Human Rights, Health Rights and Accountability
COPASAH Training Renu Khanna
September 21, 2013,
What are Human Rights?
Those rights that every human being possesses and is entitled to by virtue of being human, irrespective of citizenship, nationality, race, ethnicity, language, sex, sexuality or abilities
the birth right of all human beings based on the fundamental principle that all persons possess an inherent human dignity
A powerful tool for promoting social justice and dignity of all people
Principles and Values underlying Human Rights
EqualityNondiscriminationDignityBodily integritySelf determination CompassionInterdependence
Modern History of Human Rights
Universal Declaration of Human Rights (1948)
International Covenant of Civil and Political rights
International Covenant of Social, Cultural and Economic Rights
Third generation of rights: CEDAW, CRC, Racial Discrimination etc.
Another definition….What does one mean by a ‘right’?
a right is an entitlement that locates the particular concerns, needs and interests of certain class(es) of individuals against a set of objective standards such that such needs and interests can be claimed and asserted irrespective of an individual’s, a community’s or a government’s views on the issues around them
Sources of Rights Constitution of countries National law International human rights conventions, covenants,
treaties Regional human rights conventions, charters Declarations, programmes of action of various
international and UN conferences Committees eg CEDAW
These sources of rights often define – or lead to - the objective standards
Obligations of the State
To respect: no obstacles in enjoyment of rights
To protect: to protect against violations by third parties
To fulfill: to create enabling conditions so that rights can be met – legislations, policies, budgets
Right to Health in International Documents
Universal Declaration of Human Rights, Article 25
International Covenant on Economic, Social and Cultural Rights, Article 7, 11 and 12
Convention on the Elimination of All Forms of Discrimination Against Women, Article 10, 12 and 14
Convention on the Elimination of all forms of Racial Discrimination, Article 5
Convention on the Rights of the Child, Article 24
Constitution of India
Fundamental Rights do not guarantee right to health, however certain rights can be interpreted to protect against violations of right to health Right to Equality, Article 15 - Prohibition of
Discrimination; Right to Freedom, Article 21 - Protection of
Life and Personal Liberty.
Directive Principles of State Policy
provide direction to state planning Article 47 – level of nutrition, standard of
living, public healthArticle 39 – health and strength of workers
incldg childrenArticle 41- right to public assistance in case
of unemplmt, old age, sickness, disabilityArticle 42 – humane conditions of work and
for maternity relief
Health as a Human Right
Right to HEALTHRight to food, Right to a healthy environment ,
Right to adequate housing, Right to education, Right to work and rights at work, Right to life, Right to information, Physical integrity
Right to HEALTH CARECESCR Article 12, General Comment 14 on
health…highest attainable standard of health, availability, accessibility, acceptability, quality
Highest attainable standard of health.. Article 12, General Comment 14 on Health
Availability Services, facilities, goods, programmes in sufficient
quantities Trained personnelEssential drugsDeterminants of health e.g. water, sanitation etc.
AccessibilityNon-discriminationPhysical accessibility including for vulnerable
groups (old, dalits, disabled...)Economic accessibilityInformation (along with confidentiality)
Acceptability Culturally appropriate (Life –cycle, gender,
minorities)Medical ethics
QualityScientifically, medically appropriate Skilled personnelRational, unexpired, quality drugsAseptic proceduresSafe blood
Rights ApproachNeeds and Rights?
A rights approach views a health condition in human rights terms
IncludesKnowledge of rights and their sourcesIdentification of gaps, violationsEducation and awareness about rightsClaiming of rights
Rights Approach
uses international human rights treaties and norms and national law to hold governments accountable for their obligations
can be integrated into any number of advocacy strategies and tools including monitoring; community education and mobilization; litigation; and policy formulation.
Rights Analysis of HealthProblems
People with influence (providers, managers, policy makers)
Affected groups
Rights awareness
Rights claiming
Changes in laws, policies, programmes and their implementation and grievance redressal
Rights approach - ActorsRights holders – women and men in the community,
vulnerable and marginalised groups and individuals – When they are conscious of their rights they become rights claimants
Duty Bearers – Government institutions and officials responsible for planning, implementing and monitoring policies and programmes – including policy makers and providers
Guardianship Institutions – Courts, Commissions, ombudsman organisations
Human rights advocates – Activists, NGOs, advocacy groups, human rights organisations
Rights approach Role of the Government
Creating a legal framework – repealing old laws framing new ones
Formulating new policies and programmes Training of providers in the rights approach Providing a gender sensitive service delivery
environment Community based planning – involving women Building women’s leadership skills Developing therapeutic standards Citizen’s charter Grievance redressal mechanisms
Rights approach Role of the Human Rights advocates
Studies to identify rights violationsCase workRights education of communities, Mobilising communities for campaigns Social audits Develop new programme modelsTraining of policy makers and providersDocumentation of successful experiments
Guardianship institutions: Eg. National Human Rights Commission and State
HRCs Health Committee of NHRC.
Entertains representation of violation health rights issues/cases
Institutes inquiries and fact finding missionsInvites explanations from State Governments
Some of the issues taken up: organ trading, silicosis, quality of care in mental health institutions, population policy, etc.
Rights elements in NRHM ?
Janani Shishu Suraksha KaryakramIndian Public Health StandardsCitizens Charter of RightsVillage Health CommitteesCommunity Monitoring
citizen other stakeholders government
voice respective roles respectparticipation protect
fulfil
laws, policies, information, services, resources, accountability
AVAILABLE, ACCESSIBLE, ACCEPTABLE, QUALITY
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