This is a presentation for social activists to use a rights based approach for monitoring of health programmes in India.

1. Human Rights, Health Rights
and Accountability
COPASAH Training
Renu Khanna
September 21, 2013,

2. 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

3. Principles and Values
underlying Human Rights
Equality
Nondiscrimination
Dignity
Bodily integrity
Self determination
Compassion
Interdependence

4. 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.

5. 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

6. 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

7. 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

8. 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

9. 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.

10. Directive Principles of State
Policy
provide direction to state planning
Article 47 – level of nutrition, standard of
living, public health
Article 39 – health and strength of workers
incldg children
Article 41- right to public assistance in case
of unemplmt, old age, sickness, disability
Article 42 – humane conditions of work and
for maternity relief

11. Health as a Human Right
Right to HEALTH
Right 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 CARE
CESCR Article 12, General Comment 14 on
health…highest attainable standard of health,
availability, accessibility, acceptability, quality

12. Highest attainable standard of health..
Article 12, General Comment 14 on Health
 Availability
Services, facilities, goods, programmes in sufficient
quantities
Trained personnel
Essential drugs
Determinants of health e.g. water, sanitation etc.
 Accessibility
Non-discrimination
Physical accessibility including for vulnerable
groups (old, dalits, disabled...)
Economic accessibility
Information (along with confidentiality)

13.  Acceptability
Culturally appropriate (Life –cycle, gender,
minorities)
Medical ethics
 Quality
Scientifically, medically appropriate
Skilled personnel
Rational, unexpired, quality drugs
Aseptic procedures
Safe blood

14. Rights Approach
Needs and Rights?
A rights approach views a health condition in
human rights terms
Includes
Knowledge of rights and their sources
Identification of gaps, violations
Education and awareness about rights
Claiming of rights

15. 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.

16. Rights Analysis of Health
Problems
People with influence
(providers, managers, policy makers)
Affected groups
Rights awareness
Rights claiming
Changes in laws, policies, programmes and
their implementation and grievance redressal

17. Rights approach - Actors
Rights 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

18. 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

19. Rights approach
Role of the Human Rights advocates
Studies to identify rights violations
Case work
Rights education of communities,
Mobilising communities for campaigns
Social audits
Develop new programme models
Training of policy makers and providers
Documentation of successful experiments

20. 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 missions
Invites explanations from State Governments
Some of the issues taken up: organ
trading, silicosis, quality of care in
mental health institutions, population
policy, etc.

21. Rights elements in NRHM ?
Janani Shishu Suraksha Karyakram
Indian Public Health Standards
Citizens Charter of Rights
Village Health Committees
Community Monitoring

22. citizen other stakeholders government
voice respective roles respect
participation protect
fulfil
laws, policies, information, services, resources, accountability
AVAILABLE, ACCESSIBLE, ACCEPTABLE, QUALITY