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Health Rights & the PRIDE Project in Pakistan
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Health Rights & the PRIDE Project in Pakistan

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  • 1. PRIDE Project’s Rights- Rights-Based Approach 3 August 2009
  • 2. What is a “Rights-Based Approach”? “Rights- • Health and development initiatives often speak of a “Rights-Based Approach” • Seldom well understood or explained • No single way of applying a RBA • Simply new jargon to some • Completely new approach to others • Needs to be carefully considered and meaningfully applied • This presentation describes current thinking on the right to health and PRIDE’s approach…
  • 3. The Right to Health Concepts and actions
  • 4. Key human rights concepts Universal • All have rights • Recognized in international standards and conventions Indivisible, interdependent & interrelated • “Health rights” cannot be separated from other rights Right holders • All entitled and have responsibilities to claim • Emphasis on most vulnerable and marginalized Duty bearers • Obligation of the state to respect, protect and fulfill rights • All responsible for influencing enjoyment of rights Addressing root causes • Cycles of poverty and social disadvantage • Underlying determinants of poor health
  • 5. Health “is a fundamental human right that that is indispensable for the exercise of other human rights. Every human being is entitled to the enjoyment of the highest attainable standard of health conducive to living a life in dignity.” Committee on Economic, Social and Cultural Rights, General Comment No. 14 (2000), par. 1 http://www.unhchr.ch/tbs/doc.nsf/(symbol)/E.C.12.2000.4.En?OpenDocument
  • 6. Sphere Standards for Protection in Health 1. Health programs provide disaster-affected populations with safe and equitable access to health facilities and services 2. Health staff respond appropriately to individuals or groups that are victims of physical and/or sexual violence, torture or other human rights abuses 3. Health services respect the cultural and religious context to the extent that this does not undermine other fundamental human rights
  • 7. Although there is no prescribed way of making health rights real… “At the heart of the right to the highest attainable standard of health lies an effective and integrated health system, system, encompassing medical care and the underlying determinants of health, which is responsive to national and local priorities and accessible to all.” Hunt & Backman 2008
  • 8. Minimum health related obligations include the right to… • Access to health facilities, goods and services on a non-discriminatory basis, especially for vulnerable or marginalized groups • Access the minimum essential food which is nutritionally adequate and safe • Access shelter, housing and sanitation and an adequate supply of safe drinking water • The provision of essential drugs • Equitable distribution of all health facilities, goods and services
  • 9. This is also linked to ideas of… Accountability Accessibility Acceptability Availability Respect Equity Representation Protection Information Participation Involvement Sustainability Transparency Quality
  • 10. Putting ideas into action… “The concept of a right to health can be used to formulate policies, organize systems and services, and develop actions that promote better health outcomes outcomes.” De Negri Filho 2008
  • 11. What actions might a RBA include? • Critical analysis and monitoring • Right holder / civil society mobilization • Duty bearer / government capacity building • Awareness raising • Advocacy and lobbying • Policy / legal reform • Intersectoral partnerships
  • 12. Continuums of rights orientations Purpose of Activity Demand Duty Generation Fulfillment Methodological Orientation Promotional & Protection & Educational Enforcement Style of Programming Consensus Escalating Building Opposition Prioritization within Programming Implicit Explicit & & Indirect Integral
  • 13. Which rights orientations and actions are appropriate and feasible? Determined by… – Country context – Orientation of organization – Position of project – Individual interpretation
  • 14. PRIDE Project Statement A rights orientation for health programming in Pakistan
  • 15. Our challenge… How can the concept of rights be translated into health realities?
  • 16. Pakistan’s challenging rights context Pakistan subscribes to: Pakistan is not party to: • Convention on the • Economic, Social and Elimination of All Cultural Rights Forms of Covenant Discrimination • Civil and Political Against Women (with Rights Covenant some reservations) • Convention against Torture • Children’s Rights • Convention Relating Convention (with to the Status of some reservations) Refugees Limited respect for human rights and lagging health indicators
  • 17. PRIDE’s rights orientation PRIDE focuses on: • A rights lens for planning and programming • Longer term perspectives for sustainable solutions • System support above direct delivery of commodities and services (except in response to emergencies) • Equity of access (e.g. gender, geographic location, ethnicity, language, literacy), particularly for most vulnerable and marginalized • Improving attitudes, skills, behaviors of duty bearers and right holders • Participatory approaches to building constructive partnerships between duty bearers and right holders
  • 18. PRIDE activities addressing rights • Building institutions and communications enabling communities to increase demand for and involvement in health and health services • Developing support for setting and achieving standards for quality services • Increasing access to essential services and commodities • Contributing to improved management systems • Monitoring equity of intervention coverage • Advocating for policy and program reform
  • 19. Further Information on the Right to Health Selected web links
  • 20. Health rights concepts • Basic primer, Center for Economic and Social Rights http://www.cesr.org/health • Health and human rights, WHO http://www.who.int/hhr/en/ • Health and human rights, Human Rights Watch http://www.hrw.org/doc/?t=health • Health rights web links, American Medical Student Association http://www.amsa.org/global/hhr.cfm
  • 21. Health rights in reality • The right to health, WHO & OHCHR http://www.ohchr.org/Documents/Publications/Factsheet31.pdf • The right to health: a resource manual for NGOs, Asher http://shr.aaas.org/pubs/rt_health/rt_health_manual.pdf • Applying a rights-based approach: an inspirational guide for civil society, Boesen & Martin http://humanrights.dk/files/pdf/Publikationer/applying%20a%20rights%20ba sed%20approach.pdf • Health systems and health rights, Hunt & Backman http://www.hhrjournal.org/index.php/hhr/article/view/22/106 • Human rights applications to public health programming, De Negri Filho http://www.hhrjournal.org/index.php/hhr/article/view/29/107
  • 22. Health rights advocacy resources • Alma Ata Declaration on Primary Health Care http://www.who.int/hpr/NPH/docs/declaration_almaata.pdf • People’s Charter for Health (Urdu) http://www.phmovement.org/files/phm-pch-urdu.pdf • People’s Health Movement http://www.phmovement.org • Human Rights Impact Resource Centre http://www.humanrightsimpact.org • Women’s Global Network for Reproductive Rights http://www.wgnrr.org
  • 23. Rights in Pakistan • State of Human Rights in Pakistan 2007, Human Rights Commission of Pakistan http://www.hrcp-web.org/hrcpDetail_pub3.cfm?proId=528&catid=173 • Know your rights, Sustainable Development Policy Institute http://www.sdpi.org/know_your_rights/know%20you%20rights/ • Pakistan’s human rights record, NY Times http://query.nytimes.com/gst/fullpage.html?res=9C01EEDD1F3BF93 AA15750C0A9649C8B63 • Literacy, health and rights, IRIN http://www.irinnews.org/Report.aspx?ReportId=78097

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