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| Projects |
The Program on International Health and Human Rights (PIHHR) is at the forefront of developing the field of health and human rights research, and is a leader in developing health and human rights tools for analysis, programmatic intervention, monitoring and evaluation. PIHHR works to strengthen the practical implementation of human rights for public health programming in a variety of ways – from the design and application of specific analytic and programmatic tools to conducting trainings in various areas of health and human rights.
The Program is widely recognized as a leader in developing and testing practical approaches – products such as training modules, assessment and evaluation instruments, and analytical guides – that fully integrate human rights into the work of public health, including program design, implementation, and evaluation. Development of such tools is critical to validating the essential links between health and human rights and to improving the delivery of services and health outcomes. The Program conducts research, capacity building, policy development and health programming in a variety of areas focusing on HIV/AIDS, reproductive and sexual health, child and adolescent health, and health systems strengthening.
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| Monitoring and Evaluation and Human Rights |
Evaluating the Impact of Integrating Legal Support and Health Care
OSI
For populations such as people living with HIV and AIDS, people who use drugs, sex workers, survivors of gender-based violence, and people needing palliative care, legal services both promote and protect human rights and improve health outcomes. The Program is collaborating with the Open Society Institute, Public Health Program Law and Health Initiative and the Open Society Initiative for East Africa using human rights concepts and methods to evaluate the impact of three projects in Kenya integrating legal support and health care as a way of advancing the health and human rights of socially marginalized groups. The project aims to evaluate the impact of these projects to both inform OSI’s work and provide important information which can be used in advocacy for the scale-up of such services.
Monitoring and Evaluation of Human Rights in the HIV Response
UNAIDS
Human rights have been the cornerstone of many responses to HIV since the start of the epidemic but their contribution to these responses has been poorly understood to date. PIHHR collaborates with the UNAIDS Evaluation Department (UNAIDS) on the monitoring and evaluation of human rights issues relevant to the global response to HIV with the overall aims of improving national-level reporting in this area and increasing understanding of how human rights contribute to efforts in the field of HIV. As part of this project, revisions were recently carried out to the National Composite Policy Index (NCPI), which guides some national-level monitoring of the 2001 Declaration of Commitment on HIV/AIDS. Part of this work includes analyzing the 2010 country reports on the NCPI and assessing, from a human rights perspective, the quality and implementation of national-level HIV policies and programs.
Female Genital Mutilation/Cutting: Accelerating Change
UNFPA and UNICEF
In 2007, the United Nations Population Fund (UNFPA) and the United Nations Children's Fund (UNICEF) created the Joint Programme on Female Genital Mutilation/Cutting: Accelerating Change. The goal of the Programme is to contribute to the accelerated abandonment of Female Genital Mutilation/Cutting (FGM/C) in 17 countries in Africa by creating a rapid shift in social norms. The Joint Programme aims to achieve greater gender equality, reproductive rights, advocacy and empowerment of women and adolescent girls promoted through an enabling socio-cultural environment that is conducive to male participation and the elimination of harmful practices. In order to ensure the goals of the Programme are met, developing appropriate mechanisms to support the monitoring of achievements at the national level is critical. UNFPA and UNICEF has partnered with the Program on International Health and Human Rights at the Harvard School of Public Health to sharpen the process and outcome indicators as well as monitoring and evaluation tools for the Joint Programme.
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| HIV and AIDS and Human Rights |
Gender-Based Violence and HIV
UNFPA
Gender-based violence (GBV) intersects with HIV in complex ways. Around the world, efforts are occurring to establish evidence for causal linkages between these dual epidemics and to test joint interventions. PIHHR is conducting a literature review of peer-reviewed studies on the intersections between GBV and HIV in order to consolidate the existing evidence base, extract key findings and identify research gaps. The findings will be analyzed from a human rights persepctive to determine implications for future policy and programming, as well as research and advocacy efforts.
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| Child and Adolescent Health and Human Rights |
Child Rights-Based Planning and Programming
World Health Organization, Department of Child and Adolescent Health and Development
The aim of Millennium Development Goal 4 is to reduce child mortality by two thirds by 2015; this will require improved efficiency and effective use of available resources. Working towards these aims, WHO’s Department of Child and Adolescent Health and Development (WHO/CAH) is collaborating with the Program on a series of projects with the overall aim of establishing a systematic framework for undertaking child rights-based planning and programming within the department.
The current projects encompass a wide range of activities that seek to demonstrate the role that human rights can play in different elements of WHO/CAH’s work. This includes promoting the systematic consideration of human rights into national-level situation analyses as well as into programming tools, guidelines and other documents produced by the department. Efforts include the production of documents as well as field-testing of suggested tools to ensure their effectiveness for use by the department and others working in this area. Complementary to this, and as part of broader efforts by WHO/CAH and UNICEF to understand the role of law in efforts to achieve the health-related Millennium Development Goals, a working paper is being produced on how legislation can be used to promote the child’s right to survival.
Addressing Orphanhood in São Paulo, Brazil
David Rockefeller Center for Latin American Studies
Mortality rates due to both AIDS and homicide in São Paulo, Brazil are alarmingly high, which has contributed to a large and growing orphan population. PIHHR is collaborating with researchers at the Brazilian Nucleus for AIDS Prevention Studies at the University of São Paulo in an effort to better understand how children’s health status is affected by orphanhood. The extent to which promotion, protection or violation of human rights mediate orphans’ experiences and the options that exist for addressing their health issues are also being studied. The overall aim is to identify areas where further intervention/support to orphans is required. This project is part of a long-term collaboration between the Program and the research team in São Paulo.
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| Sexual and Reproductive Health and Human Rights |
Human Rights-Based Approaches to Programming: Practical Implementation Including a Training Manual, Training Materials and Training of Trainers
United Nations Population Fund, Culture, Gender and Human Rights Branch of the Technical Support Division
In support of the UN’s mandate of rights-based work, the Program is collaborating with UNFPA to promote the systematic inclusion of human rights standards and principles in the organization’s country-level programs, policies and advocacy work. The project involves supporting UNFPA staff and their partners in the design, implementation and monitoring and evaluation of rights-based approaches. A manual and accompanying training materials are being created and ‘training of trainers’ workshops are being carried out in three regions in collaboration with local partners who have experience in rights-based training. The partners are: Women in Law and Development in Africa (WiLDAF); the Center for Arab Women Training and Research (CAWTAR); and International Women’s Rights Action Watch – Asia Pacific (IWRAW-AP).
Using Human Rights to Improve Maternal and Newborn Health: A Tool for Strengthening Laws, Policies and Standards of Care
World Health Organization, Department of Reproductive Health and Research
One of the Millennium Development Goal targets is to reduce maternal mortality by three quarters by 2015, but maternal and neonatal mortality rates remain unacceptably and unnecessarily high in many countries. To help address these issues, program staff are collaborating with WHO’s Department of Reproductive Health and Research to develop an innovative instrument to help countries use a human rights framework to identify and address legal, policy and normative barriers to women’s access to and use of quality maternal and newborn health care services. Piloted in Mozambique, Brazil, and Indonesia, the tool is now being adapted for use in the areas of adolescent health and sexual and reproductive health.
Reproductive and Sexual Health of HIV Positive Men and Women
World Health Organization, Department of Reproductive Health and Research
The Program is collaborating with the World Health Organization (WHO) on development of policy and programmatic guidance for health systems on ways to ensure that women and men living with HIV have access to sexual and reproductive health services that help them realize their reproductive goals while ensuring the respect protection and fulfillment of their human rights. As part of this effort, Program staff and a close collaborator drafted a working paper for presentation at a meeting in Ethiopia co-hosted by WHO, UNFPA and Engender Health which brought together a range of partners working in this area.
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| Non-State Actors and Human Rights |
Current Debates on Realizing Health and Human Rights
Merck Company Foundation
Human rights obligations have traditionally been viewed as the domain of national governments, but with the rise of the corporate sector, the applicability of human rights obligations to private sector companies has increasingly become an area of interest. This project explores the roles and responsibilities of the pharmaceutical industry as well as other state and non-state actors with regard to alleviating disease burdens worldwide. As a first step, the Program recently completed a working paper highlighting key issues and potential ways of moving these debates forward. This paper is publicly available at www.hsph.harvard.edu/pihhr. Currently, the Program is in the process of creating a blog to serve as the premier source for debate on these issues and organizing a series of activities intended to push critical thinking of engaged stakeholders to the next level.
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