title: Looking for Evidence of the Impact of Introducing a Human Rights-Based Approach in Health: The SaluDerecho Experience.
abstract: This paper summarizes the background, methodology, results, and lessons learned from SaluDerecho, the Initiative on Priority Setting, Equity and Constitutional Mandates in Health. Originally facilitated by the capacity-building arm of the World Bank in 2010, it was implemented in Latin American countries and later expanded to other regions of the world. Segmentation, decentralization, and lack of coordination in health systems; weak information systems; stratified societies; and hierarchical power relations in participating countries are some of the characteristics that inhibit a human rights-based approach to health. Hence, deliberate interventions like SaluDerecho are vital. Facilitating the participation of multiple stakeholders in a more informed and transparent dialogue creates a "safe" working environment to co-create policy solutions to improve transparency and accountability. The proposed evaluation methodology involves several steps that begin with an assessment of behavioral changes in actors (including policy makers, citizens, payers, and health care providers) that reshape relationships and, over time, change the functioning of health systems. Despite certain limitations, SaluDerecho has provided evidence of positive change among participating countries.
authors.affiliation: Health economist, independent consultant, and former Health System Practice Manager at the World Bank, Washington, DC, USA.
authors.forename: María-Luisa
authors.initials: ML
authors.lastname: Escobar
authors.affiliation: Psychiatry resident at the Geisel School of Medicine at Dartmouth College, Lebanon, NH, and former Senior Health Specialist at the World Bank, Washington, DC, USA.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Cubillos
authors.affiliation: Senior Health Economist at the World Bank, Washington, DC, USA.
authors.forename: Roberto
authors.initials: R
authors.lastname: Iunes
mesh_terms: D014943:Global Health; D018166:Health Care Reform; D006291:Health Policy; D006292:Health Priorities; D006806:Human Rights; D006801:Humans; D011050:Policy Making