Call for Papers on children's health and human rights (2)
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> Call for Papers on children's health and human rights
> Health and Human Rights Vol. 5, No. 2:
> Children's Health and Human Rights
Dear Laura,
Would the following piece qualify as a short piece for this issue being
planned?
HUMAN RIGHTS BASED PLANNING: THE NEW APPROACH
Claudio Schuftan MD
The Secretary General of the United Nations has mandated that, starting
this year, all agencies of the UN have to switch to designing and exe-
cuting HUMAN RIGHTS BASED PLANS OF ACTION. Beyond this new mandate,
little explanations were given of what exactly this entails.
UNICEF has taken a lead in defining in a bit more detail what Human
Rights Based Planning means and entails. Here is the explanation of
what this new concept is all about:
All action in development projects/programs has to be based on a solid
situation analysis. The latter has to be based on an Assessment and an
Analysis of the existing situation leading to decisions being made for
Action: a triple A (AAA) process. The assessment and analysis cannot be
done without having a Conceptual Framework of the causes of the prob-
lems that we are trying to solve. This means that we have to have a
conceptual understanding of how the problem comes about -- what its de-
terminants are -- before we can decide what the best options are to do
something about it. In other words, "You find what you look for"(.based
on a conceptual framework).
In our case as health/nutrition practitioners,
* the OUTCOME in the conceptual framework is malnutrition and excess
ill-health;
* the IMMEDIATE CAUSES are inadequate food intake and high prevalence
of preventable diseases;
* the UNDERLYING CAUSES are household food and fuel insecurity, inade-
quate maternal and child care, low water and sanitation levels and in-
adequate access to (or utilization of) health care services, particu-
larly by the poor;
* the BASIC CAUSES are limited access to education (particularly for
girls) and insufficient community control (power) over the resources
they need to solve their problem(s) at each causal level (i.e. human,
financial/material and organizational resources).
The essence of a good situation analysis is to carry out a CAUSAL
ANALYSIS based on a pre-existing conceptual framework and basing all
decisions for action being made on this analysis; appropriate interven-
tions for the main causes at each causal level have to be found. Ad-
dressing each cause is necessary but not sufficient to change the out-
come (ill-health and malnutrition). Communities need to act at all lev-
els of determinants at the same time. This is why so many "selective
interventions" have failed in the past.
So much for what we were expected to be doing up to now to solve our
deep-rooted health and nutrition problems. Now comes the human rights
based approach to planning. The essence of this approach is to addi-
tionally carry out what is called a CAPACITY ANALYSIS.
What is a capacity analysis? To analyze any human rights situation it
is essential to identify two main groups of actors: Claim Holders and
Duty Bearers.
Claim holders are the groups whose universally recognized entitlements
are or are not being provided for and whose rights are thus being up-
held or violated.
Duty bearers are those individuals or institutions that are supposed to
uphold each specific right related to each entitlement.
For example, in the case of a child (the claim holder), the first-line
duty bearer is the mother; next are the father and other family mem-
bers. But there also are duty bearers for children's rights further up
the ladder: community leaders, district and provincial authorities, na-
tional and international institutions.
The end result of a good causal/situation analysis is a list of locally
specific immediate, underlying and basic causes that determine the
problems at hand. The participatory AAA process that identifies those
respective causes then also comes up with the possible solutions for
each cause identified. This is the point where capacity analysis comes
in.
Capacity analysis identifies what needs to be done for each determinant
identified starting by looking at what is already being done or not be-
ing done. It then looks at who should be doing it [individual and/or
institution(s) who is (are) the corresponding duty bearer(s)] and at-
taches the name of that (those) person(s) or institution(s) to each
cause identified. They are the ones who have to be targeted to get the
proposed solutions implemented.
The end result of a good capacity analysis is a four or five columns
table:
* the first column has the causes listed from immediate to basic;
* the second column lists the respective right(s) being violated for
which group of claim holders for each cause;
* the third column has the gap between what is being done and what
still needs to be done (i.e. the actions needed);
* the fourth column identifies the respective duty bearer(s) by name
(individuals and/or institutions responsible, often at more than one
level);
* a fifth column may be added to specify who is going to approach that
duty bearer and by when.
This table thus becomes an action plan to foster the respect of the
various human rights deemed to be violated for each specific group of
claim holders, in our case children.
What this new human rights approach to planning does is to couple
causal and capacity analysis. At first glance, this may not mean much
to readers being introduced to this new concept. But it is a powerful
combination. It not only identifies what needs to be done, but it tar-
gets the person or institution that has to be lobbied/pressured,
BECAUSE THEY ARE LEGALLY RESPONSIBLE to do something about it under the
covenants of international human rights officially signed and ratified
by almost all countries in the world.
The human rights approach gives us advocates new powers. When appropri-
ate, we now approach duty bearers as guilty of not performing what they
are legally (and not only ethically) supposed to do. The human rights
covenants currently in force are very explicit about this. We just have
not sufficiently used this added power in our work so far. Duty bearers
have to be approached using the human rights violation justification,
and have to be made accountable to comply! "Lack of resources" is not a
good enough justification by duty bearers not to uphold the rights be-
ing violated. They have to convincingly demonstrate to us that re-
sources available (even if meager) are not being used for other less
essential functions.
If we all do follow this new approach, we may set a growing precedent
that will further the cause of those claim holders whose basic human
rights are being violated worldwide.
Issues are a bit more intricate than here reflected, but this is a good
introduction.
Claudio Schuftan
Hanoi, Vietnam
mailto:aviva@netnam.vn
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