Department of Public Administration and Institute for Legal, Legislative, and Policy Studies, University of Illinois at Springfield, Springfield, IL, 62703, USA.
BMC Int Health Hum Rights. 2019 Aug 2;19(1):24. doi: 10.1186/s12914-019-0211-9.
Scholars have long been sceptical about the effectiveness of human rights treaties in changing the behaviour of states parties and prior empirical research has often justified that scepticism. However, only a few prior studies have considered the effects of adoption of core human rights treaties on health outcomes and only one prior study has analysed the effects of adoption of the Convention on the Rights of the Child (CRC) on children's health outcomes.
In this study, we estimated the effects of CRC adoption on child mortality rates and vaccination rates in less developed countries. In particular, we compared 43 less developed countries that adopted the CRC in 1990 with synthetic control groups drawn from 21 less developed countries that adopted it after 1992.
We find that CRC adoption may be related to additional reductions in infant and under-5 mortality rates of about 1 to 2 deaths per 1000 live births, on average, during the first three years after adoption, although those relationships are not statistically significant. And we find that CRC adoption is related to additional increases in vaccination rates for the five vaccines that we considered of about 4 to 5%, on average, during the first three years after adoption and that those relationships remain significant for up to seven years after adoption.
From a policy perspective, our results further support the effectiveness of CRC adoption in promoting children's right to health in less developed countries. And from a research perspective, our results show the advantages of using synthetic control methods in these types of studies, because our analyses using other methods that have most commonly been used in these studies did not find any consistent, significant relationships between CRC adoption and mortality or vaccination rates.
学者们长期以来一直对人权条约在改变缔约国行为方面的有效性持怀疑态度，先前的实证研究往往证明了这种怀疑是有道理的。然而，先前只有少数研究考虑了通过核心人权条约对健康结果的影响，只有一项先前的研究分析了通过《儿童权利公约》（CRC）对儿童健康结果的影响。
在这项研究中，我们估计了 CRC 通过对较不发达国家儿童死亡率和疫苗接种率的影响。特别是，我们比较了 1990 年通过 CRC 的 43 个较不发达国家与 21 个 1992 年后通过 CRC 的较不发达国家的合成对照组。
我们发现，CRC 通过可能与婴儿和 5 岁以下儿童死亡率额外降低有关，平均而言，在通过后的头三年每 1000 例活产中约有 1 至 2 例死亡，尽管这些关系没有统计学意义。我们还发现，CRC 通过与我们所考虑的五种疫苗的接种率额外增加有关，平均而言，在通过后的头三年中增加了约 4%至 5%，并且这些关系在通过后长达七年的时间内仍然显著。
从政策角度来看，我们的结果进一步支持 CRC 通过在促进较不发达国家儿童健康权方面的有效性。从研究角度来看，我们的结果显示了在这些类型的研究中使用合成控制方法的优势，因为我们使用这些研究中最常用的其他方法进行的分析没有发现 CRC 通过与死亡率或疫苗接种率之间存在任何一致的、显著的关系。
