USC Institute on Inequalities in Global Health, University of Southern California, Los Angeles, CA, USA.
World Health Organization, Geneva, Switzerland.
Glob Public Health. 2021 Oct;16(10):1559-1575. doi: 10.1080/17441692.2020.1828986. Epub 2020 Oct 6.
The need to prioritise those furthest behind is well understood in global health circles, and how human rights norms and standards can help often touted. As rights concerns are particularly recognised in sexual and reproductive health (SRH) programming, as part of a larger exercise, a review was conducted to identify documented barriers and facilitators to implementation. Given the role global guidance plays in implementing rights-based approaches to SRH, UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP) guidelines, tools, recommendations and guidance that include the explicit mention of human rights principles served as the basis for this exercise. This was followed by an extensive review of the literature. Sources reviewed confirmed barriers include not only broad structural, policy and health systems barriers but financial, staffing and time constraints, as well as lack of understanding of concretely how to include human rights in these efforts. Facilitators include the existence of human rights champions, leadership, strong civil society participation, training, and funding made available specifically for implementation. Investment in indicators and documentation sensitive to human rights is warranted in sexual and reproductive health, as well as other health topics, to best serve populations who need them most.
在全球卫生界,优先考虑处于最不利地位的人群的需求是众所周知的,并且经常有人吹捧人权规范和标准如何能够提供帮助。由于性健康和生殖健康(SRH)方案编制中特别认识到权利问题,因此作为一项更大的工作的一部分,进行了一次审查,以确定实施方面的有文件记载的障碍和促进因素。鉴于全球指导在实施基于权利的 SRH 方法方面发挥的作用,开发署/人口基金/儿基会/世卫组织/世界银行人类生殖研究、发展和培训特别方案(HRP)的准则、工具、建议和指导,包括明确提及人权原则,这些都是本次审查的依据。随后对文献进行了广泛审查。经审查的资料来源证实,障碍不仅包括广泛的结构、政策和卫生系统障碍,还包括财政、人员配备和时间限制,以及缺乏具体了解如何在这些工作中纳入人权。促进因素包括存在人权拥护者、领导层、强大的民间社会参与、培训和专门用于实施的供资。有必要在性健康和生殖健康以及其他健康专题方面投资于对人权敏感的指标和文件,以便最有效地为最需要的人群服务。