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The Brazilian Human Rights Indicators System: The Case of the Right to Health

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The Right to Health

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Abstract

This chapter focuses on the Brazilian government’s project to build a National Human Rights Indicators system (NHRI) for the right to health as outlined in Article 12 of the International Covenant on Economic, Social and Cultural Rights (ICESCR). First, the notion of human rights indicators is developed based on reflections from three key documents: the Report on Indicators for Monitoring Compliance with International Human Rights Instruments (HRI/MC/2006/7), the Report on Indicators for Promoting and Monitoring the Implementation of Human Rights (HRI/MC/2008/3), and the Guidelines for Preparation of Progress Indicators in the area of economic, social, and cultural rights. Subsequently, the major initiatives undertaken by the Secretariat of Human Rights to create the NHRI are assessed, such as the development of the Monitoring Technical Committee (CTA). This chapter draws upon the right to health according to the Brazilian Constitution and the law, the current health indicators used by the Brazilian Ministry of Health, and indicators proposed by the Brazilian government, taking into account the unique attributes of the Public Health System and the context of social and economic inequalities in Brazil. This contribution examines which health-related indicators proposed by the United Nations Office of the High Commissioner for Human Rights (OHCHR) and the Inter-American Commission on Human Rights are appropriate for Brazil; it considers which indicators might be useful to other countries; it explores which health indicators used by the Brazilian Ministry of Health are applicable to the NHRI; and it contributes to the discussion on the use of human rights indicators to evaluate government progress toward accomplishing their health-related human rights obligations.

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Notes

  1. 1.

    U.N. Committee on ESCR (CECSR), General Comment No. 14: The right to the Highest Attainable Standard of Health, para 43, U.N. Doc. E/C.12/2000/4 (11 August 2000) (Hereafter: General Comment 14), para 43 (f).

  2. 2.

    OHCHR 2013.

  3. 3.

    OHCHR 2013.

  4. 4.

    UNDP 2000.

  5. 5.

    The Additional Protocol to the American Convention on Human Rights in the area of Economic, Social, and Cultural Rights, more commonly known as the "Protocol of San Salvador," was opened for signature in the city of San Salvador, El Salvador, on 17 November 1988. The Protocol prescribes social, economic, and cultural rights, as well as the right to health, to work, and to education, which were treated generically in the American Convention on Human Rights.

  6. 6.

    Organization of American States 1999, Article 19.

  7. 7.

    Inter-American Commission on Human Rights, “Guidelines for Preparation of Progress Indicators in the Area of Economic, Social and Cultural Rights” (2008). Available from http://cidh.org/countryrep/IndicadoresDESC08eng/Indicadoresindice.eng.htm.

  8. 8.

    It is important to highlight Paul Hunt’s Report “A human rights-based approach to health indicators,” elaborated in 2006, as Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health.

  9. 9.

    Brazil 2009.

  10. 10.

    United Nations 2012.

  11. 11.

    The objective of the National System of Human Rights Indicators, in the first stage of the project, is to deal with the following rights: the right to education; the right to health; the right to work, the right to life, and the right to environment.

  12. 12.

    OHCHR 2011.

  13. 13.

    OHCHR 2008a.

  14. 14.

    OHCHR 2008a.

  15. 15.

    OHCHR 2011.

  16. 16.

    The four elements of the human right to health are: availability, accessibility, acceptability and quality of healthcare systems. (A) Availability: each State must have a sufficient number of public healthcare facilities, goods and services, as well as healthcare policies and programs. The mentioned services also encompass those related to basic health, such as clean and potable water, and appropriate sanitation. Also important is the number of hospitals, clinics and other healthcare facilities; healthcare personnel; essential medication defined in the Action Programme on Essential Medication of the World Health Organization, made available by the State. (B) Accessibility: it is defined as the commitment made by the States so that healthcare facilities, goods and services are available to all, with no discrimination of any kind. It is subdivided into: (I) non-discrimination: healthcare facilities, goods and services must be accessible, in fact and in law, to the marginalized and vulnerable parts of the population; (II) physical accessibility: healthcare facilities, goods and services must be physically reachable by the entire population, especially those marginalized and vulnerable groups, minorities, indigenous people, women, children and adolescents. People living in rural areas are included in this category; (III) economic accessibility: healthcare facilities, goods and services must be available to all, and the payment for the services must observe the principle of equity; (IV) access to information: it is the right to ask for, receive and divulge information and ideas. (C) Acceptability: it is defined as the respect for ethics and cultural standards by the healthcare services providers. (D) Quality: it is the conformity of healthcare facilities, goods and services to the scientific, medical and quality-related standards (CESCR 2000).

  17. 17.

    OHCHR 2008b.

  18. 18.

    There is a difference between human rights indicators and health indicators. According to Hunt (2006), health indicators may be used to monitor aspects of the progressive realization of the right to health provided: (a) they correspond, with some precision, to a right to health norm, such as article 12 of ICESCR; (b) they are disaggregated by at least sex, race, ethnicity, rural/urban and socio-economic status […]; (c) they are supplemented by additional indicators that monitor […] essential and interrelated features of the right to health.

  19. 19.

    OHCHR 2008a.

  20. 20.

    OHCHR 2008a.

  21. 21.

    OHCHR 2011.

  22. 22.

    OHCHR 2008a, b.

  23. 23.

    OHCHR 2008a.

  24. 24.

    OHCHR 2011.

  25. 25.

    OHCHR 2008a.

  26. 26.

    IACHR 2008.

  27. 27.

    IACHR 2008.

  28. 28.

    IACHR 2008.

  29. 29.

    Raworth 2005.

  30. 30.

    Malhotra and Fasel 2005.

  31. 31.

    IACHR 2008.

  32. 32.

    WHO 2012.

  33. 33.

    Gruskin and Ferguson 2009.

  34. 34.

    Hunt 2006.

  35. 35.

    Hunt 2006.

  36. 36.

    Hunt 2006.

  37. 37.

    Hunt 2006.

  38. 38.

    Hunt 2006.

  39. 39.

    Hunt 2006.

  40. 40.

    OHCHR 2008a, b.

  41. 41.

    Hunt 2006.

  42. 42.

    Hunt 2006.

  43. 43.

    CESCR 2000.

  44. 44.

    CESCR 2000.

  45. 45.

    Telles et al. 2011.

  46. 46.

    United Nations 2012.

  47. 47.

    Malhotra and Fasel 2005.

  48. 48.

    Telles et al. 2011.

  49. 49.

    UNFPA 2011.

  50. 50.

    Telles et al. 2011.

  51. 51.

    INESCa 2012.

  52. 52.

    SDHa 2012.

  53. 53.

    INESCb 2012.

  54. 54.

    OHCHR 2008a.

  55. 55.

    SDHb, INESCb.

  56. 56.

    OHCHR 2008a.

  57. 57.

    Telles et al. 2011.

  58. 58.

    SDHc 2012.

  59. 59.

    OHCHR 2008a.

  60. 60.

    The infant mortality rate is one aspect of child health that encompasses policies and programs that have a much wider scope, like the policies/programs related to violence against children.

  61. 61.

    SDHc.

  62. 62.

    SDHb, SDHc, SDHd and SDHe.

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Authors and Affiliations

  1. UNESCO Chair of Bioethics, University of Brasilia, Human Rights Secretariat, Brasilia, Brazil

    Aline Albuquerque

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  1. Aline Albuquerque
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Correspondence to Aline Albuquerque .

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Editors and Affiliations

  1. Faculty of Law, Constitutional and International Law, University of Groningen, Groningen, The Netherlands

    Brigit Toebes

  2. Law, Irish Centre for Human Rights, Galway, Galway, Ireland

    Rhonda Ferguson

  3. Institute of Social Sciences, Belgrade, Serbia,Institute of International Law, Graz, Austria

    Milan M. Markovic

  4. Faculty of Law, Dept of Public and Private Law, University of Nigeria, Enugu Campus, Enugu, Nigeria

    Obiajulu Nnamuchi

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© 2014 T.M.C. ASSER PRESS and the authors

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Albuquerque, A. (2014). The Brazilian Human Rights Indicators System: The Case of the Right to Health. In: Toebes, B., Ferguson, R., Markovic, M., Nnamuchi, O. (eds) The Right to Health. T.M.C. Asser Press, The Hague. https://doi.org/10.1007/978-94-6265-014-5_9

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