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Right to Health Series: Part 2

May 25, 2011

The first installment of this series on the right to health summarized what this right requires of governments. Human rights are more than just prescriptions for governments, however. They are an ethical system that applies to everyone and are the responsibility of everyone to practice. Human rights treaties, the written comments of the treaty committees, and the experiences of people practicing human rights are a guide to living together with the values that are the foundation of human rights: justice, dignity, inclusion, equity/equality and solidarity.

Practicing human rights in our daily lives and work is often referred to as a rights-based approach. The concepts that form the core knowledge base of the rights-based approach (RBA) grew out the work of the international development community. After many years of failing to significantly decrease poverty, some development organizations began to look critically at their work. They realized that poverty is not merely an absence of resources, but results from human rights violations. Simply trying to meet material needs, or provide health care services, whether through the government or the market, will not decrease poverty and marginalization over the long term. Neither addresses the deep injustices and societal systems that produce poverty in the first place. Only empowering people whose rights are violated can change those systems.

As people who work mostly in health we are very comfortable with a needs-based approach. When faced with a health problem we know what resources or actions are needed to treat and prevent it. For example, when diarrhea is common in a community there are a couple of strategies we commonly use. First, we try to change community members’ behaviors that promote diarrhea. We provide community education to teach hand washing and how to boil or chlorinate drinking water. Another strategy is to provide so-called appropriate technology and small-scale infrastructure. We fund wells or village level water purification systems and latrines. These projects may decrease diarrhea and lead to other improvements in the short term, but over time the human rights violations that maintain the system that produced the living conditions of the community will limit and undermine the positive change. The community might not have (or might lose) the know-how or resources to maintain the well pump. Because they live on marginal land, a flood or landslide might destroy the well.

A RBA explicitly uses different strategies to solve problems. It doesn’t exclude addressing needs, but it emphasizes realizing rights by uncovering and addressing the root causes of problems – the systems that perpetuate human rights abuses. A RBA protects and takes into account the groups most at risk of human rights violations due to marginalization and discrimination. The people affected by the problem are always included in all aspects of the program to solve it. A RBA program often focuses on building the capacity of marginalized groups and victims of human rights violations to claim their rights from governments or other duty bearers. But it also targets duty bearers to increase their willingness and capacity to fulfill their responsibilities. By identifying underlying causes, claim holders, and duty bearers a RBA enables people to specifically change systems of power.

Characteristics of NEEDS-BASED vs. RIGHTS-BASED programs

NEEDS-BASED                                                            RIGHTS-BASED
Emphasize meeting needs                                             Emphasize realizing rights
Focus on input and outcome                                         Focus on process and outcome
Individuals deserve assistance                                      Individuals are entitled to solidarity
Focus on immediate causes of problems                    Focus on structural causes and their manifestations
Recognize needs as valid                                                Recognize individual and group rights as claims
on duty-bearers
Individuals are objects of anti-poverty                       Individuals and groups are empowered to claim their
interventions                                                                     rights

Much of the information and the table in this article were adapted or copied from The Advocates for Human RightsA Rights-Based Approach to Social Justice Work: Training of Trainers Manual by Emily Farrell and Madeline Lohman.

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