The Citizen Observatory for Health (OCS) – in partnership with various Civil Society Organizations working in health sector in Mozambique, namely: NAMATI and Medicus Mundi – calls for more flexible actions aimed at reviewing and updating the Charter of Patients’ Rights and Duties (CDDD).

According to these organizations, the document in question, approved by Resolution 73/2007 of 18 December, is out of date with the country’s current health reality and is not inclusive, leaving out people with physical disabilities, key populations and other vulnerable groups.

The CDDD is also intended to make room for penalizing health professionals involved in violating the rights of users of the National Health Sistem (SNS). 

In order to make known the consensus that has already been reached, as well as the current stage and subsequent steps in the revision of the CDDD, the Coordinator of the Public Participation Pillar at the OCS, António Mate, explained that the revision process has now entered the phase of validating the aspects that have so far been discussed between the parties and that need to be revised in the new charter, which is intended to be called the Charter of User Rights and Duties (CDDU), as it is understood that not every user is a patient in a health unit.

Below follws an interview with the Coordinator of the Public Participation Pillar at the OCS

The Citizen Observatory for Health (OCS), in partnership with other civil society organizations, has long been calling for a revision of the Charter of Patients’ Rights and Duties (CDDD) to adapt it to the current context:

Citizen Observatory for Health (OCS): What consensus has already been reached with the Ministry of Health (MISAU) on this issue?

António Mate (AM): The first consensus reached with the Ministry of Health is to change the name of the Charter of Rights and Duties of the Patient to the Charter of Rights and Duties of the User, making it more inclusive. But there is also a need to review and update the CDDU because it is out of step with the new health reality in Mozambique, and because the epidemiological picture has been constantly evolving. We have a greater number of chronic illnesses, a growing number of people with disabilities and other vulnerable groups, which require the National Health System (SNS) to make a profound legal intervention that can respond to the current challenges, related to the new framework marked by the weight of other illnesses and other public health problems.

Another consensus reached is linked to the penalizing and disciplinary nature that the CDDU should incorporate in order to bring accountability to all health professionals who violate users’ rights, as set out in the new directive now under review, but also to enforce users’ duties in relation to the protocols established at the level of the Health Units.

 We believe that this is the best mechanism for creating a marriage and not a divorce between users and health professionals, and therefore this new Charter will be a user’s bible, which also provides for the mandatory fulfillment of their duties in terms of respecting the rules established in the Health Units (US).

OCS: What aspects does civil society want to see included in the new Charter that are not included in the current CDDD?

AM: Safeguarding the rights of people with disabilities and special needs, respect for the rights of key populations, a package of benefits for the elderly, the chronically ill and adolescents. Aspects related to the structure of the Charter, which begins by explaining the right to health and its implications for the National Health System. We also want to strengthen aspects related to stigma and discrimination, confidentiality and privacy in hospital care, as well as access to essential medicines. It should include the aspect of the right to an accompanying person for children, the elderly, pregnant women, and people with walking difficulties or other disabilities that limit access to health services on their own. There should be support from the National Health System in relation to the right to food for hospitalized patients, regulating the end of barriers to access to health services based on the clothing and appearance of users. Therefore, in addition to the humanization aspects, the structural aspect of the charter must be given special and in-depth attention.

OCS: At what stage is the process of revising the Charter of User Rights and Duties?

AM: We are currently at the stage of validating aspects that have been discussed up to the present time. It’s been a very complex process, which has respected the principle of including various groups in society. Various groups in society have been consulted and involved, from the key population, to people with disabilities and special needs, to teenagers and young people, where the basic principle of every action taken is to leave no group behind. After validation, a presentation meeting will be held with various groups in society and civil society organizations by the end of February. We want this Charter to be representative. Meetings will also be held with parliamentarians and working committees of the Assembly of the Republic, health professional associations and associations, before the charter is sent to the Office of the Minister of Health.

OCS: We also know that the Observatory has held and taken part in several consultation meetings. What is your assessment in terms of contributions to improving the CDDD?

AM: The balance is positive, as we have managed to involve and listen to various civil society groups and organizations throughout the process. We also took part in meetings with the Health Ministry, the Mozambican Parliament, through its standing Committee, the Committee on Constitutional Affairs, Human Rights and Legality, with the aim of defining and influencing the agenda of the new charter. At these meetings, we were networking through the Alliance for Health and through the National Civil Society Platform for Health and Human Rights. This approach was established throughout the country, through the involvement of Community Based Organizations (CBOs) at provincial and district level.

From this process, in-depth aspects were raised to energize the CDDU, favoring the assumption of its inclusion, since the previous one excluded some groups considered to be the most vulnerable. With this into consideration, a technical group made up of the Citizen Observatory for Health, NAMATI, Medicus Mundi, the National Council to Combat Aids (CNCS) and the MISAU was set up to harmonize the points that had been presented and discussed with the first extended group, which included representation from various civil society organizations at national level.

OCS: Any other contributions you think are important.

AM: As this is an election year, the focus of the day’s agenda is on managing the electoral process and this could jeopardize dialogue with the government, parliamentarians and the Assembly of the Republic’s working committees, so there was consensus between the Civil Society Organizations and the MISAU to repeal the previous Charter. This means that we still have a long way to go before the Resolution becomes law. (OCS)

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