|Essays on Food, Hunger, Nutrition, Primary Health Care and Development (AVIVA, 480 p.)|
1. All agencies of the UN regularly prepare long term plans of action for approval by their respective boards. To arrive at them, these agencies go through detailed situation analyses that identify the most important causes of the problems each specialized agency deals with. As part of the latest UN reform process, the Secretary General of the United Nations has recently mandated that, starting in the year 2000, all agencies of the UN have to change the format of their upcoming plans and switch to what has been called Human Rights based plans of action. (1) Despite a rich literature on and a growing understanding of Human Rights in general, the Secretary General gave few explanations of what exactly this new approach to UN planning would entail.
2. UNICEF has taken a lead in defining in a bit more detail what Human Rights Based Planning means and entails for them. (2) What follows is a bare bones explanation of what this new concept is all about:
3. All actions in development projects/programs have to be based on a solid situation analysis. The latter has to be based on an Assessment and an Analysis of the existing situation that will then lead to decisions being made for Action; this has been called a triple A (AAA) process. But the assessment and the analysis cannot be done in a vacuum --without previously having worked on a Conceptual Framework of the causes of the problems that are to be solved. This means that one has to have an in depth understanding of how those problems come about --what their determinants are-- before one can decide what the best options are to do something about them. In other words, "One finds what one looks for" (...based on a conceptual framework). (3)
4. In the case of advocating for better childrens health and nutrition, the first concept that has to be agreed upon is that poor childrens excess mortality, excess ill-health and malnutrition are actually Outcomes in the conceptual framework. The three are determined by a series of Immediate Causes that include inadequate food intake and high prevalence of preventable diseases. The latter two, are themselves the result of yet another level of causality, Underlying Causes, that include household food and fuel insecurity, inadequate maternal and child care, low water and sanitation levels and inadequate access to (or utilization of) health care services, particularly by the poor. This whole pyramid of causes has at its base a series of Basic Causes represented by limited access to education (particularly for girls) and insufficient community control (power) over the resources (human, financial/material and organizational) poor people need to solve their problems at each causal level. (3)
5. The essence of a good situation analysis, then, is to carry out a Causal Analysis based on a pre-existing Conceptual Framework and to base all decisions for action to be taken on this analysis. Therefore, appropriate interventions for the main causes at each causal level have to be found. Addressing each cause is necessary, but not sufficient to change the outcome (i.e. ill-health, malnutrition and excess deaths). Communities need to act at all levels of determinants at the same time. This is why so many selective PHC interventions have failed in the past.
6. The above, basically summarizes what professionals in the field were expected to be doing up to now when trying to solve poor childrens health and nutrition problems. But the upcoming Human Rights Based Approach to Planning brings with it a new perspective to our work.
7. The essence of the Human Rights based approach is that it tells us that, additionally, we now need to carry out what is called a Capacity Analysis (or accountability analysis). (2)
What is a Capacity Analysis?
8. To analyze any Human Rights situation it is essential to identify two main groups of actors: Claim Holders and Duty Bearers. (4)
9. Claim Holders are the groups whose universally recognized entitlements are or are not being catered for by the societies they live in, and whose rights are thus being upheld or violated.
10. Duty Bearers are those individuals or institutions that are supposed to uphold the specific right related to each entitlement.
11. For example, in the case of a child as a claim holder, the first-line duty bearer is the mother; next are the father and other family members. But --forming a veritable pattern-- there also are duty bearers for children's rights further up the ladder: community leaders, district and provincial authorities, national and international leaders and institutions. (2)
12. To recap, the end result of a good causal/situation analysis is a list of locally specific immediate, underlying and basic causes that determine the problems being addressed. The participatory AAA process that identifies all those causes then also comes up with the suggested solutions for each cause identified.
13. It is here --when potential solutions have been collectively identified-- where Capacity Analysis comes in.
14. Capacity Analysis takes what is being proposed to be done for each determinant at each causal level and looks at what is already being done or not being done (and why) for that problem. It then looks at who should be doing something about it [individual and/or institution(s) who is (are) the corresponding duty bearer(s)] and attaches the name of that (those) person(s) or institution(s) to each proposed solution. This results in a list of the most crucial persons/institutions that have to be approached to push them to get the proposed solution(s) for each cause implemented. Note that, often, a particular duty bearer cannot meet her/his obligations because some of her/his rights are being violated by a duty bearer higher up (parents without resources to pay school fees cannot be blamed...). (2)
15. In a very simplified way, the end result of a good Capacity Analysis is a four or five columns table:
· the first column lists the causes listed from immediate to basic;
· the second column lists the respective right(s) being violated, for which group of claim holders (for example, children) for each cause (e.g. the right to food, the right to healthcare, etc);
· the third column identifies the gaps between what is being done and what still needs to be done (i.e. the actions needed --and one action may push duty bearers to finally carry out several previously neglected duties);
· the fourth column --to be realistic-- identifies the most critical respective duty bearer(s) by name (individuals and/or institutions responsible, often at more than one level);
· a fifth column may be added to specify who is going to approach those duty bearers and by when.
16. This table thus becomes an action plan to get the various Human Rights deemed to be violated redressed for each specific group of claim holders.
17. What this new Human Rights Approach to Planning does, then, is to couple the causal and the capacity analyses. At first glance, this may not mean much to readers being introduced to this new concept. But it is a powerful combination.
18. The coupling not only identifies what needs to be done, and at what level, but it also targets the person or institution that has to be lobbied/pressured, because they are legally responsible to do something about it under the Covenants of International Human Rights officially signed and ratified by almost all countries in the world.
19. The Human Rights approach, therefore, gives advocates of childrens welfare new powers: When appropriate, as advocates we can now approach duty bearers as guilty of not doing what they are legally (and not only ethically) supposed to do. The Human Rights covenants currently in force are very explicit about this. (5) We just have not sufficiently used this added power in our work so far.
20. Duty bearers have to be approached using the Human Rights violation justification, and have to be made accountable to comply! (6, 7) Alleging a lack of resources is not a good enough justification by duty bearers not to uphold the rights being violated. They have to convincingly demonstrate to us that resources available (even if meager) are not being used for other less essential functions. (7)
21. If we all do follow this new approach, we may set a growing precedent that will further the cause of those claim holders (children, for example) whose basic human rights are being violated worldwide.
22. Issues are a bit more intricate than here reflected, but this is a good introduction.
Claudio Schuftan, Hanoi
(1) Annan, K., UN Secretary-General Reform Program, UN, N.Y., 1997.
(2) Jonsson, U., An approach to Human Rights based programming in (UNICEF ESARO), SCN News No. 20, July 2000, pp. 6-6, ACC/SCN, Geneva, and UNICEF ESARO, Human Rights-based planning guidelines, mimeo, Nairobi, Jan. 2000.
(3) UNICEF, Nutrition Policy, UNICEF N.Y., 1990.
(4) Jonsson, U., Nutrition and the Convention of the Rights of the Child, Food Policy, 21:1, 1996, pp. 41-55
(5) Convention on the Rights of the Child, UN, N.Y., 1989.
(6) Dandan, V.B., Monitoring, supervision and dialogue in the Human Rights system, SCN News, No. 18, July 1999, pp. 34-38.
(7) UNHCR, Committee on Economic, Social and Cultural Rights, 20th session, Agenda item 7, Geneva, 26/4 to 14/5, 1999 (as quoted in SCN News No. 18, July 1999, pp. 41-45).