APPLICATION OF HUMAN RIGHTS BASED APPROACH IN MATERNAL - PowerPoint Presentation

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APPLICATION OF HUMAN RIGHTS BASED APPROACH IN MATERNAL HEALTH PROGRAMMES IN MALAWI

GRACE

TIKAMBENJI MALERA

MALAWI HUMAN RIGHTS COMMISSIONSlide2

Introduction

HRBA concept relatively

new compared to other traditional

approaches.

HRBA has

gained

ground in Malawi

Duty bearers, including the government, the Human Rights Commission and NGOs have been applying

HRBA

Developmental

programmes and projects, including in the area of maternal

health.Slide3

Introduction

This is evident from:

The Constitution which recognises health as a developmental and rights issue

The recognition of women’s rights in the

Constitution

Ratification of Maputo Protocol and other instruments

The implication of this is that health issues, including maternal health are given the status of “rights”, which can be claimed

This gives a good basis for the application of a rights-based approachSlide4

Introduction

The National Sexual and Reproductive Health Policy of 2009 expressly refers

to:

human rights-based approach,

equity

,

gender

sensitivity,

accountability

, and

community

participation

as some of the policies guiding principles.

These

are some of the key components of HRBASlide5

Introduction

Even before the Technical Guidance was adopted, there have been efforts to integrate HRBA in maternal health

programmes

To concretise these efforts, in 2013, a team of the country team UN Agencies, OHCHR, the NHRI and CSOs held a conference on HRBA and maternal healthSlide6

Introduction

Against this background,

the presentation

illustrates

some of the programmes in Malawi that have integrated a HRBA

The added value of the technical guidance

Lessons learnt, including challenges and suggestions for the futureSlide7

Why HRBA

Human rights

denials and discrimination against women

are significant contributing factors to preventable maternal and child

mortality

Malawi has one of the highest maternal mortality rate

Notwithstanding the significance improvement recorded in last years, 675/100,000,

Low access to SRH and MNH services, especially in hard to reach areas,

low coverage, high unmet family planning needs, high rate of unsafe abortionsSlide8

Why HRBA

Need for greater accountability

Need for increased participation and empowerment

Non-discrimination and attention to vulnerabilities and marginalization

Express linkage to rightsSlide9

Activities by the Malawi Human Rights Commission

In 2009/10 a National

survey on the right to health from an HRBA

perspective was carried out

The Survey aimed at assessing Government’s fulfillment on its obligations on the right to health using an HRBA lens:

It assessed the following components:

Availability, Accessibility, Affordability and quality of services

Participation of claim holders

Empowerment of communities and

Accountability of duty bearers

The Results were used to engage Government in order to influence greater integration of rights based approaches to health programmingSlide10

Activities by the Malawi Human Rights Commission

In 2010 – 11, HRC implemented a programme called “Promote Human Rights: Improve Maternal Health” funded by UNFPA

Activities included

a community Based Public Inquiry,

Training

on Human Rights and Maternal Health

a

National Conference on Human Rights Based Approach to Maternal

healthSlide11

Why Public Inquiry

To address issues of systemic human rights violations with respect to maternal healthSlide12

Activities by the Malawi Human Rights Commission

The

public inquiry

aimed at:

identifying

and assessing the accessibility, availability, acceptability and quality of maternal health care in TA Kachere community in Dedza District,

strengthening

the accountability of duty-bearers by increasing knowledge and understanding of women’s human rights, more especially maternal health rights for the poor and rural women.

Strengthening capacities of local health workers and community leaders to implement effective strategies and mechanisms for improving maternal health

Engaging Government and its partners on implementation of Government polices and guidelines on sexual and reproductive health. Slide13

Public Inquiry: Participants

Members of the community – Claim holders

Safe motherhood committees

Traditional birth attendants

Health Personnel

HIV and AIDS Support Groups

Members of CBOs

Youth Organisations

Traditional Leaders

Members of ParliamentSlide14

Findings of the Public Inquiry

With an intensified level of community engaged which is crucial in HRBA, the inquiry brought out evidence-based findings on barriers relating to accessing maternal health services such as:

Limited availability of services,

Shortage of personnel

Infrastructural constraints, roads, medical facilities (e.g. lack of adequate waiting rooms)

Shortage of drugs, supplies and equipment

Limited awareness on maternal health issues

Low education attainment levels

Harmful social and cultural beliefs, traditions, attitudes and practicesSlide15

Barriers

Negative attitudes of health personnel

Family responsibilities

Limited food supplies at household level

Lack of or limited youth friendly services

Common theme of disempowerment of women and gender imbalanceSlide16

Findings - Recommendations

Government – formulate laws and policies furthering the rights guaranteed in the Constitution – Enact a Reproductive health law

Prioritize maternal health issues and human rights mainstreaming in policy

Institutional capacity issues: provision of adequate equipment to rural health centers, harness and consolidate capacity of safe motherhood committees;

Intensify capacity building of duty bearers on the topic of HRBA

Develop and implement grievance and complaints handling protocolsSlide17

Capacity Building: Regional HRBA Conference

Malawi hosted the regional conference on applying HRBA to maternal, Newborn, Child Hea

lth and Sexual and Reproductive Health Issues

Organised jointly by OHCHR, UNFPA, WHO and other stakeholders

Tanzania, Malawi, Uganda and South AfricaSlide18

Expected outcomes

Long term programming which will lead to strengthening of legal and policy environments that support improving women’s and children’s rights, including health outcomes

Interrogation of implications of planning, budgeting, implementation and monitoring and review and remedies

Consolidating multi-stakeholder platforms

Strengthening national linkages between human rights and health practitioners

Effecting institutional changes that address the intersection between human rights and public healthSlide19

Current Activities

Capacity Building

National level analysis of the legal and policy environment for

MCNSRH

National dialogue

Action plan

Additional – Public inquiry

Submission to the Public Health Act Review

Capacity BuildingSlide20

Challenges in integrating HRBA

Different levels- community, district, national, structural

Capacity gaps

Limited awareness of human rights – claim holders and duty bearers

Politicizations of developmental programmes

Financial constraints

Conceptual – nature of Economic, Social and Cultural Rights as progressive – prioritisationSlide21

Lessons Learnt – Best practices

Constitutional provisions – rights

Law review – Public health Act, Gender Equality Act

Express provisions of HRBA in Policies

Patients charters

Service delivery charters

Community empowerment

Accountability forums

Bridging the gap between health and human rights practitioners

Evidence-based engagement through inquiriesSlide22

Way Forward

Establish a multi-stakeholder technical working group

Develop tailor made manual on HRBA

Foster capacity building efforts

Focus on budget monitoring and tracking

Greater community mobilisation

Push for establishment of a Parliamentary Committee on Human Rights

Work through the

decentralised

structure – district assemblies

HRBA to integrated in post 2015

dev

agendaSlide23

Conclusion: Added Value of the Technical Guidance

Critical tool in integration of HRBA – instructive on a structured and systematic application of HRBA

Contributes to challenging the status quo in power dynamics -

the central inquiry is: how can Government and other stakeholders be made to deal with these very concrete problems that thousands of women in the country face?

Most importantly allows for a systematic

application of human rights standards and principles in designing, implementing and monitoring development

interventions

Allows us to look at both process and outcome for sustainable developmentSlide24

Conclusion

The Technical Guidance offers value-addition to work of NHRIs, NGOs and Health practitioners

Good for bridging the

defacto

public health and human rights gap

Fundamental shift in thinking – Robust accountability mechanism

THANK YOU