Implementation of human rights approach: reform Chilean health

• Published in: Revista venezolana de gerencia Vol. 19; no. 66; pp. 287 - 306
• Main Authors: Cunill-Grau, Nuria, Fernandez, Margarita
• Format: Journal Article
• Language: Spanish
• Published: 01.01.2014
• Subjects: Appropriations and expenditures; Chileans; Directors; Equality; Government and politics; Health policy; Human rights; Management; Public policy; Public spaces; Social service
• ISSN: 1315-9984

The purpose of this work is to analyze the effect of public institutional architecture on implementing public policies with a focus on human rights. The Chilean health reform, from 2005 on, is adopted as a case study. It recognizes enforceable guarantees for citizens to access, opportunity, quality and financial protection for a set of health problems, independent of their subscription to the public or private system. The methodology integrated a qualitative analysis of legal norms, management instruments and in-depth interviews, principally with health directors. Results show that, despite the evident achievements of the Chilean reform for equity in health treatment, efforts to give systematic governance, accountability and public space to its institutional architecture are limited, thereby compromising the intention to install a human rights focus. Conclusions are that the hegemonic pattern of the institutional design, organization and management of the social services should be confronted in order to build viability into implementation of this type of policy. The study suggests the importance of adopting differentiated strategies for accountability that consider social asymmetries in the appropriation and enforceability of rights. Adapted from the source document.