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Ariel Frisancho National Coordinator Health Rights Program

“Improving the Health of the Poor: a Rights-Based Approach” Program (PPA Health Rights Program) - CARE Perú. Ariel Frisancho National Coordinator Health Rights Program APHA 134 th Annual Meeting & Exposition Boston, November 4th – 8th, 2006. Health Rights Program.

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Ariel Frisancho National Coordinator Health Rights Program

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  1. “Improving the Health of the Poor: a Rights-Based Approach” Program (PPA Health Rights Program) - CARE Perú Ariel Frisancho National Coordinator Health Rights Program APHA 134th Annual Meeting & Exposition Boston, November 4th – 8th, 2006

  2. Health Rights Program • The purpose of the CARE UK – CARE Perú Health Rights Program is to strengthen Peruvian state / society relations in the health sector, promoting poor people’s right to health. • Program interventions develop three principles: inclusion, participation and fulfilling obligation.

  3. Outputs: a) Civil society organisations develop and strengthen strategies for making health sector policies and institutions respond to, protect and promote health rights of the poor and excluded people; b) People and health providers have developed participatory and inclusive mechanisms for planning, provision and evaluation of health services; c) Multilateral organisations, international co-operation agencies, civil society and public opinion know and internalise the lessons and knowledge constructed along the Program.

  4. To strengthen Peruvian state / society relations in the health sector, in a way this “improved relations” contribute to poor people’s health rights realization • Purpose • Action Lines Strengthening civil society for health rights realization (Foro Salud, Health Rights Observatory, APDS, EDHUCASalud, etc + other Health Programs & Projects) – Contributes with civil society organizatiuons to develop strategies to make more inclusive health policies Promoting Social & citizen participation at existing invited spaces and strengthening capacities for local health decentralization process (CLAS, Local Government, Regional Governm,ent, Health Regional Councils) Strengthening capacities for State Responsiveness (MoH, Regional Government, Health Regional Authorities, Ombudsman Office) Advocacy and Strategic Alliancesthat contribute with Health Rights Realization

  5. Key Actors International • UUNN, Universities, HR Centers • USAID, DFID • Multi-laterals (BM, BID) • Other Bi-laterals • CARE UK / CARE USA Shared Spaces Public Institutions & Duty- bearers • Regional Government • Ministry of Health • RegionalHealth Authorities • Local Government • Health providers • Ombudsman Office Civil Society (Rights Holders) • Foro Salud • Regional Health Fora • Health Rights Observatory (FF) • APDS • Policy Project / PDI (USAID) • PHR Plus / PRAES (USAID) • Universities • Grass root Organizations National Health Council Regional Health Council Health Conferences (national /regional) Policy Dialogues ACLAS Other key spaces

  6. C.1. Strengthening civil society for health rights realization Participatory building of a Health Rights Agenda for theHealth Rights Realization (National and 17th. Regions)

  7. C.1. Strengthening civil society for health rights realization II National Health Conference, august 2004

  8. C.1. Strengthening civil society for health rights realization III National Health Conference, july 2006

  9. C.1. Strengthening civil society for health rights realization Participatory building of the concept of health as right and responsibility

  10. C.1. Strengthening civil society for health rights realization Health Policies debate between the main political parties challenging the national election (with ForoSalud, Colegio Médico, Cayetano Heredia School of Public Health and UNFPA)

  11. C.1. Strengthening civil society for health rights realization • Social Communication capacities amongst media (Ayac/Hvca)

  12. C.2. Promoting Social & citizen participation at existing invited spaces and strengthening capacities for local health decentralization process Technical Assistance to ACLAS for improved participatory management of health facilities

  13. C.2. Promoting Social & citizen participation at existing invited spaces and strengthening capacities for local health decentralization process Regional Committee for Health Functions Transference to Local Governments (Huancavelica, March 7, 2006)

  14. C.3. Strengthening capacities for State Responsiveness • Technical assistance to MoH for the construction of an institutional approach to Health Rights

  15. C.3. Strengthening capacities for State Responsiveness Institutional Strategies to promote Health Rights nation-wide: National Initiative on Health Rights and Responsibilities (Macroregional Workshops on the Right to Health, 2004-05)

  16. C.3. Strengthening capacities for State Responsiveness Technical Assistance to MoH and Huancavelica Regional Health Authority & Officers for implementation of prioritised pilot experiences(Yauli, December 2005)

  17. C.3. Strengthening capacities for State Responsiveness • Strengthening Management of Maternal & Birth Delivery Emergency drawing on CARE outputs & learning from FEMME Project

  18. C.4. Advocacy and Strategic Alliances to contribute with Health Rights Realization National Political Parties Health Agreement (March 2006)

  19. C.4. Advocacy and Strategic Alliances to contribute with Health Rights Realization • Partnership with Health Rights Observatory (Ford Foundation) for key research on the “forgotten agenda” of the RECURSO WB – DFID study to improve poor people access to health care • International Health Rights Diploma (UPCH, Ombudsman Office, IDS/ Sussex) – New version currently in design

  20. Achievements towards the Outputs: Output 1 • ForoSalud, the main health civil society network, has been strengthened in its programmatic competencies, and has decentralised its organisation throughout 17 regional forums, becoming “a network of networks”.The Program has supported the bottom-up, participatory process of construction of the National and regional health agenda from the civil society (Agenda for Dialogue with the State) • The Right to Health and its principles are present at ForoSalud national and regional proposals.The recent health policy guidelines of the III Health National Conference, defined after a series of national and regional workshops, are in direct relation with the Program principles: how to achieve universal access to good quality health services, health determinants and health promotion (consensus to identify exclusion and inequalities as the main health determinant) and social participation in health policy design and implementation.

  21. Achievements towards the Program´s Output 1 • Most regional government authorities are increasingly recognising regional ForoSalud as referents / counterparts for the construction / analysis of policy proposals. Some of the proposals constructed in a participatory process at the regional level have been included in the Regional Health Plan. • The programmatic proposal for a Health Sector Reform towards the realization of health rights, including the first analysis of the importance of health determinants, has been received with increased interest by political party representatives and diverse regional actors. • Program has contributed with the participatory construction of the concept of rights and respon-sibilities amongst poor rural communities of Huan-cavelica (Peruvian Andes). That participatory process has incorporated vulnerable groups of the communities (“the excluded from the excluded”)

  22. Achievements towards the Program´s Output 2 • Health rights and RBA are increasingly present on the MoH public speech and statements, and are in process of being formally institutionalised. It is a fact that this is a development which was not previously present in the MoH. Although other organisations are recently working on health rights, the Project might claim credit for this MoH increasing and sustained focus on health rights (beyond the traditional ground of sexual and contraceptive rights). • As a matter of fact, Rights-based principles (inclusion, participation and fulfilment of obligations) propelled by the Program’s approach are those of the MoH proposals and published documents.CARE´s contribution has been explicitly mentioned in a recent MoH publication on the initiative of the National Health Letter (december 2005).

  23. Achievements towards the Program´s Output 2 • MoH has increasingly given attention to citizen participation,though improvement could be achieved in terms of the composition and mechanisms of participation at “invited spaces” There are steps made at the regions. • Achievements towards the Program´s Output 3 • The Program, in alliance with academic and research centres, has propelled capacity building strategies and evidence raisingon key issues related to the realization of the right to health • Recognition of social participation as one of the five key areas for Health commitments of 16 national Political Parties, and the election of ForoSalud as public recipient of those commitments

  24. ¡Muchas Gracias! Ariel Frisancho Arroyo National Co-ordinator Health Rights Program CARE Perú afrisancho@care.org.pe

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