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