A Rights Based Approach to the Right to Health
What is the right to health?
‘As human beings, our health and the health of those we care about is a matter of daily concern. Regardless of our age, gender, socio-economic or ethnic background, we consider our health to be our most basic and essential asset. […]The right to health is a fundamental part of our human rights and of our understanding of a life in dignity.’
Human rights standards
The right to health is enshrined in article 24 of the Convention on the Rights of the Child (CRC), as well as other treaties such the International Covenant on Economic, Social and Cultural Rights (Article 12).
It is acknowledged in the CRC that the rights to economic, social and cultural rights, such as the right to health, are ideals that may be difficult to attain – particularly in States with fewer resources. Article 4 states:
With regard to economic, social and cultural rights, States Parties shall undertake such measures to the maximum extent of their available resources and, where needed, within the framework of international cooperation.
The Committee on the Rights of the Child held a Day of General Discussion in 2008 on the subject of what, in practice, is meant by “the allocation of resources to the maximum possible extent”. For information on the discussions, visit: http://www.crin.org/resources/infoDetail.asp?ID=12859&flag=event
What can be done?
A rights based approach to health recognises that children’s rights under the CRC are interrelated and cannot be viewed in isolation. For example, such an approach focuses on the health rights of children in relation to: the best interest of the child (article 3), the right to be heard (article 12), and the principle of non-discrimination (article 2). For more on this read CRIN’s submission the Office of High Commissioner on Human Rights’ Study on Children’s Right to Health.
Children are entitled to be actively involved in their own health-care from the earliest possible age. The CRC recognises the value of a child’s views and the need to give them weight in accordance with the age and maturity of the child. This approach clearly endorses the need to reject strict age requirements with regards to children’s health-care rights and instead adopt a more flexible approach that takes account of individual characteristics of the child. Children should be listened to, their views should be taken seriously and their right to privacy and respect for confidentiality should be recognised.
Appropriate and effective complaints mechanisms, including the right to compensation, should be available for children who become victims of any medical intervention, drug treatment and/or any form of violence or abuse that may have happened before or during their visit to health facility. A free 24-hour helpline should be put in place and made available to children to give them a chance to talk to someone to share their experience and discuss their options. More importantly, children should know of the existence of those complaints mechanisms and the way to use them.
A rights based approach assesses how internationally agreed human rights principles and standards can be used in practical ways to protect the lives, health and dignity of all children. This includes identifying and addressing the underlying determinants of ill-health such as poverty and access to safe and affordable water and sanitation. It also means shifting the emphasis from paternalistic or top-down health policies and programmes towards interventions that focus on access, empowerment, accountability and participation.
Making special efforts to reach those most vulnerable to ill-health is essential. Identifying how often and how severely certain population groups suffer illness may reveal inequitable health care provision. Disaggregating data by such variables as ethnicity, sex and age can help find out who is suffering the most from ill-health in communities. Politicians can then use this information to eliminate disparities in health resulting from social disadvantage and provide an important tool for poverty reduction.
A key means of implementing children's rights standards may be through training and raising awareness about basic health care issues. Agencies can facilitate participation by giving workshops in basic health and sanitation, listening to what children have to say, and encouraging the active participation of children in programming and policy formulation.
This is essential to secure the good governance, political accountability and legal redress mechanisms needed to achieve sustainable, quality health care.