Advancing human rights in patient care through higher education in Eastern Europe and Central Asia.

Background: In Eastern Europe and Central Asia, for society's most marginalized people, health systems are too often places of violations of basic rights, rather than of treatment and care. At the same time, health practitioners are largely unaware of how to incorporate human rights norms in their work. Additionally, they may face abuses themselves, such as unsafe working conditions and sanctions for providing evidence-based care. Similarly, legal professionals have limited experience working in the health sector, trying to address abuses that occur.

Context: Republics of the former Soviet Union and Yugoslavia have emerged from communism and experienced continued restructuring of their health care systems. As faculties of law, public health, and medicine have sought to incorporate these rapid changes into their curricula, this period of reform and openness to new approaches presented a particular opportunity to integrate human rights education.

Results: The Open Society Foundations have attempted to respond to the need to build health and human rights capacity by supporting the development of over 25 courses in human rights in patient care in nine countries. Targeted at different audiences, these courses are now part of the regular offerings at the academic institutions where they are taught. Student evaluations point to the strength of the interdisciplinary approach and the need to integrate practical examples and exercises. Faculty response has led to the development of a virtual community of practice and series of workshops to gain exposure to new ideas, strengthen interactive teaching, and share materials and experiences.

Reflections: Critical to this initiative has been working with faculty champions in each university, who shaped this initiative to meet the needs in their context. It quickly became apparent that teaching methodology is as important as content in human rights education. Meaningful engagement with health practitioners has entailed connections to day-to-day practice, participatory methodology, inclusion of marginalized voices, and linkages to provider rights and challenges.