Health rights is an essential component of the universal right to the highest attainable standard of physical and mental health, enshrined in the Universal Declaration of Human Rights and in other international human rights conventions, declarations, and consensus agreements. The World Health Organization defines health as a state of complete physical, mental and social well being and not merely the absence of disease or infirmity. Human rights standards require states to respect, protect, and fulfill the right to sexual and reproductive health, and the states must also ensure that individuals have the opportunity to actively participate in the development of health care policy and in individual care decisions —including determining whether and when to have children and in protecting the rights of others to sexual and reproductive health, including through ensuring violence-free relationships and homes and in seeking information, education, and care for one’s children. The constitution of Nepal 2015 has redefined the health rights as basic human rights. The new constitution addresses right to health in article 35 which highlights that 1) Every citizen shall have the free basic health services from the State and no one shall be deprived of emergency health services, 2) Every Citizen shall have the right to get information about his or her medical treatment, 3) Every citizen shall have equal access to health services, 4) Every citizen shall have the right of access to clean drinking water and sanitation.
Since 2007 Nepal has adopted a policy of free health care services to the poor and vulnerable citizens attending primary health care centers and district hospitals to meet the demand of rural population, poor and needy people. The government has brought health services closer to the communities through a decentralized health system. Similarly the government of Nepal has introduced new national health policy 2014 replacing the two decades old national health policy 1991. The 1991 policy was based on rural health while access to health care was its major focus. Similarly the policy had focused more on combating communicable diseases. To protect the achievements that have been made so far and to adequately address prevalent and new challenges faced within health sector National health policy 1991 was updated and National health policy 2014 was formulated.
In the past two decades Nepal has made notable progress on improving the overall health outcomes of its citizens. Between 1990 and 2014 Nepal has successfully reduced under five mortality rate as well as maternal mortality rate. Despite the progress our country still faces many challenges including inequality. Many citizens continue to face financial, socio-cultural, geographical barriers in accessing health services. Despite efforts to reduce the gender based inequality the women of Nepal are still marginalized in society which affects their health and wellbeing. Therefore the government has introduced special programs and incentives such as free health care programme and incentives such as free health care programme and safe delivery incentive scheme to reduce inequity in health. Similarly the government has emphasized on improving access to health care services by expanding health facilities and strengthening community based interventions. In the last few years the government has also initiated provided free health services including treatment of non communicable disease like diabetes and gynaecological problems like uterine prolapse. Similarly the concept of social security is still new in Nepal. Nepal has recently introduced the scheme in few districts and plans to increase its coverage throughout the country. However the question remains as whether poor families can afford it in spite of the scheme being designed to decrease the financial burden of the poor.
Thus despite these progress and interventions, Nepal faces a huge challenge in implementing these policies in reality. It is still to be observed whether all the health services provided by the government are accessible to all? In Nepal the political dynamics has changed. Nepal had its first local election after 20 years and first to be held since the promulgation of 2015 constitution. This is a huge opportunity for all of us to advocate for health rights. Against this background, RECPHEC plans to prepare first health desk report to understand the health rights of people in the country. In this regard RECPHEC will conduct desk review of government’s effort and also compile reports from district based network. The first health desk report will be made public in 2019. With this vision, RECPHEC planned to conduct Training of Trainers to its staff to enable them to train district based network members in compiling health rights issues in their communities.
Thus the main objectives of TOT are as follows:
1. To learn basics of Human Rights broadly including socio-cultural, economic and political rights
2. To identify different components of health rights
3. To identify health rights violation at peoples level
4. To prepare district based health rights violation reporting format
5. To capacitate RECPHEC staff and provincial focal persons to design the ToT at Provincial Level
• The TOT will be provided by Health and Human Right experts.
• Follow up action: The trained staff will conduct training to all Health Rights and Tobacco Control Network members at district level.