Health Exchange

The People’s Health Movement has launched a Global Right to Health Care (RTHC) Campaign to document violations of health rights, present country level assessments of the right to health care, and advocate for the fulfillment of commitments to the right to health from the national to the global level.

Claudio Schuftan, campaign co-ordinator explains about the campaign and how anyone can get involved.

The Right to Health includes rights to the full range of social determinants of health – clean water, food security and nutrition, education, housing, clean and safe environment – as well as the right to health care. The People’s Health Movement (PHM) recognises the urgent need to address the global health system’s crisis characterised by weakening public health systems; privatisation and promotion of private insurance; failure to implement comprehensive primary health care; fragmented and often donor-driven health programmes; and a shortage of health care personnel. All these factors lead to the denial of quality health care for a large proportion of the world’s population.

The Right to Health Care (RTHC) Campaign has three phases:

• Phase I is an assessment of the RTHC in over 20 countries using an ad-hoc assessment guide so as to produce reports with some comparability.
• Phase II is the holding of Regional Assemblies with supportive health ministers, World Health Organization headquarters and regional staff, policy makers and funders to share assessment results and action plans.
• Phase III is the global expansion of the campaign beginning at the World Health Assembly 2012.

What is the PHM’s Guide for the Assessment of the Right to Health and Health Care?

The assessment guide leads you through a five-step process to document aspects of the denial of the RTHC in your country. Then it suggests how to set up activist strategies to address the violations identified.

STEP 1: What are your government’s commitments?
Government commitments are the standards you can hold your government accountable for. If your government made a commitment under national and/or international law, you can hold it legally responsible for the impact its policies have on the Right to Health.

You will list the major commitments entered into by your government concerning the right to health, based on it having signed relevant UN or regional covenants. You will also examine provisions in your constitution, your national laws and policy agendas. In the event that your government has not signed a particular covenant, this too needs to be noted.

STEP 2: Are your government’s policies appropriate to fulfill these obligations?
You will examine health-related policies and programmes to determine whether they are adequate to fulfill the right to health and health care commitments your government has made. This will include looking at budgetary allocations at all levels. The influence of larger political and economic factors (e.g., structural adjustment) and the role of external agencies (such as the World Bank) should be analysed in relation to the evolution of health policies. Fragmentation into national vertical programmes, often promoted by different donor agencies, should also be noted.

STEP 3: Is the health system of your country adequately implementing interventions to realise the right to health and health care for all?
You will look at the actual structure and functioning of the health system in your country to evaluate:

• The availability of health facilities and services (urban and rural); availability of health personnel especially in rural areas; availability of medicines and medical supplies; and other parameters you may add
• Access to immunisation programmes and pre/postnatal care, average health care expenditure per household and other access indicators;
• The acceptability, appropriateness and accountability of health services by assessing aspects like decentralisation, participation in decision-making, mechanisms for accountability to the community and the provision of relevant information to beneficiaries.

The private health sector and the pharmaceutical industry is also evaluated — particularly the mechanisms for its regulation (if any), including price controls. You will investigate health care inequities by comparing health care availability and access in your country for the more privileged versus the less privileged, vulnerable groups, and groups with special needs.

STEP 4: Does the health status of marginalised social groups and the population as a whole reflect progress in their right to health and health care?
Here, you will look at what impact the health system is having and how the social determinants are being addressed. You will review major health indicators that will tell you to what extent the right to health and health care of various social groups is being fulfilled. Health inequities will be assessed by comparing health status indicators for the more privileged with those of the less privileged.

STEP 5: What does the denial or fulfillment of the Right to Health mean in your country?
The final step is to contrast the obligations outlined in Step 1 with the realities documented in Steps 2, 3 and 4, and briefly highlight the main areas of denial of health rights in your country. Looking at recent trends will help assess whether the country is moving forward or backward in the realisation of this right. You will be judging whether your government is doing all it is capable of to realise the Right to Health and if its efforts are adequate or inadequate as related to its existing capacity.

Once you have identified the areas in which your government is in violation of its human rights commitments, you will make a plan for how to change its health policies.

The guide takes you through all these steps in a user-friendly manner and finally gives some advice on how to develop successful lobbying and activism strategies.

The entire PHM’s Guide for the Assessment of the Right to Health and Health Care can be downloaded from  www.phmovement.org following the link to ‘campaigns’.

For more information or to get involved, contact Claudio Schuftan
cschuftan@phmovement.org

Filed under: Rights to health