Use human approach to address health issues

By Oscar Okech Kanyangareng 

HEALTH
                                                                                       
The Ministry of Health while celebrating the National Resistant Movement 32 years in power ran a supplement the New Vision of Tuesday, February 6, about its achievements in the health sector.

However, much as there is some progress and the stories and statistics looked pleasing on the surface, they are far from meeting global goals, targets and standards.

Take for example, the maternal mortality ratio-the number of women who die while giving birth out of every 100,000 was applauded as having reduced from 438 seven years ago to 336 today. But it is still far from the agreed target of 70 by 2030 in the Sustainable Development Goals. And at the current phase, we are not measuring up to global standards.

While the ministry stated that 73% of approved jobs of health workers are filled, the Health Sector Development Plan 2015/16 to 2019/20 states that most of these health workers are in bigger and urban-based facilities such as Mulago Hospital. All health centre IIs that operate at parish level have a staffing level of only 45%.This is where the majority of the poor and marginalised people live and cannot afford alternative health services.

That is why in order to address these gaps and imbalances to equitable access to universal health coverage, there is need for a paradigm shift to address health issues using a human rights approach in order to promote equitable development and accelerate the process of achieving agreed global targets.

Its basis is in the UN declaration on the right to development of 1986 and its follow-up 1967 convention on the rights to economic, social and cultural development that includes health. Development actors later designed the rights-based approach to development (RBA) to translate development needs and interventions as a rights that have been denied or violated and should be fulfilled. RBA does not replace, but compliments previous development approaches.

So, when women need family planning services, the RBA translates it that women have a right to reproductive health rights and services. When a village lacks water, it does not say the villagers need water, but have a right not only to water but one that is also available, accessible, affordable, clean, safe, acceptable and usable.

The States and development actors then become ‘duty bearers' and the people ‘rights holders' with rights and responsibilities. It promotes social justice, equality and freedom and tackles the root causes of poverty, exploitation and marginalisation. It has agreed globally goals; targets and norms with specific results, standards of service delivery, conduct and results are time bound. It promotes participation, transparency and accountability by all actors.

Although the Ministry of Health has mentioned health as a right in its Health Development Plan for 2015/16 to 2019/2020, it is mentioned in passing under the headline of the ‘Global Health Development Agenda'. It is not mentioned in the section of the Uganda Government health development frameworks. So, it is not domesticated and owned by the Government. It is still a foreign idea.

Besides, most developing countries globally are hesitant to adopt RBA because it puts obligations and targets to achieve that.

Most people often associate the right to health with access to healthcare and the building of hospitals, but it in reality extends further to include a wide range of factors that include addressing the "underlying social determinants of health" like food and nutrition. It addresses gender inequality and contains freedoms like the right not to be used for an experiment and entitlements such as the right to a system of health protection providing equality of opportunity for everyone to enjoy the highest attainable level of health.

Without using the rights-based approach to resolving health issues, the few statistical indicators will cloud our eyes with an illusion of progress that won't lean to transformative change in the health sector. We should, therefore, make a paradigm shift in order to achieve universal health coverage by 2030.

The writer is a development specialist and civil society activist