: What background conditions better explain more universal and comprehensive health systems for undocumented migrants? Findings By answering this research question the paper concludes that the Italian health system is more comprehensive than the British health system insofar it guarantees access free of charge to different levels of care, including primary, emergency, preventive and maternity care, while the rule in the British health system is the recovering of charges for the provision of services, with few exceptions. One possible legal explanation for the differences in access between Italy and UK is the fact that the right to health is not recognised as a fundamental constitutional right in the latter as it is in the former. Originality/value The paper contributes to ongoing debates on Universal Health Coverage and migration, and dialogues with recent discussions on social justice and welfare state typologies.

scholarly journals Right to health: (in) congruence between the legal framework and the health system

2016 ◽  
Vol 24 (0) ◽  
Author(s):  
Fernando Mitano ◽  
Carla Aparecida Arena Ventura ◽  
Mônica Cristina Ribeiro Alexandre d'Auria de Lima ◽  
Juvenal Bazilashe Balegamire ◽  
Pedro Fredemir Palha
Keyword(s):  
Health System ◽  
National Health ◽  
National Health System ◽  
Universal Coverage ◽  
Legal Framework ◽  
Right To Health ◽  
Theory And Practice ◽  
Levels Of Care ◽  
Management Actions ◽  
The Right

Objective to discuss the right to health, incorporation into the legal instruments and the deployment in practice in the National Health System in Mozambique. Method this is a documentary analysis of a qualitative nature, which after thorough and interpretative reading of the legal instruments and articles that deal with the right to health, access and universal coverage, resulted in the construction of three empirical categories: instruments of humans rights and their interrelationship with the development of the right to health; the national health system in Mozambique; gaps between theory and practice in the consolidation of the right to health in the country. Results Mozambique ratified several international and regional legal instruments (of Africa) that deal with the right to health and which are ensured in its Constitution. However, their incorporation into the National Health Service have been limited because it can not provide access and universal coverage to health services in an equitable manner throughout its territorial extension and in the different levels of care. Conclusions the implementation of the right to health is complex and will require mobilization of the state and political financial, educational, technological, housing, sanitation and management actions, as well as ensuring access to health, and universal coverage.

The state-of-play in physician health systems leadership research

2019 ◽  
Vol 32 (4) ◽  
pp. 620-643
Author(s):  
Betty Onyura ◽  
Sara Crann ◽  
Risa Freeman ◽  
Mary-Kay Whittaker ◽  
David Tannenbaum
Keyword(s):  
Health System ◽  
Health Systems ◽  
Leadership Practices ◽  
Future Research ◽  
System Reform ◽  
Physician Leadership ◽  
Content Type ◽  
Physician Participation ◽  
System Leadership ◽  
Systems Leadership

Purpose This paper aims to review a decade of evidence on physician participation in health system leadership with the view to better understand the current state of scholarship on physician leadership activity in health systems. This includes examining the available evidence on both physicians’ experiences of health systems leadership (HSL) and the impact of physician leadership on health system reform. Design/methodology/approach A state-of-the-art review of studies (between 2007 and 2017); 51 papers were identified, analyzed thematically and synthesized narratively. Findings Six main themes were identified in the literature as follows: (De)motivation for leadership, leadership readiness and career development, work demands and rewards, identity matters: acceptance of self (and other) as leader, leadership processes and relationships across health systems and leadership in relation to health system outcomes. There were seemingly contradictory findings across some studies, pointing to the influence of regional and cultural contextual variation on leadership practices as well entrenched paradoxical tensions in health system organizations. Research limitations/implications Future research should examine the influence of varying structural and psychological empowerment on physician leadership practices. Empirical attention to paradoxical tensions (e.g. between empowerment and control) in HSL is needed, with specific attention to questions on how such tensions influence leaders’ decision-making about system reform. Originality/value This review provides a broad synthesis of diverse papers about physician participation in health system leadership. Thus, it offers a comprehensive empirical synthesis of contemporary concerns and identifies important avenues for future research.

Bridging human rights and social determinants of health: Argentina, Chile, Paraguay, and Uruguay

2019 ◽  
Vol 13 (1) ◽  
pp. 3-17
Author(s):  
Juan Smart ◽  
Alejandra Letelier
Keyword(s):  
Human Rights ◽  
Health Status ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Right To Health ◽  
Determinants Of Health ◽  
Human Right ◽  
Content Type ◽  
Health And Human Rights ◽  
The Right

Purpose The purpose of this paper is to do a systematic assessment and testing of identified human rights norms alongside social determinant approaches in relation to identified health issues of concern in four Latin American countries (Argentina, Chile, Paraguay and Uruguay) to show how social determinants and human rights frameworks improve population health. Design/methodology/approach To do so, in the first part the authors analyze the inequalities both between and within each of the selected countries in terms of health status and health determinants of the population. Then, in the second section, the authors analyze the level of recognition, institutionalisation and accountability of the right to health in each country. Findings From the data used in this paper it is possible to conclude that the four analysed countries have improved their results in terms of health status, health care and health behaviours. This improvement coincides with the recognition, institutionalisation and creation of accountability mechanisms of human rights principles and standards in terms of health and that a human rights approach to health and its relation with other social determinants have extended universal health coverage and health systems in the four analysed countries. Originality/value Despite of the importance of the relation between human rights and social determinants of health, there are few human right scholars working on the issues of social determinants of health and human rights. Most of the literature of health and human rights has been focussed specific relations between specific rights and the right to health, but less human right scholar working on social determinants of health. On the other hand, just a few epidemiologists and people working on social medicine have actually started to use a universal human rights frame and discourse. In fact, according to Vnkatapuram, Bell and Marmot: “while health and human rights advocates have from the start taken a global perspective, social medicine and social epidemiology have been slower to catch up”.

scholarly journals Adapting results-based financing to respond to endogenous and exogenous moderators in Zimbabwe

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Artwell Kadungure ◽  
Garrett Wallace Brown ◽  
Rene Loewenson ◽  
Gwati Gwati
Keyword(s):  
Health System ◽  
Scale Up ◽  
System Reform ◽  
Middle Income ◽  
Health System Reform ◽  
Content Type ◽  
Middle Income Countries ◽  
Exogenous Factors ◽  
Multi Stakeholder ◽  
Results Based Financing

PurposeThis study examines key adaptations that occurred in the Zimbabwean Results-Based Financing (RBF) programme between 2010 and 2017, locating the endogenous and exogenous factors that required adaptive response and the processes from which changes were made.Design/methodology/approachThe study is based on a desk review and thematic analysis of 64 policy and academic literatures supplemented with 28 multi-stakeholder interviews.FindingsThe programme experienced substantive adaption between 2010 and 2017, demonstrating a significant level of responsiveness towards increasing efficiency as well as to respond to unforeseen factors that undermined RBF mechanisms. The programme was adaptive due to its phased design, which allowed revision competencies and responsive adaptation, which provide useful insights for other low-and-middle income countries (LMICs) settings where graduated scale-up might better meet contextualised needs. However, exogenous factors were often not systematically examined or reported in RBF evaluations, demonstrating that adaptation could have been better anticipated, planned, reported and communicated, especially if RBF is to be a more effective health system reform tool.Originality/valueRBF is an increasingly popular health system reform tool in LMICs. However, there are questions about how exogenous factors affect RBF performance and acknowledgement that unforeseen endogenous programme design and implementation factors also greatly affect the performance of RBF. As a result, a better understanding of how RBF operates and adapts to programme level (endogenous) and exogenous (external) factors in LMICs is necessary.

scholarly journals Acción social colectiva por el derecho a la salud, Bogotá, 1994-2010

2011 ◽  
pp. 232-269
Author(s):  
Mauricio Torres Tovar
Keyword(s):  
Health System ◽  
Social Action ◽  
Collective Identity ◽  
Right To Health ◽  
Political Struggle ◽  
Human Right ◽  
Social Actions ◽  
Negative Impacts ◽  
The Individual ◽  
The Right

A finales del año 1993 Colombia estableció a través de la Ley 100 una política de Estado en salud que tiene como base el aseguramiento individual a un mercado de servicios de atención a la enfermedad. El desarrollo de este sistema de salud ha generado impactos negativos sobre la garantía del derecho a la salud de la población, razón por lo cual se fue estableciendo un campo de contienda política por el control de la salud en el país. L articulo describe y analiza las acciones sociales colectivas por el derecho a la salud realizadas después de la expedición de la Ley 100 y hasta el 2010, teniendo como estudio de caso la ciudad de Bogotá. Se hace una caracterización de lo que fueron estas acciones sociales colectivas tanto contenciosas como no contenciosas, permitiendo evidenciar que, producto de la realización de estas acciones colectivas se pudo avanzar en la construcción de una identidad colectiva alrededor de la comprensión de la salud como derecho humano y se configuro un movimiento social capaz de ganar la contienda política y establecer las decisiones necesarias para transformación el campo de la salud a favor de los sectores sociales que demandan la garantía del derecho a la salud. Collective Social Action for the Right to Health, Bogotá, 1994-2010 Through the law 100 Colombia established at the end of 1993 a health policy that is based on the individual access of services market of the care disease. The development of this health system has resulted in negative impacts on the guaranteed right to health for the population, and it was establishing a field of political struggle for control of health in the country. The article describes and analyzes the collective social actions for the right to health made after the expedition of law 100 until 2010, taking Bogota as a case study. A characterization of these collective social actions, both contentious and non-contentious, shows how it has advanced in the construction of a collective identity around the understanding of health as a human right. The article also pinpoints how social movement for the right to health was configured, but without producing a political subject capabla of winning in the political contest, and establishing the necessary decisions for transforming the health field for the social sectors that demand the guarantee of the right to health. Keywords: Colombia, Right to Health, Collective Action, Political Struggle, Health System. 

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