1. The ‘chronic emergency’ situation in the health, nutrition, education and other service sectors in an important number of the developing countries only sporadically. becomes a ‘loud emergency’. However, if things stay their present course or worsen, such loud emergencies will increasingly become inevitable.
2. At the base of this is the fact that we are witnessing a failure of governments to sustain the provision of basic services, to pay the full cost of such public services and to respect, protect and fulfill people’s human rights. Moreover, traditional sectoral approaches to development – aid-backed or not – are not delivering expected results (or are not delivering them fast enough to reach the Millennium Goals).
The need and the challenges:
3. There is thus an urgent need to accelerate the implementation of a human rights-based development strategy centered around this emerging development paradigm that incorporates the poor beneficiaries as protagonist actors. This paradigm also merges ethics and science, ideology and politics and theory and practice (i.e., what ought to be done and what can be done) into one consolidated development compact – one that effectively responds to the dire necessity here briefly sketched and one that is taken up as an active engagement or covenant with the people whose rights are being violated day-in, day-out.
4.A much wider participative and empowering Assessment-Analysis and Action (AAA) process (2) – as an operational framework for the human rights-based approach – has to be set in motion (or strengthened if elements of it are already in place). To bring about change, people have to come from their very own experience (getting at their own realities). AAA processes are thus tools of social mobilization and of mobilization and progressive control of the resources needed. Such proactive AAA processes should be ultimately pursued in all areas and sectors of development. Social mobilization only succeeds if the repetitive/iterative character of the AAA operational framework begins to work. Positive AAA processes will then lead to the needed social mobilization at the community level. This mobilization envisions a key role for mobilizers/animators with three types of skills, namely:
-Moral Advocacy skills,
-Social Activism skills, and
-Political Advocacy skills.
These animators are the indispensable promoters of the needed mobilization process; they become the catalizers in the interaction between outsiders and the community -bridging the “them and us” schism between development organizations and the community. All active concomitant development AAA processes have to be identified and assessed at national and sub-national level so as to select our strategic allies and mark and neutralize our strategic opponents in implementing this new human rights-based approach.
5. This rights-based approach will give equal importance to process and outcome achievements, carefully targeting the most vulnerable in society – those whose rights are most flagrantly being violated – so as to make the endeavor truly equitable.
6. Quite a bit can be learned from successful coping mechanisms already used by households. Poor people are already doing; we need to asses what they are doing and build from there. [Note that reinforcing coping mechanisms risks locking the poor into a ‘low level of changes’ trap; it may keep them away from pursuing a more radical reappraisal of their needs, one more related to the structural determinants of their present condition]. Be it as it may, these spontaneous (or project-related) success factors need to be documented and better understood to consider them for eventual replication. (Keep in mind that going for small gains first is OK provided the ultimate vision remains to fully reverse gross violations of human rights).
The strategy:
7. The new human rights-based strategy will focus-on/center-around the household and its members, i.e. around legitimate household members’ rights and their respective entitlements/claims. This means first providing for the household members’ basic entitlements, i.e., reaching a minimum level of family security. It is at the household level that we ultimately need to achieve significant changes, especially in health, nutrition and sanitation behaviors and status.
8. The needed community support mechanisms and structures to help identify and assist vulnerable households will have to be developed and/or strengthened. It is here where mobilizers (activists/advocates) become essential. We will not achieve our human rights goals unless we put in place a veritable “army” of such animators. (3)
9. The household entitlements/rights we are talking about here are in the realm of:
– food and nutrition (macro and micronutrients),
– cooking fuel,
– health (curative and preventive),
– the care of children an the support of women to do so,
– clean water supply and sanitation facilities and services,
– education (pre-primary and primary with a focus on girls and female literacy/numeracy),
– shelter and clothing,
– income (in kind and in cash including employment opportunities),
– women’s own gender-related needs and entitlements,
– access to credit (especially by women) and to selected agricultural inputs subsidies,
– legal protection (especially of women’s and children’s rights),
– physical environmental safety,
– physical personal safety during armed conflicts, and
– women’s personal safety from domestic violence.
10. Key, easily measurable, process and outcome indicators (or proxy indicators) for each of these entitlements will need to be agreed upon and monitored in our work with communities.
11. To make sense of these indicators, the human rights-based strategy will have to have its own Conceptual Framework (2) that will allow us to move up and down the causality chain to inquire about/find out what determines the findings represented by those indicators. Such a conceptual framework is crucial to help us create a consensus on the causes of family insecurity and the violation of its members’ rights. When using the conceptual framework, interpretation of the analyses is inevitably value laden; therefore, the values have to be shared. (It is good to be reminded that, as social actors, we inescapably become technicians with an identifiable – even if hidden – political agenda). [My own preference is for this conceptual framework to be “upside-down” in relationship with the 1990 UNICEF conceptual framework of the causes of preventable ill-health, malnutrition and early deaths: i.e., the basic causes should be on top. If interested in one such tentative conceptual framework being prepared for wider discussion, you can request a copy from claudio@hcmc.netnam.vn].
12.The role of an indispensable (and specially designed) Information/Education/Communication (IEC) component in the human rights-based strategy needs to be emphasized here.
13.A new human rights-based strategy will thus:
– be rights-based (emphasis here on purpose),
– be process and outcome oriented,
– be beneficiary centered/driven,
– be participatory in a de-facto empowering way (4),
– be problem identifying/problem solving (using participatory positive AAA processes as an operational framework),
– be guided by a scientific causal analysis (using an explicit conceptual framework),
– be implemented progressively and in a targeted way, and
– be advocacy/activism-focused (using ethical, scientific, technical and political arguments and avenues to achieve the goals set; the “global embarrassment” trump card is also to be used widely). (5)
14. The human rights-based strategy will combine top-down and bottom-up actions (making it bottom-centered) and will explore and take advantage of all potential synergisms and convergences when applying different cross-sectoral interventions. [Traditional sectoral boundaries should become virtual in a true human rights-based strategy].
15. Decentralization-cum-democratization (and not only de-concentration) with devolution of decision-making power to the periphery through community-driven actions backed by funds being truly made available locally are all crucial to the human rights-based approach.
16. The mobilization of financial resources is to cover both (the higher) initial costs of interventions and their (lower) recurrent maintenance costs – the latter being progressively borne by local communities for a) sustainability purposes, and b) to assure the process is actually more and more controlled by the beneficiaries themselves.
17. In the existing ocean of confusion about the term, ‘community participation’ will be more clearly defined as a truly empowering tool in the context of the human rights-based strategy. (4) Guidelines will need to be written on how to apply its principles.
18. The long-term vision and aims of the human rights-based strategy will have to be defined as well, especially on how priorities will respond to the most pressing felt needs of the people as set locally (and not set in general by the strategy proponents at central level).
19. Additionally, beyond completing a participatory capacity analysis, the human rights based strategy will focus:
– on empowering people (this is crucial),
– on reducing poverty and inequities (especially around gender issues),
– on mobilizing all necessary local and external resources for relevant actions (with the community progressively gaining control over them),
– on using the pressure of facts – acquired through the use of local information systems – to trigger action by fueling relevant positive AAA processes and genuine micro-regional planning. (This encompasses the participatory assessment and measurement of actionable indicators so as to create awareness and a true dialogue among the people),
– on using this community surveillance data to prompt and keep up local mobilization efforts,
– on demanding accountability and transparency, as well as on exposing corruption at all levels,
– on delivering basic services, and on expanding access to and coverage and utilization of them, as well as improving their quality,
– on assuring an adequately functioning peripheral health care system with both viable and fitting curative and preventive, as well as rehabilitative care strategies (arrived at in true partnership between providers and users),
– on making services more responsive to the needs of the population,
– on building capacity and raising people’s political consciousness,
– on developing human resources that are conversant with the principles of the human rights-based approach,
– on strengthening existing institutions to do the above, as well as on organizing meaningful exchange visits,
– on achieving sustainability and assuring replicability, as well as on geographically converging different actions to maximize outcomes,
– on communicating and sharing successes,
– on networking, on building coalitions and on doing active national and international solidarity work,
– on identifying and working with strategic allies/helping forces and on neutralizing strategic opponents/hindering forces,
– on applying operations research techniques to decide on the best long-term course of action to follow,
– on setting up ongoing on-the-job cum support supervision activities that will replace workshop-based, mostly theoretical, training,
– on building, equipping and staffing minimum needed PHC infrastructures and, from there, providing ongoing outreach services,
– on working with ‘deserving’ NGOs that have revisioned their future and have taken up a new mission around the human rights-based approach,
– on giving environmental protection a higher profile, and
– on setting up more equitable cost-sharing approaches.
20. Moreover, the human rights-based strategy will not neglect improving management practices at local level allowing communities to de-facto share the responsibility of co-managing resources and services.
21. The strategy will need one or two explicit, quantified and timed ‘poverty redressal objectives’ monitored at least yearly. (6) Social and political mapping of resources and their control will thus have to be carried out yearly as well. (7)
22. Finally, the human rights-based strategy will have to take an unequivocal proactive stand towards reversing the negative effects:
– of structural adjustment programs,
– of the processes of globalization and privatization being pushed by the WB, the IMF and other agencies,
– of the diverse multilateral and bilateral donor, as well as NGO development projects not in line with the human rights-based approach,
– of social marketing unidirectionally applied to change people’s behavior without letting them decide why such change is needed,
– of existing national development policies that have become obsolete, and
– of existing current government development resources allocation formulae not in line with human rights priorities.
In closing:
23. The additional elements here presented emphasize the sizeable dissemination and lobbying challenge ahead of us in the next decade in our efforts to have governments, development agencies and NGOs – as well as beneficiaries – adopt the new human rights-based strategy.
24. We are talking about creating a movement; not only using the human rights-based approach as a methodology (as a tool box); if we do the latter, we will fail, as many packaged tool boxes have failed before – even if those tools evolved some as they were used.
(1): Capacity Analysis takes what is being proposed to be done for each determinant of a human rights violation 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(s) 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 major proposed solution(s) for each main problem implemented.
(2): Situation analyses have 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, in a participatory way, decide what the best options are to do something about them, i.e., “one finds what one looks for”. The essence of a good situation analysis, then, is to carry out a Causal Analysis based on a preexisting 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. preventable ill-health, malnutrition and excess deaths). That is why communities need to act at all levels of determinants at the same time (and this is also why so many “selective PHC interventions” have failed in the past). AAA processes are happening all te time already (consciously or not) in all decision-making. From the perspective of the outcomes we want to achieve, we can identify positive, negative and neutral AAA processes: it behooves us to start and strengthen positive and neutralize the negative AAA processes in the realm of human rights.
(3): A mobilizer has a complex set of roles. Among them, some of the following can apply: she listens, observes and consults, she validates scientific information, she validates what is permissible/fair/possible/doable/right for the local context, she shares knowledge, she influences perceptions, she puts things/concepts in a local context, she fosters evidence-based decision-making, she catalyzes/facilitates, she mobilizes/inspires people in the community, she advocates/convinces/persuades, she influences actions, she builds people’s capacities, she empowers them, she lobbies, she networks/liaises, she negotiates and goes into strategic and tactical partnerships, she carries out social and political mapping of resources, she mobilizes local and outside resources, she educates, she organizes, leads, manages, she sets an example, acts as a role model and is trustworthy, she assesses/re, analyzes/re, she coordinates/starts new actions, she creates space for such actions, she supervises, monitors and evaluates, she fosters and instills a vision and a hope, she raises political consciousness, she delegates, she makes decisions and solves problems, she is interested in learning from outside.
(4): Any attempted operational definition of empowerment will carry a certain bias depending on the conceptual glasses one is wearing. What is clear is that, in a mostly zero-sum game, the empowerment of some, most of the time, entails the disempowerment of others – usually the current holders of power. Different local contexts may make the same action(s) sometimes empowering, other times not. (Also, empowering people in community development work may sometimes be dangerous; it can well trigger repressive actions by the authorities). Empowerment is not an outcome of a single event. It is a continuous process that enables people to understand, upgrade and use their capacity to better control and gain power over their own lives. It provides people with choices and the ability to choose, as well as to gain more control over resources they need to improve their condition. It expands the ‘political space’ within which Assessment-Analysis-Action processes operate in any community.
(5): Global embarrassment is a term coined a few years ago in the context of lobbying. It refers to publicly blaming national and global leaders about the unacceptable levels of poverty, ill-health and malnutrition found, as well as about the host of human rights being violated in almost every country in the world; the idea is that by publicly blaming them for such an embarrassment one can trigger their response and generate greater political pressure to get the problems resolved.
(6): Poverty redressal objectives are objectives explicitly worded to reflect the specific, quantified reductions in parameters/indicators of poverty sought.
(7): Social and political mapping exercises refer to deliberate periodic assessments carried out to determine who controls the different resources the communities need to foster development actions, i.e., which social groups control them and what are their ultimate political motivations and leanings.
Claudio Schuftan, Ho Chi Minh City
schuftan@gmail.com