PHM-Exch> PHM right to health platform

[Claudio Schuftan]

**

* Right to Health Platform*

*Right to Health Care Campaign*

* *



The People's Health Movement perspective is *Right to Health – Health for
All*. The Right to Health includes rights to a range of social determinants
of health (clean water, food security and nutrition, education, housing,
clean and safe environment etc.), as well as, VERY CENTRALLY,  the Right to
Health Care.



PHM stands committed to promoting a comprehensive Right to Health and
supports an ongoing NUMBER of activities in this direction. Many of these
activities are in collaboration with the existing campaigns of various
partner coalitions and organisations. They include PHM’s WHO Advocacy Circle
that lobbies multilateral organizations, the Right to Water Campaign, and
PHM’s Research Circle which documents evidence for the effectiveness of
comprehensive primary health care strategies.



Within this larger platform of activities, PHM recognises the urgent
necessity to address the global health system crisis characterized by
weakening public health systems; privatization and promotion of private
insurance; failure to implement Comprehensive Primary Health Care;
unresponsive, 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*.



PHM has initiated a *Global Right to Health Care (RTHC) Campaign* to be
developed in collaboration with various networks, coalitions and
organisations sharing a similar perspective. This campaign will document
violations of health rights, present country level assessments of the right
to health care and advocate for fulfillment of commitments to the right to
health care at the national, regional and global levels.



*The Right to Health Care campaign has three phases of action.*



A.     *Phase** I.* Production of diagnostic assessment reports on the RTHC
in 20+ countries:

1.      PHM country circles or affiliated groups WILL use assessment guide
to produce reports with some consistency and comparability. (See the
overview of the Assessment Guide overleaf and the full document at
www.phmovement.org)

a.      All country reports will address health care systems AND can also
look at other health determinants of concern.

b.      THE assessment guide can be used in different ways in countries with
different capacities, e.g. it can be adapted by national campaigns to
facilitate inclusion of lower literacy groups, or can be used in its
original version by grassroots groups with higher literacy.

c.      Going through the assessment process leads to understanding the
human rights-based FRAMEWORK that can later be applied to other issues.

2.      Process of investigation and report preparation. THE PROCESS

a.      should include diverse related sectors in the country, not limited
to a particular sector or political tendency.

b.      should aim to build the PHM country network, and provide an
opportunity for in-country coalition-building and BENEFICIARIES’ ownership
of the campaign process.

c.      WILL lead to the creation of lobbying/activism strategies/plans that
PHM circles AND/or affiliates can implement at the national level
immediately after the assessment is completed.



B.     *Phase II.* Regional Assemblies:

1.      Participating country circles, and regional and global strategic
allies (such as supportive health ministers, World Health Organization HQ
and regional staff, policy makers, funders) will meet in several regional
assemblies

a.      to share results of assessments and action plans

b.      to enable A dialogue between PHM and partners with the national
health policy makers on implementation of health rights and related health
system improvements.

c.      to discuss and AGREE on recommendations for how THE PHM global
SECRETARIAT and allies can support national demands for compliance with RTHC
commitments, for example, via action at WHO or other multilateral
institutions, or international solidarity activities.



C.     *Phase III.* GLOBAL EXPANSION:  Beginning at THE World Health
Assembly 2010 and thereafter

1.      IMPLEMENT Phase II conclusions AND RECOMMENDATIONS as planned

2.      Could include DRAFTING AND submission of time-bound RESOLUTION(S) on
health rights FOR DISCUSSION/ADOPTION in the World Health Assembly
(supported by sympathetic governments)



*For more information or to get involved, contact:  cschuftan at phmovement.org
   *

* *





Overview of PHM’s Guide for the Assessment of the Right to Health and Health
Care

Full guide 44 pages version to be downloaded from  www.phmovement.org
  How can you assess the right to health care?

* *

The assessment guide leads you through the following five-step process to
document most aspects of the denial of the *Right to Health Care* (a
component of the right to health) in your country. Then, it suggests how to
lobby and SET UP activist strategies for addressing the violations identify.



*STEP I. 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 and health care based on it having signed
relevant UN covenants. You will also examine provisions in your
constitution, your national laws and policy agendas. In the case that your
government has *not* signed a particular covenant, this too needs to be
noted.



*STEP II. Are your government’s policies appropriate to fulfill these
obligations?*



You will examine major 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 national and provincial 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 analyzed in relation to
the evolution of health policies. Fragmentation into national vertical
programmes, often promoted by different donor agencies, should also be
noted.



*STEP III. Is the health system of your country adequately implementing
interventions to realize 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:

*Availability* of health facilities and hospital beds per capita (urban and
rural); availability of doctors, nurses and other health personnel
especially in rural areas; availability of medicines and medical supplies,
and other parameters you may add.

*Access* to immunization programmes and pre/postnatal care, average health
care expenditure per household and other good indicators.

*Acceptability*, *appropriateness* and *accountability *of health services
by assessing aspects like decentralization, 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.



Moving beyond averages, you will investigate health care inequities by
comparing health care availability and access for the more privileged versus
the less privileged, vulnerable groups, and groups with special needs IN
YOUR COUNTRY.



*STEP IV. Does the health status of different social groups and the
population as a whole reflect a progression in their right to health and
health care?*

* *

Here, you will look at the ultimate impact the health system and ITS 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 respected and fulfilled. Health inequities
will be assessed by comparing health status indicators for the more
privileged with those of the less privileged.



*STEP V. What does the denial or fulfillment of the Right to Health in your
country mean in practice?*

* *

The final step is to systematically contrast the obligations outlined in
Step I with the realities documented in Steps II, III and IV, 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 realization of this right. You will be judging whether your
government is doing all it is capable-of to realize the Right to Health, and
if its efforts are adequate or inadequate, in the light of 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.*

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