Thomas Rebekah, Kuruvilla Shyama, Hinton Rachel, Jensen Steven L B, Magar Veronica, Bustreo Flavia
Technical Officer on Gender, Equity and Human Rights at the World Health Organization.
Senior Strategic Adviser for Family, Women's and Children's Health at the World Health Organization.
Health Hum Rights. 2015 Dec 10;17(2):11-20.
Global momentum around women's, children's, and adolescents' health, coupled with the ambitious and equalizing agenda of the Sustainable Development Goals (SDGs), has exposed a tension between the need for comprehensive, multi-actor, rights-based approaches that seek to "close the gaps" and a growing economic and political imperative to demonstrate efficiency, effectiveness, and returns on specific investments. To address this challenge, this paper proposes a framework to measure "results" in a way that offers a more nuanced understanding of the impact of human rights-based approaches and their complexity, as well as their contextual, multi-sectoral, and evolving nature. We argue that the impact of human rights-based approaches is best measured across a spectrum of change-at the individual, programmatic, structural, and societal levels. Such an analysis would allow for more accurate assessments of the cumulative effect of these changes. The paper also underscores the long-overdue need to better define the parameters of a human rights-based approach to health. This is an important part of the research agenda on human rights and health in the context of the SDGs and the Global Strategy for Women's, Children's and Adolescents' Health, and amid calls for better measurement and greater accountability for resources, results, and rights at all levels. While this paper focuses on women's, children's, and adolescents' health, the proposed framework can apply as readily to other areas of health and provides a new frame of reference for assessing the impact of human rights-based approaches.
全球围绕妇女、儿童和青少年健康的势头，再加上可持续发展目标（SDGs）雄心勃勃且追求平等的议程，暴露出一种紧张关系：一方面需要采取全面、多方参与、基于权利的方法来“缩小差距”，另一方面，在经济和政治上越来越迫切需要证明特定投资的效率、有效性和回报。为应对这一挑战，本文提出了一个衡量“成果”的框架，该框架能让人更细致入微地理解基于人权的方法的影响及其复杂性，以及其背景、多部门和不断演变的性质。我们认为，基于人权的方法的影响最好在一系列变化层面来衡量，包括个人、项目、结构和社会层面。这样的分析将有助于更准确地评估这些变化的累积效应。本文还强调了早就应该更好地界定基于人权的健康方法参数的必要性。这是在可持续发展目标以及《妇女、儿童和青少年健康全球战略》背景下，人权与健康研究议程的重要组成部分，也是在呼吁在各级对资源、成果和权利进行更好的衡量并加强问责制的背景下的重要组成部分。虽然本文侧重于妇女、儿童和青少年的健康，但所提出的框架同样适用于其他健康领域，并为评估基于人权的方法的影响提供了一个新的参考框架。
