Survival Rights for Children, What are the Upstream Barriers?

Abstract

The determinants of health, water, food, shelter, a basic education and healthcare are minimum core human rights, or the rights required for survival and should be available to every child, in all countries, today. In a globalised world, there are limitations on all country’s ability to determine policy and control revenue, even when in the interest of public health. We carried out a review of the literature on the main leakages of revenue from low and middle-income countries and present a conceptual framework to identify policies or practices which may help or hinder children enjoying their survival rights. We suggest the analysis, country by country, to identify key barriers, in terms of policies and revenues (generation, allocation and utilisation). This involves systematically screening policies and practices of the main actors; national governments, high-income country partners, multinational enterprises, and international organisations for their possible influence on human rights realisation. We know that the cause of most of the child deaths in low and middle-income countries is a result of structural injustices, and while it may not be possible to prove causality between economic policies and breaches of rights, it is possible to audit upstream policy decisions through the lens of children’s right to their survival rights. We propose a pragmatic framework to do this. Child health advocates need to highlight the fact that technical interventions in the absence of action on structural injustices cannot address the fundamental causes of poor health. It could even be said that we collude with the fallacy that these injustices can be solved with technical solutions when we fail to speak out. Human rights and child health associations could lead or commission an upstream audit using this framework on behalf of children in their country in order to seek real remedies.