Citizen Participation in Health (LK0027)

Establish a sustainable mechanism for citizen participation in health sector development
1st March 2019 – 31st August 2021
Lead implementing agency/ actor Ministry in charge of the subject of Health
Commitment description
What is the public problem that the commitment will address? The health sector is currently undergoing reforms to strengthen primary healthcare. These reforms aim at addressing demands for healthcare and developing a system where the citizens can access the closest primary healthcare hospital and receive appropriate specialized care as per their needs. Although it is important for citizens to take part in the process to see these reforms through, there is currently limited engagement of citizens in health sector development. Absence of sustained mechanisms to share information and obtain citizen feedback is a primary reason for low level of citizen participation in health sector development.
What is the commitment? Citizens must understand and participate in health sector reforms to ensure their success. The purpose of this commitment is to provide strategies that will empower citizens and enable them to participate in the development of health services in the country. Existing channels of engaging the public will be revisited. Linkages formalizing citizen participation and platforms to share information will be strengthened.
How will the commitment contribute to solve the public problem? Citizens will be empowered to participate in health sector development using several strategies. More linkages will be established with citizen groups to formalize citizen participation. Improving the health ministry website to make it more people friendly will create more opportunities for citizens to easily access information and to provide feedback. This platform will also provide evidence based health information that can be easily understood which can dispel any misconceptions that hinder people’s health and contribute towards improving health literacy. Identified priority areas are: chronic kidney disease, mental health and drug supply management. While citizens can give useful feedback they also need to be empowered on changing their health seeking behaviours, i.e. the primary care strengthening will bring a system where the closest primary care hospital will become their first choice for contact care.
Why is this commitment relevant to OGP values? This commitment addresses the values of public participation as it encourages citizens to participate in implementing the health reforms in a successful manner. It promotes access to information by providing health related information more accessible to the citizens.
Additional information The reforms have been approved as the policy for health service delivery for UHC.
Milestone Activity with a verifiable deliverable Start Date: End Date:
1. A sustainable mechanism will be introduced to enable citizen participation for health improvement through formalizing existing networks of Sarvodaya and Peoples Health Movement. April 2019 February 2020
2. A people and professional friendly ministry website will be developed, improving the image of the organization in health development whilst engaging all for health improvement. April 2019 June 2020
3. A drug supply management information system up to primary care level is created informing stock outs to both providers and people April 2019 June 2020
4. Information on food based research relevant to CKDu will be made available to citizens through an organized communication strategy April 2019 February 2020
5. An evidence based mental health improvement communication campaign will be launched in schools and other social institutions July 2019 June 2020

4. Citizen Participation in Health Sector

Verifiable: Yes

Relevant to Open Government: Yes

Potential Impact: Minor

Completion: Not Started

According to Sarvodaya, a key civil society stakeholder, the initiatives under this commitment were not implemented due to the new government’s lack of investment in the open government process, exacerbated by a COVID-19 related shift in health policy priorities. This commitment intended to strengthen platforms for citizen engagement in health sector reform, carrying forward commitments from the previous action plan on chronic kidney disease and drug supply management. In terms of access to health information, there was very little progress on improving the Ministry of Health website and no communication campaigns on mental health or food-based research for chronic kidney disease. ^[37] As of November 2021, the Medical Supplies Management Information System still did not include Primary Medical Care Units. ^[38]

The commitment did not accomplish its aims in terms of formalizing Sarvodaya and the People’s Health Movement to improve public participation in health policy. However, both received some opportunities to participate in national health policy during the implementation period. In particular, during 2019, the Chairman of the National Medicine Regulatory Authority accepted the organizations’ recommendations on operationalization of the National Medical Regulations Act passed prior to the implementation period. During the same year, their recommendations on the accountability of the health system were considered for amendments to the Constitution’s fundamental rights chapter—although the process was dropped by the new government. During the pandemic, the Ministry of Health’s COVID-19 response incorporated Sarvodaya and the People’s Health Movement. Sarvodaya interpreted this as reflecting a degree of recognition of the importance of citizen participation in the health sector. ^[39]

Moving forward, there remains a need to strengthen the People’s Health Movement. Sarvodaya also recommends expanding government collaboration with civil society organizations in the health sector by building on the platform of the UN-convened COVID-19 health coordination mechanism, which currently includes the Ministry of Health, the WHO, and Sarvodaya. ^[40]