Association ESE

ESE

   Association for Emancipation, Solidarity and Equality of Women.

Bringing Justice to Health - The Impact of Legal Empowerment Projects on Public Health

For millions of people around the world, human rights violations are part and parcel of everyday life—ranging from sexual violence, discrimination in access to housing, and denial of child support, to unfair dismissal from employment, police harassment, and arbitrary detention. Such violations have a particularly harsh impact on individuals whose health is already compromised and who find themselves excluded from civic participation.

In Kenya, people who use drugs routinely face exaggerated criminal charges and heavy sentences, which contribute to their marginalization from society. A quota system in Russia motivates police to reach target numbers of drug-related convictions, resulting in countless arbitrary arrests, while in Indonesia, drug-using populations are subjected to lengthy pretrial detention and extortion at the hands of police and prison guards. Sex workers in Kenya and South Africa face high levels of police violence and harassment and have nowhere to turn for protection from abuse. People living with HIV are frequently dismissed from employment and suffer abandonment and violence based on their status; in Kenya and Uganda, women are often forced into the streets with their children when their husbands die of AIDS, their property rights all but illusory.

The health care system itself is all too often overrun with coercive treatment and violations of patients’ rights to consensual treatment and confidentiality. Members of Macedonia’s Roma population, in particular, frequently face outright denial of health care services, in addition to misinformation and abuse. Palliative care patients in Kenya are often left unaware of social benefits or pain management tools available to them, and are denied the chance to make basic arrangements regarding property disposition and family planning.

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Protection of patients’ rights with focus on people with intellectual disability

The right to health is an internationally recognized right. This right is defined for the first time by the World Health Organization as “a right of everyone to the highest attainable standard of physical and mental health”.

The right to health is closely linked to the protection of patients’ rights which represent a set of rights, responsibilities and obligations under which individuals seek and receive health care services.

People with intellectual disability have the equal right to access and use the services which are provided within the framework of the health care facilities as well as any other citizen in the country. Their marginalization in the social and public life has a negative impact on the level of exercise of the rights regulated within the health laws, including the Law on health care, Law on health insurance and Law on protection of patients’ rights.

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The implementation of the Law on the protection of patients’ rights has “STAGNATED”

The findings from the research on the level of establishment and operation of the legally set mechanisms for protection of patients’ rights indicate evident stagnation in the implementation of the Law on the protection of patients’ rights.

Thus, the following conclusions were drawn from the conducted analysis regarding the establishment and operation of each mechanism for protection of patients’ rights:

 

 Mechanisms for protection of patients’ rights

Research findings

1. Councilors for protection of patients’ rights in inpatient health care facilities

Councilors for protection of patients’ rights are appointed in 5 out of the 56 inpatient public health care facilities, whereby none is appointed in the inpatient health care facilities located in the eastern part of the Republic of Macedonia.

2. Persons for protection of patients’ rights in outpatient health care facilities

The majority of the outpatient health care facilities have appointed persons for protection of patients’ rights.

3. Person for protection of patients’ rights in the Ministry of Health

The Minister of Health has not appointed/authorized person for protection of patients’ rights in the Ministry of Health

4. Local Commissions for promotion of patients’ rights

Only 25% of the units of local self-government have instituted a commission for promotion of patients’ rights. Only part of the instituted commissions is functional.

5. State Commission for promotion of patients’ rights

The State Commission for promotion of patients’ rights is yet to be formed by the Ministry of Health.

6. Office for assistance in the Health Insurance Fund

The Health Insurance Fund of the Republic of Macedonia set up offices for assistance to insured patients for the implementation and protection of their rights regarding health insurance in most of its regional offices.

7. State Sanitary and Health Inspectorate

The State Sanitary and Health Inspectorate did not receive the funds foreseen for the implementation of the Programme for protection of consumers’ rights 2011 – 2012, thus it failed to implement the planned activities for promotion of the Law on the protection of patients’ rights which are foreseen with the Programme. 

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PARTICIPATION OF THE CITIZENS OF THE MUNICIPALITY OF TETOVO IN THE DECISION MAKING AND BUDGETING PROCESSES

 

The Republic of Macedonia, after 22 years since the independence, has failed to establish a legitimate, continuous and non-selective process of citizen participation in the operation of the local self-governments. After 15 years since the ratification of the European Charter of Local Self-Government and 8 years since the establishment of self-governing and independent units of the local self-government, the citizens of the Republic of Macedonia still only qualify as constituents and are not actively involved in the budget process or in the process of making decisions implemented at local level, although there are legal possibilities for this.

In the Municipality of Tetovo, citizens are insufficiently informed about the composition, the operations and the organization of the executive and legislative government and the local public administration; they are not informed about the municipal budget and the local budget process; they are not involved in the process of making decisions of local interest nor they participate in the preparations of the municipal budget; they are not informed about the developments in the budget process nor are they involved in its implementation; they have no trust in the local government and are not satisfied with the circumstances at local level.

This document particularly points out to existing international, regional and national documents that regulate the right of the citizens to participate in the application of public duties and to be informed; the term and the practice of citizen participation in the budget process and the decision making process in Macedonia and globally, as well as findings and conclusions of the survey in the Municipality of Tetovo; it also proposes solutions for involvement of the local population in the budgeting process and the process of making decisions at local level, as well as for increasing transparency and accountability of the local self-government units.

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PARTICIPATION OF THE CITIZENS OF THE MUNICIPALITY OF KOCANI IN THE DECISION MAKING AND BUDGETING PROCESSES

The Republic of Macedonia, after 22 years since the independence, has failed to establish a legitimate, continuous and non-selective process of citizens’ participation in the operation of the local self-governments. After 15 years since the ratification of the European Charter of Local Self-Government and 8 years since the establishment of self-governing and independent units of the local self-government, the citizens of the Republic of Macedonia still only qualify as constituents and are not actively involved in the budget process or in the process of making decisions implemented at local level, although there are legal possibilities for this.

In the Municipality of Kocani, citizens are insufficiently informed about the composition, the operations and the organization of the executive and legislative government and the local public administration; they are not informed about the municipal budget and the local budget process; they are not involved in the process of making decisions of local interest nor they participate in the preparations of the municipal budget; they are not informed about the developments in the budget process nor are they involved in its implementation; they have no trust in the local government and are not satisfied with the circumstances at local level.

This document particularly points out to existing international, regional and national documents that regulate the right of the citizens to participate in the application of public duties and to be informed; the term and the practice of citizen participation in the budget process and the decision making process in Macedonia and globally, as well as findings and conclusions of the survey in the Municipality of Kocani; it also proposes solutions for involvement of the local population in the budgeting process and the process of making decisions at local level, as well as for increasing transparency and accountability of the local self-government units.

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