Human Rights in Health Practice

Rights of the child, women and other vulnerable individuals; and key international instruments

Dr. Rilwanu Bello Tambuwal

Senior Registrar,
Department of Community Medicine,
UDUTH Sokoto
Learning objectives

• Define human rights and explain their relevance to clinical care and public
health programmes.
• Describe rights of the child, women, and other vulnerable groups in health
settings.
• Summarize key international instruments: UDHR, ICERD, CEDAW, CAT (plus
CRC and workplace/GBV standards).
• Apply rights-based principles to service delivery: non-discrimination, dignity,
consent, privacy, accountability.
Introduction

• Human rights are fundamental entitlements that every individual is born with,
regardless of nationality, ethnicity, or status
• In public health, understanding human rights is crucial for promoting health
equity, dignity, and justice
• This lecture will cover key human rights frameworks, focusing on vulnerable
populations like children, women, and those at risk of discrimination or abuse
Core concepts

Key characteristics State duties

• Respect: do not interfere with rights (e.g., no

• Universal: apply to everyone, everywhere.
coercion).
• Inalienable: not granted by the state; cannot be
• Protect: prevent third-party violations (e.g., GBV
arbitrarily removed.
safeguards).
• Indivisible and interdependent: rights reinforce
• Fulfil: take steps to realize rights (e.g., access to
each other.
essential care).
• Non-discrimination: equal protection and benefit
• Accountability: remedies, complaints, and
of the law.
oversight.
Human rights in health care and public health

AAAQ (service delivery lens) PANEL (program lens)

• Availability: sufficient facilities, goods, and staff. • Participation: engage clients/communities.

• Accessibility: non-discriminatory, affordable, • Accountability: document, audit, and remedy.
physically reachable. • Non-discrimination: equity in access and
• Acceptability: culturally appropriate; respectful; outcomes.
gender-sensitive. • Empowerment: information, consent, health
• Quality: evidence-based care, safe medicines, literacy.
competent staff. • Legality: align practice with law and standards.
Rights of Vulnerable Individuals

• Rights of the Child:

• Protection from exploitation, violence, and neglect
• Right to education, health, and participation in decisions affecting them

• Rights of Women:
• Equality, non-discrimination, and freedom from violence.
• Reproductive rights and equal opportunities.
• CEDAW (Convention on the Elimination of All Forms of Discrimination Against
Women)
• Other Vulnerable Groups: Persons with disabilities, minorities, refugees
• Protection from discrimination and access to healthcare, education, and justice.
Rights of the child (CRC-aligned)

• Best interests of the child: primary consideration in decisions.

• Right to survival and development: nutrition, immunization, WASH, safe housing.
• Right to health services: accessible, acceptable, and quality child health care.
• Protection from abuse/neglect/exploitation and harmful practices.
• Right to be heard: age-appropriate assent; adolescent participation.
• Privacy and confidentiality: especially for adolescents, within legal safeguards.
Rights of women (CEDAW-aligned)

Frequent rights issues in care Service responses (minimum set)

• Survivor-centered GBV care: privacy, safety,

• Equal access to health services without
clinical management, referrals.
discrimination.
• Remove unsupported third-party authorization
• Autonomy, informed consent, and confidentiality.
barriers.
• Respectful maternity care; emergency obstetric
• Integrate STI/HIV services with respectful
care.
counseling.
• Access to sexual and reproductive health
• Strengthen complaint mechanisms and non-
information and services.
retaliation policies.
• Freedom from gender-based violence (GBV) and
• Staff training on respectful, non-judgmental
harmful practices.
care.
Other vulnerable individuals: key protections

• Persons with disabilities: reasonable accommodation (communication and physical

access).
• Older persons: protection from neglect, financial exploitation, and discrimination.
• Migrants/IDPs/refugees: equitable access, culturally and linguistically appropriate
services.
• People living with HIV/TB/mental health conditions: confidentiality and stigma
reduction.
• Detainees/prisoners: clinical independence, dignity, and protection from ill-
treatment.
• Minority groups: equal access and quality; monitor gaps in outcomes.
Universal Declaration of Human Rights (UDHR, 1948)

• Foundational global statement of rights adopted by the UN General Assembly.

• Health-relevant rights: equality and non-discrimination; life and security; privacy;
freedom from degrading treatment.
• Right to an adequate standard of living, including medical care and necessary social
services.
• Public health implication: duties to address determinants of health (water, food,
housing, education).
ICERD (1965): eliminating racial discrimination

• Legally binding treaty requiring states to eliminate racial discrimination in all forms.
• Requires equality in enjoyment of rights, including access to public health and
medical care.
• Operational focus: identify and correct barriers affecting minority groups (geography,
language, stigma).
• Facility actions: nondiscriminatory triage, respectful communication, complaint
handling, audit inequities.
CEDAW (1979): eliminating discrimination against women

Core commitments Health relevance

• Equal access to health care services, including

• Eliminate discrimination in law and practice. family planning.
• Address discriminatory customs and stereotypes. • Remove barriers that limit women’s autonomy
• Ensure equality in education, employment, and and access.
public life. • Strengthen maternal health and respectful care
• Ensure equality in marriage and family relations. standards.
• Address GBV as a form of discrimination.
Racial discrimination, sexual harassment, and GBV: relevant standards

• In international practice, sexual harassment is treated as a form of discrimination/GBV

• CEDAW Committee General Recommendation No. 35 (2017): authoritative guidance on
gender-based violence against women as discrimination

• UN Declaration on the Elimination of Violence against Women (1993): defines violence

against women and calls for state action, including in workplaces and institutions

• ILO Violence and Harassment Convention, 2019 (No. 190): first binding international treaty
recognizing the right to a world of work free from violence and harassment

• Health sector action: clear reporting pathways, survivor-centered support, non-retaliation,

training, enforcement.
CAT (1984): prohibition of torture and ill-treatment

• Absolute prohibition: no exceptional circumstances justify torture

• States must prevent, investigate, and provide remedies for torture and cruel,
inhuman or degrading treatment (CIDT).
• Health relevance: clinical independence; refusal to participate in ill-treatment;
documentation consistent with ethical standards.
• High-risk settings: detention facilities, coercive restraints, humiliating or neglectful
care, forced procedures without legal basis.
Operationalizing human rights in facilities and programmes

Clinical practice Health system / public health

• Respect dignity: privacy, confidentiality, respectful • Patient charters and complaint mechanisms;
communication. audit and feedback.
• Informed consent and shared decision-making • Equity monitoring: access and outcomes by
(plus assent for minors). group/area.
• Non-discriminatory triage and treatment; • Workplace policies: anti-harassment, non-
reasonable accommodation. retaliation, reporting.
• Survivor-centered GBV care with strong referral • Community engagement and risk
pathways. communication (participation).
Case vignettes (discussion)

• Child with recurrent injuries and inconsistent caregiver history: safeguarding steps,
documentation, and referral.
• Woman declines spouse involvement in care: autonomy, confidentiality, and
supported decision-making.
• Client from minority group reports denial of services: non-discrimination response,
reporting, and corrective action.
• Detainee brought for care in restraints: dignity, clinical independence, and minimum
necessary security.
Key takeaways

• Human rights are a practical framework for quality, safety, and equity in health
services.
• Children: best interests, protection, development, participation, and confidentiality
safeguards.
• Women: equality, autonomy, respectful maternity care, and strong responses to GBV
and harassment.
• Vulnerable groups: reasonable accommodation, stigma reduction, and equitable
access.
• International standards (UDHR, ICERD, CEDAW, CAT; plus CRC and ILO
C190/DEVAW/GR35) guide policy and practice.
•THANK YOU FOR LISTENING
Further reading on

• OHCHR: Universal Declaration of Human Rights (UDHR) – official text

• OHCHR: International Convention on the Elimination of All Forms of Racial Discrimination (ICERD)
• OHCHR: Convention on the Elimination of All Forms of Discrimination against Women (CEDAW)
• OHCHR: Convention against Torture (CAT)
• OHCHR: Convention on the Rights of the Child (CRC)
• UN GA: Declaration on the Elimination of Violence against Women (1993)
• ILO: Violence and Harassment Convention, 2019 (No. 190); Recommendation 206
• CEDAW Committee: General Recommendation No. 35 (2017) on gender-based violence against
women