Document Type : Research articles

Authors

1 Department of Health Services Administration, South Tehran Branch, Islamic Azad University, Tehran, Iran

2 Department of Health, Islamic Parliament Research Center of the I.R.I, Tehran, Iran

3 National Research Institute of Health Law, Ministry of Health and Medical Education, Tehran, Iran

Abstract

Background: Health legislation provides a framework to implement various health policies. Participatory democracy in healthcare is inevitable. Citizens and health professionals should participate in participatory democracy, and health laws should be the result of a process in which participatory instruments and techniques have a prominent role. Health democracy can be achieved through the expansion of mechanisms for citizens participation in the legislative process. The health democracy enables citizens to participate in the decision-making process and to have equal access to services provided by the public health system.
Objectives: The current study aims to assess participatory mechanisms used by selected countries to participate their citizens in legislative processes.
Methods: The current study is a comparative study of the legislative processes of selected countries. To select countries, four issues were evaluated: (a) overall legal system; (b) how laws enforce; (c) legislative backgrounds; and (d) health system basic model.
Results: The number of legislative chambers, legislative initiatives, legislative authorities and institutions, legislative commissions, and citizens participation in the legislative process were analyzed in the selected countries. An analysis of the factors affecting public participation in healthcare legislation shows that participation in the legislative process is a complex phenomenon influenced by social, legal, cultural, political, and sovereignty factors. This phenomenon cannot be analyzed isolated from these factors. However, the way should be paved for citizens' participation. The selected countries use different methods for citizens participation, depending on their legal systems.
Conclusions: Research results show that there are various public participation mechanisms. In Iran, there is a huge potential for public participation, and members of the parliament can easily interact with the interest groups and relevant individuals. These conditions provide a golden opportunity for expert health legislation.

Keywords

  1. Brownson RC, Chriqui JF, Stamatakis KA. Understanding evidence-based public health policy. Am J Public Health. 2009;99(9):1576-83. doi: 10.2105/AJPH.2008.156224. [PubMed: 19608941]. [PubMed Central: PMC2724448].
  2. Roberts M, Berman P, Reich M.M, Hsiao W. Getting health reform right. A guide to improving performance and equity. New York: Oxford University Press; 2004.
  3. Mulgan RG. Defining ‘Democracy’. Political Science. 2017;20(2):3-9. doi: 10.1177/003231876802000201.
  4. Ross H, Baldwin C, Carter RW. Subtle implications: public participation versus community engagement in environmental decision-making. Australasian Journal of Environmental Management. 2016;23(2):123-9. doi: 10.1080/14486563.2016.1194588.
  5. Kamlage JH, Nanz P. Public Participation and Democratic Innovations: Assessing Democratic Institutions and Processes for Deepening and Increased Public Participation in Political Decision-Making. 2018.
  6. Michels A. Participation in citizens’ summits and public engagement. International Review of Administrative Sciences. 2017;85(2):211-27. doi: 10.1177/0020852317691117.
  7. Ghazishariatpanahi A. Fundamental rights and political institutions. Mizan. 14th ed. 2016.
  8. Mira JJ, Carrillo I, Navarro I, Guilabert M, Vitaller J, Pérez-Jover V, et al. Public participation in health. A review of reviews. Anales del Sistema Sanitario de Navarra. 2018;41(1). doi: 10.23938/assn.0172.
  9. Feldstein PJ. The politics of health legislation:An economic perspective. 3rd ed. Chicago: Health Administration Press; 2006.
  10. Ruseva M, Chichevalieva S, Harris M, Jakubowski E, Kluge H; Milevska-Kostova N, et al. The South Eastern Europe Health Network: A model for regional collaboration in public health. South East Eur J Public Health. 2015;3.
  11. European Court of Auditors. 'Have your say!': Commission's public consultations engage citizens, but fall short of outreach activities. European Court of Auditors; 2019, [cited 2019 Dec 10]. Available from: https://www.eca.europa.eu/Lists/ECADocuments/SR19_14/SR_Public_participation_EN.pdf.
  12. Milevska NK, Chichevalieva S, Ponce NA, Winkelmann J. The former Yugoslav Republic of Macedonia: Health System Review. Health systems in transition. 2017;19(3):1-160.
  13. Aith FM, Dallari SG. Health legislation and democratic rule of law in Brazil. Cad Saude Publica. 2014;30(10):2032-4. doi: 10.1590/0102-311xpe011014. [PubMed: 25388305].
  14. Flick U. An Introduction to Qualitative Research. 5th ed. Germany: Freie Universtität Berlin; 2014.
  15. Zarei MH. Comparative Study of Legislative Parliaments. Tehran: Islamic Parliament Research Center; 2004, [cited 2019 Dec 10]. Available from: https://rc.majlis.ir/fa/book_pub/show/837394.
  16. Martin PS, Claibourn MP. Citizen Participation and Congressional Responsiveness: New Evidence that Participation Matters. Legislative Studies Quarterly. 2013;38(1):59-81. doi: 10.1111/lsq.12003.
  17. Maye K. Egyptian Politics: The Dynamics of Authoritarian Rule. Boulder, Colorado: Lynne Rienner Publishers; 2004.
  18. Mohammadi SH, Norazizan S, Shahvandi AR. Civic Engagement, Citizen Participation and Quality of Governance in Iran. Journal of Human Ecology. 2017;36(3):211-6. doi: 10.1080/09709274.2011.11906438.
  19. Mohsenpour SR, Arab M, Razavi SHE, Sari AA. Exploring the challenges of the Iranian parliament about passing laws for resource allocation in healthcare: a qualitative study. Electron Physician. 2017;9(10):5418-26. doi: 10.19082/5418. [PubMed: 29238478]. [PubMed Central: PMC5718842].
  20. Lues L. Citizen participation as a contributor to sustainable democracy in South Africa. International Review of Administrative Sciences. 2014;80(4):789-807. doi: 10.1177/0020852314533450.
  21. Daudu IA, Fagbadebo O. Public Participation in Legislative Oversight: A Review of Nature and Practice in Nigeria and South Africa. Perspectives on the Legislature and the Prospects of Accountability in Nigeria and South Africa. Springer; 2019. p. 233-50. doi: 10.1007/978-3-319-93509-6_13.
  22. Royo S, Yetano A, Acerete B. Citizen Participation in German and Spanish Local Governments: A Comparative Study. International Journal of Public Administration. 2011;34(3):139-50. doi: 10.1080/01900692.2010.533070.
  23. Missingham R. Parliamentary library and research services in the 21st century: A Delphi study. IFLA Journal. 2011;37(1):52-61. doi: 10.1177/0340035210396783.
  24. Kamaté C. Public Participation in the Debate on Industrial Risk in France: A Success Story? In: Bourrier M, Bieder C, editors. Risk Communication for the Future: Towards Smart Risk Governance and Safety Management. Cham: Springer International Publishing; 2018. p. 17-30. doi: 10.1007/978-3-319-74098-0_2.
  25. Rumelili B, Çakmaklı D. Civic Participation and Citizenship in Turkey: A Comparative Study of Five Cities. South European Society and Politics. 2017;22(3):365-84. doi: 10.1080/13608746.2017.1354420.
  26. Marzuki A. Challenges in the Public Participation and the Decision Making Process. Sociologija i prostor/Sociology & Space. 2015;53(1).
  27. Almaspoor Khangah H, Jannati A, Imani A, Salimlar S, Derakhshani N, Raef B. Comparing the Health Care System of Iran with Various Countries. Health Scope. 2016;6(1). doi: 10.17795/jhealthscope-34459.
  28. Khodayari-Zarnaq R, Kabiri N, Alizadeh G. Health in First to Sixth Economic, Social, and Cultural Development Plans of Iran: A Document Analysis. Journal of Research and Health. 2020;10(1):1-10.
  29. Vértesy L. The Public Participation in the Drafting of Legislation in Hungary. Central European Public Administration Review. 2017;14(4). doi: 10.17573/ipar.2016.4.06.
  30. Rowe G, Frewer LJ. Public Participation Methods: A Framework for Evaluation. Science, Technology, & Human Values. 2000;25(1):3-29. doi: 10.1177/016224390002500101.
  31. Rakodi C. Politics and performance: the implications of emerging governance arrangements for urban management approaches and information systems. Habitat International. 2003;27(4):523-47. doi: 10.1016/s0197-3975(03)00004-3.
  32. International Secretariat of ParlAmericas. Regulatory frameworks for citizen participation in the legislative process in the Americas and the Caribbean. 2019, [cited 2019 Dec 10]. Available from: https://parlamericas.org/uploads/documents/Toolkit_Citizen%20Participation%20in%20the%20Legislative%20Process.pdf.
  33. Avritzer L. Participation in democratic Brazil: from popular hegemony and innovation to middle-class protest. Opinião Pública. 2017;23(1):43-59. doi: 10.1590/1807-0191201723143.
  34. Rowe G, Frewer LJ. Evaluating Public-Participation Exercises: A Research Agenda. Science, Technology, & Human Values. 2016;29(4):512-56. doi: 10.1177/0162243903259197.