Note on Right to Health activities by Jan Swasthya Abhiyan (PHM-India) during recent period
Since its formation following the ‘National Health Assembly’ in 2000, within Jan Swasthya Abhiyan (PHM-India) there has been a strong perspective to oppose the weakening of public health systems, to make health systems accountable and effective, to counter commercialization of health care, and to ensure access to health care for all within a broader ‘Right to health’ framework. Although not always adopting an explicit ‘Right to health’ terminology, a wide range of activities have been carried out by JSA in various states towards demanding the right to health care, as well as ensuring the right to various determinants of health. In this note, certain major activities carried out by JSA in a broadly ‘Right to health / health care’ framework are briefly mentioned to give some background. Then reports of certain recent activities carried out by JSA, mainly by state units towards promotion of health rights are presented as an exemplification of ‘Right to health’ activities by JSA in recent period.
JSA had an organized a national ‘Right to health care campaign’ in 2003-04 which included organisation of a national public consultation, documentation of cases of denial of health care, surveys of rural public health facilities, local ‘Jan Sunwais’ (public hearings) in some states, regional public hearings in all regions of the country followed by a national public hearing on Health rights, the last two in collaboration with the National Human Rights Commission.
It may be noted that JSA state units also have played an active role in the nationwide ‘Right to food campaign’ since its inception in 2002, considering food security and nutrition to be key determinants of Health.
Following the first phase of the Right to health care campaign in 2003-04, due to a combination of factors including a change of government at the national level, the situation regarding the public health system in India has been somewhat modified.
A ‘National Rural Health Mission’ (NRHM) was launched by the Union government in 2005, which has proposed increased public health financing as well as strengthening of rural public health facilities. In this situation, JSA’s health rights activities entered a new phase, attempting to shape NRHM in a pro-people manner while trying to assess to what extent the proposed improvements were actually being implemented in form of conducting a ‘People’s Rural Health Watch’ in seven states during 2006-08.
Further, there has been advocacy by JSA associated activists to give institutional and regular form to health rights activities and from 2007 onwards, JSA member organisations in some states have been involved in developing ‘Community based monitoring of health services’. This activity which is built into NRHM and is supported by the public health system, involves participatory monitoring of health rights by community members and civil society organisations, including regular preparation of community ‘report cards’, discussing the required improvements in multi-stakeholder monitoring committees, and periodic conduction of public hearings on health rights.
Although it is strictly speaking not an activity of JSA groups alone, JSA groups and individuals have played and continue to play a central role in this activity in various states.
Along with this, some specific health rights initiatives are currently being organised in certain states, such as campaigning for primary health services, opposition to privatization of rural public health services or public health facilities, and demanding patient’s rights in the private medical sector.
Examples of certain recent activities by JSA state units and member organisations in a ‘Right to health’ framework are as follows:
- Ongoing ‘Right to Primary Health care’ campaign by PHM-Karnataka.
- Right to essential medicines and free treatment campaign initiated by Prayas and PHM-Rajasthan.
- Campaigning for establishing people’s rights in the private medical sector, particularly patients rights by PHM-Maharashtra.
- Organised monitoring and demanding of people’s health rights from the rural public health system in form of ‘Community based monitoring of health services’ (CBM) – where JSA associated organisations are presently playing a central role in the states of Maharashtra and Rajastan.
- PHM organisations in Tamil Nadu are also centrally involved in organizing community based monitoring, along with carrying out various other activities around the Right to Health.
- CBM activities were initiated in some other states like Madya Pradesh., Orissa also, but have been presently discontinued due to negative attitude of State health authorities.
This gives some idea about the range of activities concerning ‘Right to Health’ being carried out in the recent period by PHM-India units and organisations in some states.