Every woman, man, youth and child has the human right to the highest attainable standard of physical and mental health, without discrimination of any kind. Enjoyment of the human right to health is vital to all aspects of a person's life and well-being, and is crucial to the realization of many other fundamental human rights and freedoms.

1. Human Rights and Health
PREETY THAKUR
SMVDCoN

2. What is the Human Right to Health?
• Every woman, man, youth and child has the human
right to the highest attainable standard of physical and
mental health, without discrimination of any kind.
Enjoyment of the human right to health is vital to all
aspects of a person's life and well-being, and is
crucial to the realization of many other fundamental
human rights and freedoms.

3. Human Rights relating to health
1. The highest attainable standard health
2. Equal access to adequate health care and
health-related services
3. Equitable distribution of food.
4. Access to safe drinking water and sanitation.
5. Adequate standard of living and adequate
housing.

4. Human Rights relating to health
6. safe and healthy environment.
7. a safe and healthy workplace
8. freedom from discrimination and
discriminatory social practices.
9. education and access to information relating
to health
10. appropriate environment for physical and
mental development to children

5. Governments' Commitments to Human
Right to Health
Most governments are committed to ensuring the
realization of the Human Right to Health through
declarations through many forums such:
• Earth Summit in Rio,
• International Conference on Population and
Development in Cairo,
• World Summit for Social Development in
Copenhagen,
• Habitat II conference in Istanbul.
• And many more

6. National Rural Health Mission and
Human health rights :- the connection
• NRHM is a response by the Government
to human rights related to health
• Reaffirms Government's commitment to
meet people's aspirations for better health
and access to health care.

7. What are ethical imperative to solve the
human rights issues in India ?
• Growing inequalities in access to health care .
– On one hand corporate hospitals with state-of-the-art
facilities cater to the elite
– On the other hand the majority are left to market forces and
medical expenditure is the second highest cause of rural
indebtedness.
• Health indicators like the infant mortality rate have
stagnated or even worsened in some large states,
despite growing national wealth

8. Important questions:- Can NRHM
• become part of a bold paradigm shift, from
providing services through top down planning
• build capacity and empower communities to
manage their own health care needs ?
• make an equitable reach to all rural
communities?

9. Goals of NRHM
• Reduction in IMR & MMR.
• Improved access to Maternal and Child Health
care services, improved Nutrition and
Sanitation.
• Prevention and control of communicable and
non communicable diseases.

10. Goals of NRHM
• Strengthening Comprehensive Primary Health
Care services.
• Achieving population stabilization and sex
balance in population.
• Mainstream AYUSH, revitalize local health
tradition.

11. NRHM – The Concept (I)
• The National Common Minimum Programme:
• Allocation for Public Health to go up from 0.9% of
GDP to 2-3% over next 5 years.
• Architectural correction of Health Sector to handle
such increased allocations

12. NRHM – The Concept (I)
• Policies that strengthen public health management
and service delivery in the country.
• Focus to change from Outlays to Outcomes.
• Provide effective healthcare to rural population
throughout the country with special focus on 18 states,
which have weak public health indicators and/or
weak infrastructure.

13. NRHM – The Concept (II)
Health Health Determinants
RCH-II NDCP
AYUSH General
Curative
Care
Nutrition Sanitation
& Hygiene
Drinking
Water
Supply

14. NRHM
RCH
& FW Additionalities
under NRHM
Immuni-
sation
NDCP Convergence

15. Core Strategies
• PRIs to manage Public Health Services.
• Village level female health activist (ASHA).
• Health Plan for each village – ward .
• Untied Fund at sub-centre.
• Strengthening the Rural hospital for effective curative
care
• Accountable to the community – measurable
outcomes

16. • Upgrading all Public Health Institutions to
Indian Public Health Standards (IPHS).
• Preparation and Implementation of an inter-
sectoral District Health Plan.
• Integrating vertical Health and Family Welfare
Programmes and Societies for optimal
utilization of funds and infrastructure and
strengthening delivery of primary healthcare.
• Mainstreaming AYUSH

17. • Infant Mortality Rate reduced to 30/1000 live births-(Kerala from10 to7)
• Maternal Mortality Ratio reduced to 100/100,000-(Kerala from80 to
40/100,000)
• Total Fertility Rate reduced to 2.1(in kerala to 1.5)
•.(couple protection rate raised to 65% from 61.5 in Kerala)
• Malaria mortality reduction rate –50% up to 2010, additional 10% by 2012
• Kala Azar mortality reduction rate: 100% by 2010 and sustaining
elimination until 2012
• Filaria/Microfilaria reduction rate: 70% by 2010, 80% by 2012 and
elimination by 2015
• Dengue mortality reduction rate: 50% by 2010 and sustaining at that
level until 2012
• Japanese Encephalitis mortality reduction rate: 50% by 2010 and
Expected Outcomes National Level

18. •Drugs for common ailments available at Sub-centre/
hospital level
•Assured good quality hospital care by assured
availability of doctors, drugs and quality services at
PHC/CHC level
•Improved facilities for institutional delivery
•Assured healthcare under risk pooling models
•Provision of household toilets
•Improved outreach services through mobile medical
unit
Expected Outcomes: Community Level

19. Expected Outcomes: Community
Level
• Availability of trained ASHA, with drug kit in selected states
• Monthly Health and Nutrition Day at Anganwadi for immunization, ante &
post natal care, nutrition and other services related to mother & child
healthcare, and services related to disease control programmes.
• Improved access to Universal Immunization through alternate vaccine
delivery and improved mobilization services under the programme and
improved quality of services by induction of Auto Disabled Syringes,

20. PEOPLE
NVBDCP
RNTCP
NACP
IDSP
SHP
Nutrition
Education
NCCP
NBCP
INTEGRATED SERVICE DELIVERY UNDER NRHM
IDD
PFA&
D

21. • RCH
• Immunisation
• Additionalities
• Disease control programmes
• Convergence

22. Broad aims under RCH II in KERALA
1. To reduce MMR to 40 per 100 000 live births
2. To reduce the IMR to 7
3. TFR to be brought down to 1.5
4. Incidence of RTI/STI/AIDS reduced by 75% amongst
adult population and incidence of cancer detected at an
early stage
5. Adolescent care and information needs, unmet needs and
care-seeking behaviour of adolescents addressed
6. Quality RCH services provided for the Tribal, Coastal and
Urban Slum population

23. Broad aims under RCH II – Contd.
7. Incidence of Gender based violence reduced in Kerala
8. Health concerns of older population addressed
9. Health Seeking Behaviour on health issues especially for
RCH issues improved in the society
10. Health care of BPL, under served marginalized groups and
vulnerable sections provided
11. Quality RCH services provided through Capacity
Development of Health care personnel
12. Enhanced client satisfaction through improved quality of
services.

24. What NRHM has achieved in terms of
meeting the 10 health rights ?
• Ward Health and Sanitation committees
• ASHAs
• Need based BCC/IEC Activities
• ARSH Clinics, question box in schools
• School Health Programme and CFSI
• Infrastructure – IPHS,NABH,NABL
• Manpower
• Funds-HMC-Decentralisation-LSGIs
• Convergence-AYUSH,TSC,SWDept,Education dept
• CAMPS- AROGYAMELAs , RCH,TRIBAL,migrant labour
• MNGO/FNGO
• Palliative care-Govt Policy

25. • RSBY – CHIS
• HMIS – HISP
• CME – professional bodies, other departments
• JSY
• FP/FW activities
• Immunisation – out reach, MISP,AEFI,surveillance
• Drug availability
• Transportation
• ARI,ADD
• RTI/STI services – KSACS
• NGOs - PPP

26. What NRHM is planning to do in terms
meeting 10 health right issues ?
• KUDUMBASREE
• NCD
• INFERTILITY
• Palliative Care-integration with health dept
• Nutrition
• BFHI
• DLHS – 3
• INTEGRATED PIP

27. What could be some of the
parameters to be measured
• Availability of health centers in your area
• Availability of staff and personnel
• Availability of infrastructure, services and medicines
• Availability of services for women and children
• How well are institutions PHC CHC managed
• Are the problems faced by the doctors and other
personnel managed
• Changes being introduced by NRHM
• quality of training, actual activities and tasks
performed by ASHA

28. What can you do to promote
health as a human right ?
• Serve as ASHA members
• Participate as volunteers for surveys
• Motivate formation self help groups
• Form NGOs and assist the NRHM
• Promote Public Private Participation
• Be a part of ‘public watch’ of NRHM and give
feedback
• Participate in NRHM day celebrations
• STRENGTHEN WH&SCs