Testing the OPERA framework to monitor the right to health in Uganda

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Universal health coverage - which means access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines - is the cornerstone of the United Nations Sustainable Development Goal on health, which governments committed to achieve by 2030. For the World Health Organisation, universal health coverage is a practical expression of the human right to health. The right to health can help civil society organisations hold their governments accountable for advancing universal health coverage. However, human rights law and explanations of human rights law are often formulated in a language that is difficult for people without legal training to understand. Furthermore, the right to health applies to all countries of the world - from the wealthiest to the poorest - and is therefore not specifically geared towards any particular country context. These two challenges make it especially difficult for people in developing countries to push their government to roll out universal health coverage which is essential for the right to health. The Center for Economic and Social Rights developed a tool - the OPERA framework - to help civil society organisations 'break open' human rights, by giving concrete advice on how to claim human rights more effectively. Applying the OPERA framework can help civil society organisations develop specific demands or monitor government policy (for example, the government's health budget or health workforce plan) to ensure the government complies with its human rights obligations. However, to be useful it needs to be adapted to local conditions as each country has its own human rights challenges. As a low-income country in Africa, Uganda faces particular challenges: the government budget for healthcare is only about £10 per person per year; there is a shortage of health workers; the poorest people living in rural areas benefit much less from health services than wealthier people living in the cities. In this project, UK based researchers will work with Ugandan civil society organisations so that they can to use the OPERA framework to monitor the government's policy and activities related to universal health coverage in Uganda. This two-year project will examine the introduction of one framework aimed to support advocacy and monitoring of human rights for health, the OPERA framework. Introducing this framework through a participatory method, we will rigorously assess how CSOs take up, use and adapt health based rights for Universal Health Coverage. Civil society organisations can continue to use, and modify, this Uganda specific OPERA framework to ensure that the Ugandan government respects its health rights commitments by continuing its efforts on universal health coverage. By working together this project will allow Ugandan civil society and UK researchers to use their combined knowledge to improve advocacy and monitoring of progress towards universal health coverage for Ugandans. Finally, we hope that the lessons learned while conducting this project can be adapted to other low-income countries in Africa. We will invite civil society organisations from other low-income countries in Africa to our end of year one meeting to explore opportunities for future co-operation. We are optimistic that this will lead to the spread of OPERA framework based monitoring and advocacy for advancing universal health coverage.