Healthcare: A human right imperative

Access to healthcare is one of the most vital yet basic human rights recognized universally. Though we may disagree on countless life aspects as a people, however, on this one in particular, we all understand that receiving healthcare is an essential part of every human need, regardless of age, race, religion, gender, sexual orientation, or even social status. Since this seems to be an apparent fact, let us zoom in on the seven crucial principles that encompass the holistic provision of healthcare, especially in the context of third-world countries where over 80% of the country’s population is majorly dependent on public health services. It is not enough that healthcare is simply provided, but it is just as pivotal to further explore the "how factors" of this provision.

7 Principles of healthcare provision

1. Accessibility and availability of healthcare

2. Respect of Life

3. Skilled Labour

4. Low medical risks

5. Affordability

6. Confidentiality

7. Patient feedback platforms

Accessibility and availability of healthcare

For healthcare to fulfil its human right commission on a globally relevant level, it needs to be both accessible and available to the community it intends to serve. Let us begin with "accessibility"...Regardless of geographical location, every community, rural or urban, should have access to some level of primary healthcare services, be it a local clinic or a hospital. Accessibility means that community individuals should find it easier to reach the health facility in cases of medical emergencies for the preservation of life. Beyond the challenges of accessing healthcare, the bigger question is whether the health service needed is available. What does “availability” of healthcare mean? It is a national responsibility for all governments to ensure that when communities reach medical facilities, medical resources are available. This includes availability of skilled healthcare professionals, presence of adequate working equipment within the facility and attainability of treatment options for the patients. This is why accessibility without availability becomes a fruitless effort. Accessibility and availability are the yin and yang of healthcare service delivery.

Respect of Life

Every healthcare professional is required, by natural intuition, to have a heightened sense of ‘respect for life.’ For centuries, the healthcare profession has been dubbed to be a very distinct type of profession from its professional counterparts like legal or educational professionals. Being a medical professional is globally recognised as a profession with a “calling,” linking it to a spiritual or conscientious duty to society. It is within this very context that health professionals have a responsibility to respect their patients throughout their consultation journey. Respect is the essential foundation of quality patient care. This begins with the initial display of basic mannerisms when receiving patients at a health facility through courtesy and acknowledgement of patients. Respect of the patient journey also involves healthcare professionals showing both sympathy and empathy to patients in their vulnerable state, by making them physically comfortable, as far as is possible, i.e. pain management, and mentally comfortable through reassurance and simplified explanations of one’s condition as well as clarity on available treatment options. Health professionals should always best advocate for patients in their care, having their best interest at heart.

Skilled Labour

Each healthcare facility should endeavour to ensure that all healthcare professionals employed under the facility are indeed legitimately qualified to perform the medical duties they are expected to perform. This is a human resource responsibility; however, every management team should enforce compliance around these lines. Keeping a skilled and qualified workforce improves patient care quality. In this way, there is less medico-legal hazards within the facility, meaning less mortality. This supports the principle of healthcare, which is to preserve life and not compromise it. Patients feel safer in the hands of knowledgeable personnel. With the healthcare industry ever evolving, healthcare professionals owe it to themselves and the community they serve to stay current with local and global health matters, new medical improvements and innovations or changes in clinical policies and legislations within the industry that impacts patients or themselves.

Low Medical Risks

Creating a safe space for patients can never be over-emphasized. Every health facility receiving patients into their care, has an obligation to ensure that every patient is managed at the highest possible care while minimizing any medical risk, seen or unforeseen. This is where the organizational quality standards must be maintained, particularly from an ethical clinical perspective. Clinical governance plays a pivotal role in improving clinical outcomes for patients. Focus areas for reducing medical risks involve creating proper frameworks around prompt medical treatment, infection control measures, preventing medico-legal hazards, minimizing post-operative complications, and increasing pharmacovigilance. In instances where organizations fail to comply with QI (Quality Improvement) frameworks, accountability must be imposed and proper steps taken to avoid such risks in the future. Clinical negligence should never be taken lightly at any stage of health service delivery because “all human life is precious.” 

Affordability

Healthcare has globally become overly expensive, leaving much needed medical help only available to the minority who can afford it. Affordability of healthcare plays a huge role in lowering a country’s morbidity and mortality rate. In most cases, medical assistance has become extremely expensive that even middle- and upper-income individuals struggle to afford critical medical care. The medical charges imposed by private health professionals like specialist doctors leave many patients financially cornered. Health insurance expenses in the form of large amounts of upfront co-payments and upfront doctor fees which are way above medical aid rates, force patients to either create extra financial debts in order to pay these fees or having no alternative but to cancel much-needed treatments for lack of funds, leaving them with worsening medical conditions and potentially death. It is for this very reason that governments should strive to make healthcare for their citizens affordable, to the best of their ability.

Confidentiality

Confidentiality in healthcare is an ethical responsibility for everyone who has access to the patient and their health information, whether this information is given verbally or documented, manually or digitally. A patient’s confidentiality begins from the time they provide their personal information when they arrive at a health institution, to providing their sensitive medical information to healthcare personnel. This information, in whichever country you are in, is protected by various laws and regulations, all highlighting the importance of securing the privacy of every patient’s personal information. All healthcare professionals are legally bound to these laws. Though this information is protected, there are exceptional circumstances that health facilities can share this information, as in the case of information-sharing between hospital managed healthcare departments and a patient’s health insurance (medical scheme) to facilitate proper reimbursement for services rendered. Even under these circumstances, patient health information should still be utilized under controlled measures, including putting in place tight cyber-security control measures to mitigate risk of personal information falling into the wrong hands. 

Patient feedback platforms

Quality improvement is heavily dependent on customer feedback. Lack of platforms for patient feedback in our healthcare institutions leaves a massive gap in service improvement opportunities. Particularly in public health, failing to implement consistent patient feedback channels for patients to both compliment or complain about service delivery, means that the patient’s right can be easily abused and exploited with minimal accountability. Numerous public health patients report negative experiences in public health facilities from health professionals, particularly in primary healthcare facilities like local clinics in rural areas or township areas. This poor service delivery is reported as forms of verbal abuse or disrespect from nursing personnel, long waiting times for services only to be turned away without getting help and asked to return another day or, given incorrect treatments for conditions presented. Unfortunately, patients are not afforded a “voice” to have their grievances heard and investigated. A monitoring system for service delivery in public health sectors would ensure that patients are treated with both respect and dignity and thus deter the number of individuals who end up avoiding seeking medical treatment for fear of the service they might receive. Creating this platform for patients utilizing public health, with the purpose of improving service, would build accountability for all health professionals and re-build trust in the health industry for patients and communities at large.

As clearly evidenced, healthcare delivery is a composition of multiple elements which, when collaborated, provides a holistic approach to equitable health outcomes. Prioritizing healthcare as a human right forms part of every government’s fundamental obligation to its nation.

References

Tariq RA, Hackert PB. (2023) Patient Confidentiality. Available at: https://www.ncbi.nlm.nih.gov/books/NBK519540/ (Accessed on: 16 April 2025).

Whittaker S, Shaw C, Spieker N, Linegar A. (2011) Quality Standards for Healthcare Establishments in South Africa. Available at:  https://www.hst.org.za/publications/South%20African%20Health%20Reviews/5%20Quality%20Standards%20for%20Healthcare%20Establishments%20in%20South%20Africa%20SAHR%202011.pdf (Accessed on: 16 April 2025).

Scott PA. (2017) Key Concepts in Nursing Ethics. Switzerland: Springer International Publishing.

Abrahams GL, Thani XC, Kahn SB. (2022) ‘South African Public Healthcare Services and Challenges’, Considerations During the Covid-19 Pandemic, 30(2), pp. 67. doi. https://journals.co.za/doi/epdf/10.10520/ejc-adminpub_v30_n2_a7

Assessed and Endorsed by the MedReport Medical Review Board