Between Insurrectional Discourse and Operational Guidance: Challenges and Dilemmas in Implementing Human Rights-Based Approaches to Health
Between Insurrectional Discourse and Operational Guidance: Challenges and Dilemmas in Implementing Human Rights-Based Approaches to Health
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叛乱言论与操作指导之间：实施基于人权的卫生方法的挑战和困境
DOI：
10.1093/jhuman/huu019
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发表时间：
2014
影响因子：
1
通讯作者：
R. Cantor
中科院分区：
文献类型：
--
作者：
A. Yamin;R. Cantor
未来的“可持续发展”框架是否能促进地球仪各地贫困者的权利，将不仅仅取决于全球文件中的措辞。这将在很大程度上取决于基于人权的方法在实践中如何得到有意义的实施。我们在这里认为，困境产生于两个主要矛盾固有的HRBAs：HRBAs的健康需要颠覆权力关系，导致系统的模式不健康的某些人群中，但也需要与那些谁拥有权力的政府，捐助机构和机构的工作和买入。第二，人权是作为普遍的道义原则提出的;然而，在通过人权行为准则实施这些原则时，权衡取舍和深刻的政治现实必然会进入平衡。在性健康和生殖健康方面，我们探讨了这些矛盾如何导致在以下方面出现的挑战和困境：（1）从概念上界定基于人权的行动;（2）解决法律的和政策框架中的差距;（3）有意义地参与确定健康，特别是性健康和生殖健康方面的优先事项;（4）制定监测和问责的改革办法;（5）制定一个关于性别平等的战略框架;（6）制定一个关于性别平等的战略框架;（7）制定一个关于性别平等的战略框架;（8）制定一个关于性别平等的战略框架;（9）制定一个关于性别平等的战略框架;（10）制定一个关于性别平等的战略框架;（11）制定一个关于性别平等的战略框架;（12）制定一个关于性别平等的战略框架;（13）制定一个关于性别平等的战略框架;（14）制定一个关于性别平等的战略框架;（15）制定一个关于性别平等的战略框架;（16）制定一最后，（5）在国家之外设立人权行为者机构所面临的困境，包括捐助者以及与追究捐助者和其他非国家行为者的责任有关的困境。我们始终认为，如果要实现其变革潜力，人权行为准则就不能沦为技术公式，而必须确保在其概念化、战略、执行和衡量过程中，它们能促进其声称要受益的人民有意义的发言权和问责制。
Whether the future ‘sustainable development’ framework advances the rights of the immiserated around the globe will depend not just on the language in the global documents. It will crucially depend upon how meaningfully human rights-based approaches (HRBAs) are implemented in practice. We argue here that dilemmas arise from two principal contradictions inherent in HRBAs: HRBAs to health require subversion of power relations which lead systematically to patterns of ill-health among certain populations, yet also require working with and buy-in from those who have power—in governments, donor institutions and agencies. Second, human rights are set out as universal, deontological principles; yet in operationalizing them through HRBAs, trade-offs and deeply contextualized political realities necessarily enter the equation. In the context of sexual and reproductive health (SRH), we explore how these contradictions lead to challenges and dilemmas that arise in relation to: (1) conceptually defining HRBAs; (2) addressing gaps in legal and policy frameworks; (3) meaningfully engaging in priority-setting in health, and sexual and reproductive health in particular; (4) devising transformative approaches to monitoring and accountability; and, finally, (5) dilemmas faced in situating HRBAs beyond the state, both by donors and in relation to holding donors and other non-state actors accountable. We argue throughout that if they are to live up to their transformative potential, HRBAs must not be reduced to technical formulas, but rather must ensure that in their conceptualization, strategy, implementation and measurement they foster meaningful voice and accountability for the people they purport to benefit.