About the Health Legislation Database

About the Health Legislation Database

Why a health legislation database?

Why legislation matters?

Legislation takes many shapes – it covers constitutions, laws, ordinances, decrees, treaties and agreements, court decisions, contracts and any other binding pieces used by countries.

Legislation translates the priorities countries have and the choices they make as to how they organize themselves at various levels and for various sectors – including health. Legislation provides the basis to operationalize and implement countries’ health policy goals and commitments such as Universal Health Coverage.

There are many ways in which legislation influences health. Here are a few examples:

  • Legislation enshrines health and health-related rights and freedoms (right to health or health care, right to information, informed consent, prohibition of hospital detention, health and safe work environments, etc.).

  • Legislation sets up access rights in the form of health benefits.

  • Legislation establishes and defines mandates and operating modes, for health institutions such as the ministry of health, national regulatory agency, insurance bodies, national health service, national health fund, public health agency, etc.

  • Legislation defines standards for the quality and safety of health services.

  • Legislation provides mechanisms to ensure accountable and transparent operation of health systems.

Why connect legislation and policies, strategies and plans?

Legislation, policies, strategies and plans are words that can be interpreted in many different ways. The glossary [link] offers definitions for these instruments that while distinct interplay and influence one another:

  • The legal environment in place is a key factor to assess when developing policies, strategies and plans to understand the avenues and margin for action, the key institutions and actors, and the gaps or barriers that have their roots in the laws. While health policies, strategies and plans define the course of action, the feasibility and the speed of their implementation will heavily depend on the availability and quality of legislative frameworks.

  • The policies, strategies and plans are in turn a valuable reference point to understand which legislative reforms have been identified as priority action areas to best progress on the health vision of the country. They can serve as an impetus for the development of new legislation. For example, newly emerging areas in health care such as telemedicine, the use of artificial intelligence and ethics are often first addressed by policies or strategies before being regulated by the law. Due to their flexibility, policies lay a basis for regulation by defining the scope of the issue at hand and gaps in current regulation.

Legislation, policies, strategies and plans share common features:

  • They all should be the outcome of strong processes building on meaningful stakeholder engagement, data and evidence.

  • They should all be closely monitored and adjusted over time.

  • They should all be supported by relevant financial resources.

And yet, they are not interchangeable:

  • Policies, strategies and plans have the function of identifying strategic priorities based on a strong situational assessment and understanding of countries’ needs and context. In most cases, they are not legally binding.

  • Legislation has the function of providing binding force and anchor in time rights, obligations, institutional arrangements and standards (among other things). As such legislation is a powerful tool to operationalize strategic directions identified in national health policies, strategies and plans.

Not all countries use national health policies, strategies and plans to define strategic shifts. Some countries will rather leverage legislative frameworks to anchor values and direction for the health system. In these contexts, it is even more critical to ensure that legislation development and reforms are based on a strong process to capture needs, evidence, and feasibility.

What can be found in the health legislation database?

Overview

The health legislation database offers access to a wide array of legislative instruments for health. Sources as diverse as constitutions, codes, laws, decrees, ordinances, guidelines (and many more) can be found here.

This legislation database was developed in response to the scarcity of legal information on health systems as a whole in many countries. To promote a holistic approach to legal strengthening for health, this database includes legislation across all health systems areas such as governance, financing, health and care workforce, medical products, service delivery, and health information systems. In addition, the database references legislation on data protection, civil registration system, procurement, etc. which has a broader scope but influences the operation of health systems.

Some laws available on specific topics such as tobacco control, mental health, and children and women’s health are included but have not been the focus of data collection as existing databases are dedicated to these specific thematic (see information on Resources on health legislation).

The contents of the database are organized through two entry points: the Country Legislative Profiles and the Health Legislation Repository.

Country Legislative Profiles

The view “Country legislative Profiles” offers a comprehensive picture of the country’s legislative landscape for health. It includes the following:

  • Legislative Timeline: an interactive view of the adoption dates of all the legislation featured in the database along with timeframes of national health policies strategies and plans. Different colours are used to differentiate the different types of legal instruments. This timeline shows periods of (intense) legislative activity and the time interval between the adoption of a law and the adoption of its implementing rules and regulations.

  • Thematic Highlights: for every country, an analytical overview of Constitutional provisions and national health strategies policies and plans. Constitutions are reviewed to assess health-related rights and health-mandate. National health policies, strategies and plans are reviewed to identify action areas relating to legal or regulatory reforms. This thematic section highlights the level of rights-based approaches for health and the strategic priorities identified by the country for legal reforms.

  • Main Legislative Instruments (overview): a selection of the key health and health-related legislation that gives the user a concise picture of the foundational legislation for health in the country. The legislative sources represented may vary across countries but commonly include:

    • Constitution – represents the supreme legal document of the country that governs the right to health or health care and establishes mandates for the executive and legislative powers relating to health.

    • Public health law or public health code – legislation that sets the foundation for the provision of public health services in the country.

    • Laws or regulations governing the structure and mandate of the ministry in charge of health or other key health institutions – such as national regulatory authority, National Health Insurance Fund, etc.

    • National health insurance laws – legislation that establishes the framework for major national health insurance schemes.

  • Other key legislative instruments governing various elements of the health systems (e.g. human resources and medicines etc.)

  • Main Legislative Instruments (details): additional details regarding the main legislative instruments. This includes a short description of the legal instrument, its adoption and amendment date (if available), reference to texts or laws repealed by the law in question as well as three thematic spotlights. These three thematic spotlights focus on the structure and main contents of the document, and key information relating to health structures, mandates, entitlements, etc. Finally, it also includes references to related instruments such as primary legislation, implementing regulations or amending legislation.

Health Legislation Repository

The view “Health Legislation Repository” presents a centralized database of all the legal and regulatory documents collected. The files are organized in reverse chronological order and can be filtered by country or region, keywords or tags, type of instrument, adoption year and language.

Why and how to use the information provided?

Why and how to use the information provided?

Legislation for health is often scattered and analyzed in vertical ways (by program, by disease, by health system area). This database intends to reinforce the need to approach legislation’s strengthening for health in a holistic manner and to ensure that all efforts by national and international partners are grounded in a good understanding of legal and institutional arrangements in place across the board.

For this reason, the scope of legislation collected in the database is deliberately broad and designed to provide access to a comprehensive set of legislation covering all health systems areas as well as institutional frameworks (e.g., the Constitution).

The Database is open to all kinds of stakeholders who are invited to use the information throughout the different steps of the policy-making cycle and for other purposes:

  • Governments and parliaments: use the Database for research and analysis when planning legislative and policy reforms;

  • Development organizations and agencies: the Database serves as a resource to understand the institutional settings and institutional arrangements for health in the country;

  • Academia: Database serves as a source for legal and policy analysis and empirical studies;

  • Non-governmental organizations: use the Database for advocacy initiatives and accountability projects.

Disclaimer:

The sources represented in the Legislation Database were originally collected as part of an assessment of the legislative frameworks for universal health coverage in the 47 countries of the WHO African Region, complemented by online searches.

In many countries, access to legislation was scattered and different sources were consulted including websites from various ministries, regulatory agencies, parliaments, and international partners.  The team is doing their best to keep the database up to date. Yet, because of the breadth of the legal and regulatory architecture, the constantly evolving legislative updates, and the difficulty of accessing laws in some countries, there may be gaps.

If you would like to contribute by sharing additional legislation or comments, please reach out to  healthlaws@who.int

How can WHO support countries’ efforts towards legislation strengthening

WHO supports its Member States in strengthening the legislative frameworks for health based on the needs of countries by:

  • Providing technical support for legal reforms (legal mapping, assessment of laws in place);

  • Facilitating intercountry dialogue and peer exchange;

  • Capacity development by providing tools and training to the legislature; ministries, legal assistants and other stakeholders;

  • Availing evidence on the effective legal interventions for health;

  • Advocating for and promoting the importance of legal frameworks for health.

Resources on health legislation

WHO resources on health legislation

If you would like to learn more about how legislation influences health and supports countries in achieving health goals, you are invited to consult the following resources, tools and databases:

Databases

Legal assessment tools:

Key resources on health legislation and policy:

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