Child Rights and adolescent health

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Job Burns
7 years ago
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1 Child Rights and adolescent health 1

2 Children's rights and the health International legislation professional Which rights are most important for child health Indicators which are commonly used to assess rights How to assess if children in our patch are having their human rights obligations met Who is the duty bearer What can we realistically do? 2

3 The Universal Declaration of Human Rights adopted in 1948 states that everyone has a right to food, clothing, housing, medical care, social services (article 25) and education (article 26). The rights and obligations are further characterised by two subsequent covenants; the International Covenant on Civil and Political Rights and the International Covenant on Economic, Social and Cultural Rights were adopted in 1966, jointly known as the International Bill of Human Rights 3

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5 Who has ratified 5

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7 Signature vs ratification The State has not expressed its consent to be bound by the treaty until it ratifies, accepts or approves it. In that case, a State that signs a treaty is obliged to refrain, in good faith, from acts that would defeat the object and purpose of the treaty. Ratification in contrary to signature refers to the act undertaken in the international plane, whereby a State establishes its consent to be bound by a treaty. In many instances this involves approval by the national parliament. Signature alone does not impose on the State obligations under the treaty. 7

8 Which rights most directly impact health? 8

9 Maslow's hierarchy of needs 9

10 International legislation protecting children s rights Water (UNCRC) States shall Article 24 (2c) provide access to clean drinking water Sanitation Food Shelter Education Healthcare Article 24 (2e) shall ensure that all sections of society are informed about and have access to sanitation Article 24c and 27 (3) take measures within their means to assist parents or carers to provide adequate nutrition 27 (3) take measures within their means to assist parents or carers to provide adequate shelter 28 (1a) make primary school education compulsory and freely available to all Encourage the development and availability of secondary education Article 24(2b) ensure the provision of healthcare Life Article 6 every child has the right to life Article 24a take appropriate measures to diminish infant and child mortality 10

11 WHY Given the strong and pervasive links between poverty and health, a commitment to health necessarily implies a commitment to reducing poverty. Public health professionals accept that factors over which they have little influence have a greater impact on adolescent s health than the quality of their healthcare interventions. While we have little influence over the determinants of health, we spend the majority of our professional lives dealing with the consequences of this lack of access 11

12 HOW The health sector must strengthen its capacity for active, ongoing monitoring and become an effective advocate to raise awareness of the potential implications for health of human rights and call for appropriate action by developing the use of human rights-based budget analysis and auditing of policy both macroeconomic and local Challenging perceptions that human rights are limited to civil and political rights 12

13 Indicators 13

14 The different indicators when assessing compliance with human rights OUTCOME CONDUCT Outcome indicators Policy indicators implementation effort Describes the situation on the ground The legal framework National legislation and policies, local policies and decisions Efforts made in implementing a specific policy which will impact a human right Resource indicators United Nations Human Rights, Human Rights Indicators; A Guide to Measurement and Implementation, [Online]. Available: 14

15 OPERA framework W0zJf0 Centre for Economic and Social Research, OPERA, [Online]. Available: 15

16 Advocacy at a local level - proximal The majority of your adolescent patients come from very poor homes, their access to education is limited. How can you bear influence on these factors which you feel are contributing hugely to the morbidity and mortality which you encounter? 16

17 Outcome indicators States shall Water Article 24 (2c) provide access to clean drinking water Sanitatio Article 24 (2e) shall ensure that all sections n of society are informed about and have access to sanitation Food Article 24c and 27 (3) take measures within their means to assist parents or carers to provide adequate nutrition Shelter 27 (3) take measures within their means to assist parents or carers to provide adequate shelter Education 28 (1a) make primary school education compulsory and freely available to all Encourage the development and availability of secondary education Healthcar Article 24(2b) ensure the provision of e healthcare Life Article 6 every child has the right to life Article 24a take appropriate measures to diminish infant and child mortality District outcome Indicators % NO access to clean water (>200 metres or 15 minutes walk) % NO access to sanitation (no sanitation in or near the dwelling) Malnutrition MUAC < 115 (children 6-60 months) % poor housing conditions (any of the following; non-permanent, no flooring, one or two rooms) % did not complete primary school % who have NOT been immunised with DTP3 % under five mortality per 100 live births 17

18 Policy 18

19 Effort 19

20 Resources 20

21 Water Conduct indicators (Effort & Resources) midstream level District conduct indicators Is the district budget open and participatory Proportion of district revenue spent on providing improved water Sanitation Food % district revenue spent on sanitation % district revenue spent on school feeding programmes Shelter Education Healthcare % district revenue spent on primary and secondary education % district revenue spent on health 21

22 Allocation of Resources i.e. budget States shall Conduct indicators Water Article 24 (2c) provide access to clean drinking water % government budget spent on water development Sanitation Article 24 (2e) shall ensure that all sections of society are informed about and have access to % government budget spent on sanitation sanitation Food Article 27 (3) take measures within their means to assist parents or carers to provide % government budget spent on agriculture and food security adequate nutrition Shelter 27 (3) take measures within their means to assist parents or carers to provide adequate shelter Education 28 (1a) make primary school education compulsory and freely available to all Public spending as a % of GDP allocated to health Encourage the development and availability of secondary education Healthcare Article 24(2b)The provision of healthcare Public spending as a % of GDP allocated to education 22

23 Resources outside influences on a states ability to raise resources and on allocation Water and sanitation Food Rules on trade and capital Multinational enterprises Overseas development Trade rules may affect service Trade mis-invoicing and tax Projects assist with provision provision preferences reduces tax of water and sanitation Lower import tax revenue and revenue and social spending tax repayment may limit social spending. Speculation on food may increase food insecurity Tariffs on processed goods limits export value Imported subsidised food may improve access May displace small farmers/business Humanitarian aid may displace local production Education Healthcare Lower import tax revenue and debt repayment may limit social spending. Lower import tax revenue and debt repayment may limit social spending. TRIPS may limit accessibility to affordable medication. Trade mis-invoicing and tax preferences reduces tax revenue and social spending Trade mis- invoicing and tax preferences reduces tax revenue and social spending Contribution to the education budget by SWaP Loss of skilled workforce from the public sector Contribution to health budget by SWaP May skew health priorities 23

24 Children's rights and the health professional summary International legislation Which rights are most important for child health Indicators which are commonly used to assess rights How to assess if children in our patch are having their human rights obligations met Who is the duty bearer What can we realistically do? 24

25 Exercise evaluate opportunities to implement the UN Convention on the Rights of the Child in your own practice 25

Goal 1: Eradicate extreme poverty and hunger. 1. Proportion of population below $1 (PPP) per day a

Goal 1: Eradicate extreme poverty and hunger. 1. Proportion of population below $1 (PPP) per day a Annex II Revised Millennium Development Goal monitoring framework, including new targets and indicators, as recommended by the Inter-Agency and Expert Group on Millennium Development Goal Indicators At