Table 3 Common health service issues addressed by legal empowerment
From: The use of legal empowerment to improve access to quality health services: a scoping review
Problems addressed by LE programmes | Modalities | Examples |
|---|---|---|
Community lack of awareness on health rights, entitlements, and tools for grievance redress | • Training • Awareness raising, such as “legal literacy classes” • Community scorecard process to document reality against standards • Creation of tools for low literacy populations • ‘Conscientization’ in Freirean tradition | • Train detained people on their rights regarding health care access in detention • Legal Counsellors from partner NGOs undertake assessments in communities of sex workers, people who use drugs, and others regarding their knowledge and priorities, and then conduct a training on entitlements and remedy • Community-based awareness raising sessions regarding the link between civil registration and health insurance • Creation of “Health Advising Centers” that conduct information sessions • Supporting collective efforts to gain health insurance |
Poor access to systems to provide remedy and redress | • Community paralegal programmes (also called “Barefoot lawyers,” “Legal Counsellors”) • Mobile legal clinics • “Legal integration” programmes, where legal services are provided in health settings • Health Advising Centers that provide information and support to individuals • Training and collaboration with government, community-based structures, such as Village Health Committees or Health Facility Committees | • Paralegals inform providers about patient rights and entitlements and health sector policies or meet with people whose health needs are to be met (e.g. individuals in detention or women who require support with unwanted pregnancies) • Paralegals confront health providers and/or institute formal or informal complaints regarding denial of care, rude treatment, requests for bribes, or other types of mistreatments • Paralegals pressure/support providers and managers to address health system challenges, such as stock outs or absenteeism • Paralegals advise and accompany survivors of sexual violence on legal processes • An extensive network of outreach workers facilitates community member contact with paralegals and legal aid clinics • Referral to legal aid, pro-bono services, other complementary services • Registration support to establish legal personhood |
Inability of judicial processes to address gaps in effective health coverage | • Documentation for advocacy | • LE programme aggregates cases to illustrate patterns of state failure related to effective health coverage gaps • LE programme maps violations/cases in order to illustrate troubled facilities |