Giving effect to children's right to health in Colombia? Analysing the implementation of court decisions ordering health system reform

Despite major developments to provide conceptual clarity to the legal enforcement of economic, social and cultural (ESC) rights, research analysing the processes of implementing court rulings and their actual impact is scarce, and there is a lack of consensus on the impacts of this kind of intervention on public policies, the plaintiffs, society, or on how to assess these impacts. This article presents an approach for evaluating the implementation of-often complex-judicial rulings calling for health system reform. The article is based on an analysis of the process of implementation of the Colombian Constitutional Court's decision T-760/2008, which ordered extensive reforms of Colombia's health system. Concurring with the constitutional protection for children's fundamental right to health, decision T-760/2008 includes separate orders explicitly addressing children's right to health. The focus of the article is on the implementation of these orders related to children's access to health care. The article firstly describes the legal strategies, including some of the key elements related to children's right to health, included in T-760/2008. It then analyses the process of implementation through the three mechanisms identified in the framework (institutional/organizational, actors and power relations, and discourses and ideas), before finally evaluating whether the expected outcomes (as described in the parameters of the Court decision) were achieved.