Health as a Human Right

1
Health as a Human Right

• Sabri Rbeihat, Advisor to the United Nations
• Special Rapporteur
• on Disability
• The enjoyment of the highest attainable standard
  of health is one of the
• fundamental rights of every human being
• WHO Constitution

2

• Human Rights relating to health
• have been set out in all the
• basic human rights
• treaties, instruments
• conventions

3

• The human right to
• the highest attainable standard of physical,
  mental reproductive and sexual health
• equal access to adequate health care
  health-related services, regardless of sex, race,
  or other status
• a safe and healthy environment
• access to information relating to health,
  including reproductive health and family planning

4
Every world conference has made a commitment to
the right to health

• Copenhagen Summit
• Cairo Population Summit
• Turkey Habitat Summit
• Beijing Declaration
• Rio Environment Summit
• Durban World Conference
• World Conference on Ageing
• Global Action on HIV/AIDS
• (to name a few)

5
Importance of health care

• level of health is indicator of development
• development level is determined by health of the
  population
• Development level is determined by prevalence,
  availability, accessibility, coverage of health
  care services

6

• The existence of medical health services does
  not imply access for all even in the most
  industrialized countries

7

• The right to health is experienced differently by
  different segments of society, with regard to
  access, quality, entitlement, information.
• Depending on

8

• Gender
• Race
• Ethnicity
• Nationality
• Legal status
• Socio-economic status
• Geographic location
• Age
• Disability

9
Many factors contribute to lack of access

• Location of medical health service centers
  (urban centers vs rural areas)
• Poor information about health services
• Lack of information in accessible forms
• Lack of awareness about the right to health
  health services

10

• Economic inaccessibility to health services
• Health professionals not culturally sensitive to
  needs of some segments
• Social attitudes, stigma and discrimination
• Lack of experience in dealing with compound
  health issues

11

• Lack of understanding of persons with
  psycho-social disabilities
• Limited understanding among medical professionals
  of the relationship between poverty, mental
  health, physical health, disabilityetc.
• Tendencies to devalue the lives of persons with
  multiple or developmental disabilities

12
The worldwide disability movement

• Provides the answer through the concept of
• The equalization of opportunities for persons
  with disabilities
• and the motto
• whats good for us is good for all

13
What can be done

• Adoption of the equalization of opportunities
• As a social construct
• As a philosophical approach
• As a design for health planning
• As an answer to access issues
• Using the Standard Rules as the blueprint for a
  more equitable society

14
The right to health for persons with disabilities

• Standard Rules on the Equalization of
  Opportunities for Persons with Disabilities
• Rule 2. Medical care
• States should ensure the provision of effective
  medical care to persons with disabilities.
• States should ensure that persons with
  disabilitiesare provided with the same level of
  medical care within the same system as other
  members of society

15
Standard Rules

• Rule 3. Rehabilitation
• States should ensure the provision of
  rehabilitation services to persons with
  disabilities in order for them to reach and
  sustain their optimum level of independence and
  functioning.

16
Standard Rules

• Rule 4. Support services
• States should ensure the development and supply
  of support services, including assistive devices
  for persons with disabilities, to assist them to
  increase their level of independence in their
  daily living and to exercise their rights

17
The pre-requisite to full participation

• Rule 5. Accessibility
• Access to the physical environment
• Medical centers
• Rehabilitation centers
• Health care services personnel
• Access to information communication
• Health information
• Full understanding of diagnosis
• Full understanding of how to deal with the
  illness

18
Arriving at a new understanding of

• Equity
• Poverty
• Equalization
• Health medical care
• Access
• Effectiveness efficiency

19
Strategies

• Reviewing Examining
• Data
• Policies
• Legislations
• Conducting research on
• Policies
• Programmes
• Services
• Systems
• Effect people's health and well-being
• Coverage
• Budgeting (ideally 20 of social services
  allocations)
• Percentage of the population serviced
• Types of services provided

20

• Types of persons serviced
• Race
• Age
• Standard of living
• Socio-economic standing
• Etc.
• Efficiency of service provision
• Efficacy of output

21
Research should

• Be Participatory
• Making the people most concerned with services
  active participants (Participatory Rapid
  Appraisal)
• Include analysis
• Constant review
• Continuous monitoring
• Regular periodic evaluation
• Flexible
• Allowing for changes
• Involving service receivers in identifying their
  needs suggesting appropriate responses

22
The need for reliable measures

• Health care as an indicator of
• Poverty
• Development
• Health
• Economic prosperity

23
Raising the awareness of link between development
and heath care provision

• Policy decision makers
• Health care planners
• Medical professionals
• Health care providers
• Health care users
• Researchers
• Activists

24
The need for new definitions indicators

• Definitions a broad definition of health as it
  relates to
• Quality of life
• Productivity
• Employment
• Self-reliance
• Psycho-social capacity
• Definitions that are human-rights based
• Definitions need to be workable, universal,
  operational

25
The need for new Indicators

• Indicators need to be
• Qualitative as well as quantitative
• Flexible
• Able to measure variables
• Applicable to different situations
• Conceptual as well as practical