Leaving no one behind: Equity, gender and human rights policy to practice
26 MAY 2017 – The global principle behind the 2030 Sustainable Development Agenda, “leave no one behind,” is often thought of as a lofty and ambiguous goal. A side event held during the 70th World Health Assembly sought to showcase specific actions that countries are taking to operationalize this principle. The event, hosted by the Kingdom of Norway, with co-sponsorship from the Republic of Chile, the Republic of Indonesia, Mongolia, the Republic of Mozambique, the Federal Democratic Republic of Nepal, the Kingdom of Spain and Canada, brought together representatives from Member States and civil society to present ways to strengthen equity, gender and human rights in health policies, strategies, programmes and information systems.
Hans Brattskar, Ambassador and Permanent Representative of Norway to the United Nations in Geneva, chaired the event, pointing out its utility in bringing together countries to share their experiences in identifying who is being left out and why, and what can be done to address this.
Dr Carmen Castillo Taucher, the Minister of Health of Chile, said that social determinants of health (SDH) determine the majority of health inequities. Aiming to address this, the Ministry of Health undertook processes to review how health programmes can better address inequities by training health professionals to implement a focus on SDH and health equity in their work. This innovative strategy was recognized by WHO in mid-2014 and became a precursor to the Innov8 approach, an 8-step review process to enable national health programs to better address equity, gender, human rights and social determinants of health. Another review process was undertaken this year to strengthen equity and SDH, as well as a redesign process at the local level with the goal of implementing health services with a focus on equity and human rights in areas related to water and sanitation.
The presentation of Dr Ayush Tsogtsetseg, the Minister of Health of Mongolia, was delivered by Mr Dojgochoo Tumurtogoo, Director of the Department of Policy Planning of the Ministry of Health of Mongolia. He discussed the country’s collaboration with WHO and partners in the context of subnational health system strengthening for leaving no one behind; building capacity in planning, implementation and monitoring and evaluation for subnational health sector plans; and improving coordination within and beyond the health sector at the local level.
Dr Siswanto, Director-General of the National Institute of Health Research and Development of the Ministry of Health of Indonesia, showcased some of the tools developed by the Organization that the country has used, such as the Health Equity Assessment Toolkit (HEAT), to identify those who have been left behind. With this information, the government of Indonesia has been able to develop programme priorities to address health inequities, strengthen health systems and work towards UHC.
Dr Francisco Mbofana, National Director of Public Health of Mozambique, outlined the elements needed to leave no one behind: better data to capture disadvantaged subpopulations; resources distributed based on equity data, and an increased emphasis on protective and preventative services as fundamental to tackling inequities. While he observes that the Millennium Development Goals were successful in many ways, he said “most countries measured progress in averages, leaving out core segments of society. “
In order to improve the overall health of the adolescents in the country, the Ministry of Health of Nepal revisited the country’s Adolescent Sexual and Reproductive Health Strategy using WHO’s Innov8 approach. Dr Naresh Pratap Kc, Director of the Family Health Division of Nepal, said that “to further improve adolescent health, we need to further our understanding of the gaps in coverage and identify the adolescent populations being left behind because of things like distance and cost of travel, lack of privacy and confidentiality, adverse gender norms and other factors.” The review came up with diverse recommendations in terms of programme design, financing, legislation and monitoring and evaluation, and the National Adolescent Health and Development Strategy was updated in line with these.
The right to health is not achieved by the health sector alone – other sectors have significant roles to play. Dr Soon-Young Yoon, Chair of the Board at the Women’s Environment and Development Organization and UN representative for the International Alliance of Women and First Vice-President of the Conference of NGOs (CoNGO), represented the voice of civil society on the panel. Her particular focus is on gender equality, which she hopes to integrate into all of the Sustainable Development Goals (SDGs).
Concluding the session, Dr Veronica Magar, Team Leader of the Gender, Equity and Human Rights Team at WHO HQ, shared an overview of resources to support national health authorities with a “leave no one behind” focus, such as Innov8, HEAT and the upcoming HEAT Plus, the latter of which will allow users to upload their own dataset across a range of health topics. In addition, she described guidance for integrating equity, gender and rights into national and subnational health plans and methods for assessing barriers to health services experienced by disadvantaged subpopulations. “The next biennium will be a critical time for leaving no one behind, both in the pathway towards fulfillment of the SDGs, and in order to firmly place equity, gender and rights at the heart of the next General Programme of Work of WHO,” she said.