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 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

�Equality

�Nondiscrimination�Nondiscrimination

�Dignity

�Bodily integrity

�Self determination

�Compassion

�Interdependence

Modern History of Human Rights

�Universal Declaration of Human Rights (1948)

�International Covenant of Civil and Political rights

�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 entitlementthat locates the particular concerns, needs and locates the particular concerns, needs and interestsof certain class(es) of individualsagainst a set of objective standardssuch that such needs and interests can be claimed and assertedirrespective 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� 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 �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, Article25

�International Covenant on Economic, SocialandCultural Rights,Article 7, 11and12andCultural Rights,Article 7, 11and12

�Convention on the Elimination of All Forms ofDiscrimination Against Women, Article 10, 12and 14

�Convention on the Elimination of all forms ofRacial Discrimination, Article 5

�Convention on the Rights of the Child, Article24

Constitution of India

�Fundamental Rights do not guarantee right to health, however certain rights can be interpreted to protect against 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 health�Article 39 – health and strength of workers �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

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 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

Highest attainable standardof health..Article 12, General Comment 14 on Health

� Availability

�Services, facilities, goods, programmes in sufficient quantities

�Trained personnel�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)

� Acceptability �Culturally appropriate (Life –cycle, gender,

minorities)�Medical ethics

� Quality�Scientifically, medically appropriate �Skilled personnel�Rational, unexpired, quality drugs�Aseptic procedures�Safe blood

Rights Approach

�Needs and Rights?

�A rights approach views a health condition in human rights terms human rights terms

�Includes�Knowledge of rights and their sources�Identification of gaps, violations�Education and awareness about rights�Claiming of rights

Rights Approach

�uses international human rights treaties and norms and national law to hold governments accountable for their obligationsobligations

�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 Affected groups

Rights awareness

People with influence (providers, managers, policy makers)

Affected groups

Rights claiming

Changes in laws, policies, programmes and their implementation and grievance redressal

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

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� 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 violations

�Case work

�Rights education of communities, �Rights education of communities,

�Mobilising communities for campaigns

�Social audits

�Develop new programme models

�Training of policy makers and providers

�Documentation of successful experiments

Guardianship institutions: Eg. National Human Rights Commission and State

HRCs

�Health Committee of NHRC.�Entertains representation of violation

health rights issues/caseshealth 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.

Rights elements in NRHM ?

�Janani Shishu Suraksha Karyakram

�Indian Public Health Standards

�Citizens Charter of Rights�Citizens Charter of Rights

�Village Health Committees

�Community Monitoring

citizen other stakeholders government

voice respective roles respectparticipation protect

fulfilfulfil

laws, policies, information, services, resources, accountability

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