Do's and Don'ts in Human Rights Training for Health Providers

  • Author: OSI LAHI


Expert Consultation: How Can Training of Health Providers Be Effectively Used to Promote Human Rights in Patient Care?

Open Society Institute

Law and Health Initiative

Expert Consultation:

How Can Training of Health Providers Be Effectively Used to Promote Human Rights in Patient Care?



  • Plan a training as a component of a broader intervention.
  • Training should be framed as a process, rather than an event.  It necessitates action when participants go back to their work.
  • Training should be action-oriented and combined with the development of advocacy.
  • Set out ambitious, but well-defined and narrow goals.
  • The training can also serve as a leadership development workshop, increasing impact.
  • Create prestige around an issue.


  • Identify leaders at different levels in the health system who can create incentives and mobilize people for change.
  • Involve local opinion leaders.
  • Provide key people a sense of public visibility as a leader on an issue.
  • Use both a top-down and bottom-up strategy.
  • Focus on faculty for systemic impact.
  • Aim to create a culture of respect by influencing younger generations.
  • Look across the continuum of care.
  • Engage with family care physicians.
  • Use a systems approach to change and harness  multiple audiences on behalf of common goals.
  • From alliances with NGOs, professional organizations, and the medical and judicial establishment.


  • Tailor strategies to the target audience.
  • Recognize local peculiarities.
  • Use peer-led trainings.
  • Human rights should be made concrete.  Trainings could be combined with an audit or rapid assessment.
  • Bring the voices of patients and people whose rights have been violated into the room though guests, case studies, and film.
  • Include marginalized groups as an integrated part of training.
  • Doctors are also patients so it is possible to tap into their own experiences as patients.
  • Connect to the reasons health providers decided to enter the health care profession.
  • Cross role boundaries  and disciplines.  People do not work in a vacuum, but rather in relation to one another.
  • Use interactive, participatory adult methodology.
  • A technique that will work well in a large group is to show a film clip and then ask participants to discuss with their neighbour.
  • Provide a brief introduction to the legal framework, followed by many practical examples.
  • Include didactic framing at the beginning of the training and a didactic pulling out of key lessons at the end.
  • Start the workshop with provider rights so that health workers feel invested and their concerns are addressed.
  • Engage in values clarification.  Recognize the difficult situations of health professionals and that human rights answers are not easy.
  • Provide health workers a space to talk about their challenges.
  • Identify needs, desired behaviours, and the reality.
  • Tap into people’s highest aspirations. 
  • Start with an assumption of alignment, and empower participants and mobilize them to effect change.
  • Encourage participants to focus on their own sphere of influence so that they can make a difference.
  • Respect  participants as agents of their own destiny.

Evaluation and Impact

  • May want to have pulse checks during the workshop and  an independent exit interview of participants after a training.
  • Always plan for follow up.
  • Post-training, use checklists and “reminders” or visual re-enforcements, such as posters to integrate ideas in practice.
  • Identify “enablers” to people acting in the best professional sense.  These can then become outcome measures for evaluation.
  • Training is about the actions afterwards.  These actions can then become outcome measures.
  • Potential benchmarks could include clinical guidelines and observational studies to measure adherence.
  • Use both short term process indicators and measure long term impact through observational audits.
  • Employ annual audits to check how participants are doing.
  • Provide encouragement and award good behaviour.


  • Do not engage in training with no buy-in from senior leaders.  This will only lead to frustration.
  • Do not proceed with training without the gatekeepers’ buy-in and buy-in at all levels.
  • Avoid one-offs and training with no follow-up.
  • Do not hold trainings for health providers that are only led by lawyers.
  • Do not rely on lectures and didactic learning.
  • Do not envision training as the “pouring of expertise” from trainer to participants.  Rather, training is an interactive process of mutual learning.
  • Do not relay human rights as abstract principles.
  • Do not preach about human rights , while not listening to health providers and paying attention to the barriers they encounter in their work.
  • Do not attack participants.
  • Do not take a confrontational approach and rely solely on external motivations, such as the avoidance of malpractice suits.  This can lead to the practice of defensive medicine.

Questions to Consider

  • When is it appropriate to train?
  • What can training do or not do on an untouchable problem in a country?
  • Who is best placed to train?
  • If we train enough health managers, will this have an impact on policy?
  • What is the role of medical students and professional associations?
  • How general or specific should a training be?
  • How do we make human rights practical and relevant to health providers?
  • How explicit do we want to be about human rights?  Do we want to use the quality and ethics approach?
  • How can we monitor and know we achieved results?

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