several policies has been made to improve the health condition of nepalese but do you find it satisfactory?
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Background: The right to health is a fundamental part of human rights. Ensuring right to health is not straightforward; there are several challenges. Factors such as capacity of right holders and duty-bearers and practices of providing and utilizing services among others determine to ensure health rights for the whole population. Objective:The objective of this paper is to analyze whether the health policies and programs follow a human rights-based approach (HRBA) and assess the situation of rights to health among the poor and vulnerable population. Methods: The study assessed domestic instruments against human rights policies and analyzed the implementation status of the policies and programs. An analytical case study method is used by utilizing qualitative and quantitative data. Results: Around 90% medicines are available in the facilities; however, 22% of health worker posts are vacant. Persistence of unequal distribution of health facilities, high out-of-pocket payment, and cultural and language barriers does not ensure accessibility of health services. Acceptability of health-care services in terms of utilization rate and client satisfaction is improved after introduction of new policy. Nepal has made significant progress in improving maternal mortality ratio, infant/child mortality, immunization rates, and life expectancy at birth. Conclusions: Although a progressive realization of the right to health is being achieved, more efforts are still needed to follow HRBA so as to achieve quality and equity in health-care services.The right to health does not only mean we have a right to be healthy. It requires immediate and targeted steps to be taken to progressively ensure that health services, goods, and facilities are available, accessible, acceptable, and of quality. However, right to nondiscrimination, including on the grounds of social and health status, should be immediately enforced rather than realized progressively. Moreover, all human rights to be realized depend on each other and all rights form a whole and no rights are more important than other rights.[1]
Ensuring right to health is not straightforward; there are several challenges such as fiscal space of the country, capacity of rights-holders (individuals and communities) and the duty-bearers (states),[2] lack of exercises, and appropriate indicators to measure the violation and realization (progressive or stagnant or retrogressive) of rights to health among others. Development and health indicators are often used as proxy indicators to measure the situation of rights to health;[3] however, these indicators do not provide sufficient information while measuring the health rights.[4] For example, increased percent of utilization of health-care services does not ensure the increase in utilization of the services by the vulnerable groups and the consumption of health-care services without violation of rights to health.[2] Health policy-making and programming are to be guided by human rights standards, principles, and national as well as international commitment and aim at developing capacity of duty-bearers to meet their obligations and empowering rights-holders to effectively claim their health rights.[5]
The Constitution of Nepal ensures free basic health services to its citizen by making it a fundamental human right. There are a number of human rights in the Constitution of Nepal that is closely connected to the right to health, such as rights to education, right to equality, right to access to information, and right to participation among others. The Ministry of Health has been implementing policies and programs to provide free essential health-care services to all citizens, whether poor or not, at below district-level health facilities since 2008.
However, out-of-pocket (OOP) expenditure contributes almost 55% of total health expenditure with the cost of medicines alone accounting for 50% of OOP expenditure.[6] O'Donnell et al.[7] points out that Nepal's health-care subsidy is pro-rich because of several constraints, such as problem of identification of poor.
Therefore, the paper has twofold objectives: To provide the status on progressive realization of the right to health and other health-related human rights in Nepal and to assess the situation of rights to health among the poor and vulnerable population particularly analyzing availability, accessibility, acceptability, and quality by utilizing a human rights-based approach (HRBA).
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Ensuring right to health is not straightforward; there are several challenges such as fiscal space of the country, capacity of rights-holders (individuals and communities) and the duty-bearers (states),[2] lack of exercises, and appropriate indicators to measure the violation and realization (progressive or stagnant or retrogressive) of rights to health among others. Development and health indicators are often used as proxy indicators to measure the situation of rights to health;[3] however, these indicators do not provide sufficient information while measuring the health rights.[4] For example, increased percent of utilization of health-care services does not ensure the increase in utilization of the services by the vulnerable groups and the consumption of health-care services without violation of rights to health.[2] Health policy-making and programming are to be guided by human rights standards, principles, and national as well as international commitment and aim at developing capacity of duty-bearers to meet their obligations and empowering rights-holders to effectively claim their health rights.[5]
The Constitution of Nepal ensures free basic health services to its citizen by making it a fundamental human right. There are a number of human rights in the Constitution of Nepal that is closely connected to the right to health, such as rights to education, right to equality, right to access to information, and right to participation among others. The Ministry of Health has been implementing policies and programs to provide free essential health-care services to all citizens, whether poor or not, at below district-level health facilities since 2008.
However, out-of-pocket (OOP) expenditure contributes almost 55% of total health expenditure with the cost of medicines alone accounting for 50% of OOP expenditure.[6] O'Donnell et al.[7] points out that Nepal's health-care subsidy is pro-rich because of several constraints, such as problem of identification of poor.
Therefore, the paper has twofold objectives: To provide the status on progressive realization of the right to health and other health-related human rights in Nepal and to assess the situation of rights to health among the poor and vulnerable population particularly analyzing availability, accessibility, acceptability, and quality by utilizing a human rights-based approach (HRBA).
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