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Basic orientation on the Right to Health, issues and challenges in the present healthcare system in the Philippines and the Healthcare system we want (framework)
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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 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
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.”
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
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.”
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
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.”
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
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
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
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
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
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
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
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
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
The People’s The People’s Healthcare SystemHealthcare System
through community-managed health plans (CMHPs)
Another Healthcare Model
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
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
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 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