universal healthcare in the context of the right to health

Universal Healthcare in Universal Healthcare in the context of Human the context of Human RightsRights

Presented by: Presented by:

Monina Geaga Monina Geaga Secretary General, SARILAYA Secretary General, SARILAYA

December 14,2013 (Saturday), 10 AM,December 14,2013 (Saturday), 10 AM,Tri-mona Healthy DiningTri-mona Healthy Dining

Right to Health

or Right to be Healthy?

Universal Healthcare in the context of Human Rights Universal Healthcare in the context of Human Rights Presented by: Monina Geaga, Secretary General, SARILAYADecember 14,2013 (Saturday), 10 AM, Tri-mona Healthy Dining

Legal BasisLegal Basis• Section 15, Article II and Sections 11, 12, 13,

Article XIII, 1987 Philippine Constitution• Article 25, Universal Declaration of Human Rights • Article 8, Declaration on the Right to

Development • Article 12, International Covenant on Economic,

Social and Cultural Rights• Article 5e.iv, International Convention on the

Elimination of All Forms of Racial Discrimination • Article 12, Convention on the Elimination of All

Forms of Discrimination Against Women• Article 24, Convention on the Rights of the Child • Articles 28, 43 and 45, International Convention

on the Rights of All Migrant Workers and Members of their Families

• Articles 25 and 26, Convention on the Rights of Persons with Disabilities


Universal Declaration of Universal Declaration of Human Rights Human Rights “Everyone has the right to a standard of living adequate for the

health and well-being of himself and of his family, including food, clothing, housing and medical caremedical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.”

International International Convention on Convention on

Economic, Social and Economic, Social and Cultural Rights (ICESCR) Cultural Rights (ICESCR)

Article 25Article 25 “The States Parties to the present Covenant recognize the right of everyone to the enjoyment of the highest attainable standard of physical and mental health.”


The 1987 Philippine The 1987 Philippine ConstitutionConstitution

Article 2, Section 15 and Article 13, Sections 11-13Article 2, Section 15 and Article 13, Sections 11-13• “The State shall protect and promote the right to health of the

people and instill health consciousness among them.”

• “The State shall adopt an integrated and comprehensive approach to health development which shall endeavor to make essential goods, health and other social services available to all the people at affordable cost. There shall be priority for the needs of the under-privileged, sick, elderly, disabled, women, and children. The State shall endeavor to provide free medical care to paupers.”

• “The State shall establish and maintain an effective food and drug regulatory system and undertake appropriate health, manpower development, and research, responsive to the country's health needs and problems.”

• “The State shall establish a special agency for disabled person for their rehabilitation, self-development, and self-reliance, and their integration into the mainstream of society.”


Right to Health Right to Health according to World Health Organizationaccording to World Health Organization

“A state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”


Definition: Freedom and Entitlements

Freedom• Freedom to control one’s health and

body• Freedom from interferenceEntitlements• Entitlement to variety of

health facilities, goods, services and conditions


Basic Entitlementsthat should be provided by the State

1. Maternal, child & reproductive health

2. Healthy workplace & natural environment

3. Prevention, treatment & control of diseases, including access to essential medicines, and

4. Access to safe & potable water Universal Healthcare in the context of Human Rights Universal Healthcare in the context of Human Rights Presented by: Monina Geaga, Secretary General, SARILAYADecember 14,2013 (Saturday), 10 AM, Tri-mona Healthy Dining

Extends to the Underlying

Determinants of Health• Food and nutrition

• Housing• Access to safe and potable

water and adequate sanitation

• Safe and healthy working conditions

• Healthy environment• Education• Participation


Normative Normative Elements Elements

of the Right to of the Right to HealthHealth1.Availability

2.Accessibility• Physical• Economic • Information

3.Acceptability4.Quality

Normative Normative Elements of the Elements of the Right to HealthRight to Health1.Availability

2.Accessibility• Economic• Physical• Information

3.Acceptability

4.Quality

ObligatiObligationsons

1.Core2.Progressive

Realization3.Equality4.Nondiscrimination5.International

Cooperation and Assistance

6.Respect7.Protect8.Fulfill (facilitate

and provide)

1. Consultation same as PARTICIPATION?

2. CURRENT level of participation?

3. DESIRED level of participation?4. How to raise level of

participation?5. “Exercising rights

responsibly?”6. How duty bearers implement

obligations? 7. Claimholder and duty bearer

contributions to promote rights?

8. What prevents claimholders and duty bearers from exercising accountability? How to address?

9. Inherent disadvantages of claimholders?

10. Prejudices, customary or other practices to be addressed?

11. Temporary special measures to be applied?

12. How to avoid discrimination?13. Information needed?14. Form, language, media?15. When information released?16. How to remove “veil of

secrecy?”17. How to avoid corruption?

18. Actions to overcome claimholder vulnerability?

19. Safeguards or safety nets?20. Nature of power relations?21. What motivates claimholders to

act? What facilitates claimholders to make informed decisions?

22. What prevents actors from acting? How to address this?

23. Aspects of power (power to, power with, power from within, power over) addressed?

24. Dimensions of empowerment (economic, human and social, political, cultural) promoted?

25. Empowerment approach (agency or structural) applied?

26. Right of reparation claimed? 27. Compliance with obligations

arising from right of reparation?28. Barriers or obstacles?29. How to overcome barriers or

obstacles?

AQUINO HEALTH AGENDA (AHA)The Universal Healthcare under Aquino Admin

•Primary Health Care•Health Sector Reform•Integrated Referral System•National Health Insurance Program (PhilHealth)

SOCIETAL GOAL

SECTOR OUTCOME

HEALTH SUB SECTOR

Inclusive Growth and Poverty ReductionInclusive Growth and Poverty Reduction

Health Status Financial Risk Responsiveness Protection Health Status Financial Risk Responsiveness Protection

Access to quality education, training

& culture

Access to quality education, training

& culture

Improved Improved Health Health StatusStatus

Improved Improved Health Health StatusStatus

Access to shelter security

Access to shelter security

Access to quality Access to quality social protectionsocial protectionAccess to quality Access to quality social protectionsocial protection

Access to asset

reform

Access to asset

reform

Human Development Status ImprovedHuman Development Status Improved

Health in the Social Contract: Inclusive Growth

Improved Health especially for the

Poor and Vulnerable

Improved Health especially for the

Poor and Vulnerable

Secure access to quality care at

facilities

Achieve the public health MDGs

Provide financial risk protection

INTERVENTIONS OF CARE

Primar

y Pre

vention

and H

ealth

Prom

otion

Curative Health

Care

Secondary Prevention and Primary Care

DOH Outcome and Strategies

Issues and ChallengesPreliminary Observations


Our Our NeedsNeeds

Our Vision Our Vision "Have a healthy citizenry for a productive and fulfilling life!"

Our Inspiration: The Alma-Our Inspiration: The Alma-ata Declaration on Primary ata Declaration on Primary

Healthcare, 1978Healthcare, 1978

Universal Healthcare in the context of Human Rights Presented by: Monina Geaga, Secretary General, Universal Healthcare in the context of Human Rights Presented by: Monina Geaga, Secretary General, SARILAYA December 14,2013 (Saturday), 10 AM, Tri-mona Healthy DiningSARILAYA December 14,2013 (Saturday), 10 AM, Tri-mona Healthy Dining

GoalGoal• For people to be at the heart of the healthcare

system in terms of taking control and as informed participants/beneficiary of the system.

• Access to affordable and quality healthcare for all.

• Quality would mean:– Wide range of choices of evidence-based, safe

healthcare modalities / integration of different systems of medicine

– Rooted in the culture of the people• Preventive, promotive, curative and

rehabilitative medical products and services


The People’s The People’s Healthcare SystemHealthcare System

through community-managed health plans (CMHPs)

Another Healthcare Model


Thank You!Sources:• Maria Socorro Diokno’s Presentation 2010 and

2013 edition Handouts from her 3-month Advanced HRBA Course sponsored by EED

• DOH Presentation of the 2014 Budget• Medical Action Group Presentation 2013• Alma-ata Declaration• Film Clip: Sicko, Michael Moore• Analysis from issues & challenges to framework

chart developed by healthactivist.ph with the inspiration of healthcare movement in the Philippines (INAM, SARILAYA and ABI-Health) with edits from Ms. Diokno


universal healthcare in the context of the right to health

Health & Medicine