1. Access to Health Services OIYP Kaleidoscope Workshop October 2007

2. Access to Health Services Aim: Aim: To explore the importance and meaning of ‘right to health’ To explore the importance and meaning of ‘right to health’ To explore how strategies can help to achieve the right to health To explore how strategies can help to achieve the right to health To analyse local health needs and barriers to fulfilling these needs To analyse local health needs and barriers to fulfilling these needs To develop local, national and international health strategies focused on increasing access to health services for the marginalised To develop local, national and international health strategies focused on increasing access to health services for the marginalised

3. Importance of Health Poor health causes and contributes to poverty by destroying livelihoods, reducing worker productivity, lowering educational achievement and limiting opportunities. Poor health causes and contributes to poverty by destroying livelihoods, reducing worker productivity, lowering educational achievement and limiting opportunities. Poor health is also often a consequence of poverty due to diminished access to medical care, increased exposure to malnutrition, other major diseases. Poor health is also often a consequence of poverty due to diminished access to medical care, increased exposure to malnutrition, other major diseases. Accordingly, Poor health is both a cause and a consequence of poverty: sick people are more likely to become poor and the poor are more vunerable to disease and disability. Accordingly, Poor health is both a cause and a consequence of poverty: sick people are more likely to become poor and the poor are more vunerable to disease and disability. Rights-Based Health Program Guide

4. Therefore :- good health is central to creating and sustaining the capabilities that poor people need to escape from poverty. Key asset of the poor, good health contributes to their greater economic security. Good health is not just an outcome of development: it is a way of achieving development Therefore :- good health is central to creating and sustaining the capabilities that poor people need to escape from poverty. Key asset of the poor, good health contributes to their greater economic security. Good health is not just an outcome of development: it is a way of achieving development

5. Millennium Health Goals 2015 Reduce under-five child mortality by two thirds Reduce under-five child mortality by two thirds Reduce maternal mortality by three quarters Reduce maternal mortality by three quarters To half the proportion of people without sustainable access to safe drinking water To half the proportion of people without sustainable access to safe drinking water To reverse the spread of HIV/AIDS, incidence of malaria and other major diseases To reverse the spread of HIV/AIDS, incidence of malaria and other major diseases

6. Human Right to Health Services Human rights to essential health services were developed in order to strengthen the process of achieving health related development goals such as the MDGs Human rights to essential health services were developed in order to strengthen the process of achieving health related development goals such as the MDGs What is the definition of the ‘right to health’? What is the definition of the ‘right to health’?

7. Meaning of ‘Right to Health’ The right to the enjoyment of a variety of facilities, goods, services and conditions necessary for the realisation of the highest attainable standard of health. The right includes both health care and the underlying determinates of health including; The right to the enjoyment of a variety of facilities, goods, services and conditions necessary for the realisation of the highest attainable standard of health. The right includes both health care and the underlying determinates of health including; Acces to safe and potable water and adequate sanitation Acces to safe and potable water and adequate sanitation Adequate supply of food, nutrition and housing Adequate supply of food, nutrition and housing Healthy occupational and environmental conditions Healthy occupational and environmental conditions Acces to health related education and information (including sexual and reproductive health) Acces to health related education and information (including sexual and reproductive health) Human Rights Approach to poverty reduction Strategies Human Rights Approach to poverty reduction Strategies

8. The ‘Right to Health’ can also be broken down to a number of more specific health rights including: The ‘Right to Health’ can also be broken down to a number of more specific health rights including: The right to maternal, child and reproductive health The right to maternal, child and reproductive health The right to healthy natural and workplace environments The right to healthy natural and workplace environments The right to prevention, treatment and control of diseases The right to prevention, treatment and control of diseases The right to health facilities, goods and services The right to health facilities, goods and services International Human Rights Law

9. The ‘Right to Health’ strategies should consider both freedoms, entitlements and legal obligations The ‘Right to Health’ strategies should consider both freedoms, entitlements and legal obligations The freedoms include the right to control one’s body, including reproductive health, and the right to be free from interference, such as freedom from torture and non-consensual medical treatment. The freedoms include the right to control one’s body, including reproductive health, and the right to be free from interference, such as freedom from torture and non-consensual medical treatment. The entitlements include a system of health care and protection that is available, accessible, acceptable and of a good quality. This the right to health implies that functioning public health and health care facilities are available in sufficient quantity within a state. It also means that they are accessible to everyone without discrimination. The entitlements include a system of health care and protection that is available, accessible, acceptable and of a good quality. This the right to health implies that functioning public health and health care facilities are available in sufficient quantity within a state. It also means that they are accessible to everyone without discrimination.

10. Legal Obligations are derived from the rights may be analysed by reference to the duties to respect, protect and fulfill. In relation to health the duty to respect requires the duty bearer not to breach directly or indirectly the enjoyment of any health rights. The duty to protect requires the duty bearer to take measures that prevent third parties from abusing the right. The duty to fulfill requires the duty bearer to adopt appropriate legislative, administrative and other measures towards full realization of health rights Legal Obligations are derived from the rights may be analysed by reference to the duties to respect, protect and fulfill. In relation to health the duty to respect requires the duty bearer not to breach directly or indirectly the enjoyment of any health rights. The duty to protect requires the duty bearer to take measures that prevent third parties from abusing the right. The duty to fulfill requires the duty bearer to adopt appropriate legislative, administrative and other measures towards full realization of health rights

11. Access Access plays an important role in achieving the right to health and needs to be an integral part of ‘right to health’ strategies, national policies, etc. Access plays an important role in achieving the right to health and needs to be an integral part of ‘right to health’ strategies, national policies, etc. Accessibility has a number of dimension, including physical, information and economic accessibility. Thus ‘information accessibility’ includes the right to seek, receive and impart information concerning health issues, subjects to the right to have personal health data treated with confidentiality. ‘Economic accessibility’ means that health facilities, goods and services must be acceptable ie respectful of medical ethics and culturally appropriate, and of good quality. Accessibility has a number of dimension, including physical, information and economic accessibility. Thus ‘information accessibility’ includes the right to seek, receive and impart information concerning health issues, subjects to the right to have personal health data treated with confidentiality. ‘Economic accessibility’ means that health facilities, goods and services must be acceptable ie respectful of medical ethics and culturally appropriate, and of good quality.

12. Strategies – Right to Health Strategies need to be developed at international, national and local level in order to work towards realizing the ‘right to health’ Strategies need to be developed at international, national and local level in order to work towards realizing the ‘right to health’ Activities to achieve such strategies will need to include considerations of freedoms, entitlements and accessibility. Activities to achieve such strategies will need to include considerations of freedoms, entitlements and accessibility. Give some examples of international, national or local strategies to increase access to health services? Give some examples of international, national or local strategies to increase access to health services?

13. MDG 4 – Reduce Child Mortality Human Right to Health Human Right to Health The right to the enjoyment of a variety of facilities, goods, services and conditions necessary for the realisation of the highest attainable standard of health. The right includes both health care and the underlying determinates of health including; The right to the enjoyment of a variety of facilities, goods, services and conditions necessary for the realisation of the highest attainable standard of health. The right includes both health care and the underlying determinates of health including; Acces to safe and potable water and adequate sanitation Acces to safe and potable water and adequate sanitation Adequate supply of food, nutrition and housing Adequate supply of food, nutrition and housing Healthy occupational and environmental conditions Healthy occupational and environmental conditions Acces to health related education and information (including sexual and reproductive health) Acces to health related education and information (including sexual and reproductive health) International strategy to increase access to child health care services International strategy to increase access to child health care services National strategy to provide free for basic child health care services for the marginalised National strategy to provide free for basic child health care services for the marginalised Local strategy to provide monthly health clinic Local strategy to provide monthly health clinic

14. Health Strategies Its essential to involve the communities were possible when formulating strategies to increase the probability of addressing the real needs of the communities Its essential to involve the communities were possible when formulating strategies to increase the probability of addressing the real needs of the communities The following questions will help in formulating strategies, particularly national and local strategies: The following questions will help in formulating strategies, particularly national and local strategies: What problems are being faced by the communities? What problems are being faced by the communities? What rights are being violated and not fulfilled? What rights are being violated and not fulfilled? Which groups suffer the most as the result of the problems Which groups suffer the most as the result of the problems What is the root of the problem that cause violation of rights What is the root of the problem that cause violation of rights

15. Group Exercise Pona’s Story Pona’s Story What health problems are faced by Pona’s family? What health problems are faced by Pona’s family? What rights are being violated or not fulfilled? What rights are being violated or not fulfilled? What is the root of the problem that cause violation of rights? What is the root of the problem that cause violation of rights? Develop local, national and international strategies to improve access to health services for Pona’s family Develop local, national and international strategies to improve access to health services for Pona’s family