Patient’s rights’ are “those rights that are attributed to a person seeking health care”. Some of the levers to enforce patient rights are health ombudsman, litigation, patient grievance redressal systems, media, and public protests. Patient’s rights’ are important because it has implications for the quality of health care. An effective and functional patient grievance redressal system acts as a key accountability tool but can also galvanize structural improvements in the health system. Furthermore, practicing patient rights will reinforce ethics in health care. The published academic literature on patient rights is mostly from Europe and there is a paucity of scholarly work on the implementation of patient rights’ in Low and middle-income contexts(LMIC). In India, research studies and media reports have captured the concerns on patient rights violations both in the public and private health care facilities. There is limited knowledge on how the existing state policies on patient’s rights’ are translated at the district/subdistrict and the health facility level in India.

The proposed PhD will break new grounds by developing a theoretical framework to guide the implementation of patient rights policies in the health facilities from the multi-level governance perspective based on a systematic scoping review. The framework will then be tested in an LMIC setting (i.e.Karnataka, a southern state in India) using the comparative case study design. Using the framework, the PhD research will examine how the state policies in a federal political/administrative system give expression to patient’s rights in the Karnataka state. It will provide causal explanations on the existing implementation practices of patient’s rights policies at multiple levels (district/subdistrict and health facility). Policy recommendations specific to Karnataka will be formulated and validated in a stakeholder consultation workshop.

The theoretical framework will serve two purposes:
i) build knowledge in the domain of patient rights from a non-Western (Indian) perspective
ii) generate critical policy lessons for different levels to overhaul the existing patient rights enforcement system in the state of Karnataka, India, and similar other LMIC settings. These policy lessons for India on patient rights enforcement are critical for health governance – a key aspect to achieve universal health coverage.