Using health rights to improve programme design: a Papua New Guinea case study

Abstract

The non-state sector is becoming increasingly influential in funding and implementing global health programmes. However, their disease-specific focus and vertical interventions have led to criticism that these programmes can be unsustainable and unable to achieve long-term goals. This paper demonstrates that health rights can inform programme design to guide the design of appropriate and sustainable aid-funded health programmes. It draws on UN General Comment 14, which clarified the right to health duties of states and their international partners, and which determined that 'core obligations' in health must become progressively available, accessible, acceptable and of good quality. A rights-based tool assessed the design of activities proposed for Papua New Guinea by a consortium of Australian non-government organisations. The tool revealed that none of the 36 indicators was addressed in full. Five of the 12 indicators pertaining to availability were addressed partially, as were three of 10 relating to accessibility and one of six concerning human rights concepts. As shown by the case study, failure to address the indicators in this tool will result in simplistic programme designs that can win political or financial support, but will fail to respect health rights or deliver a quality health service, available, accessible and acceptable to all.