Office of the United Nations High Commissioner


C. Key targets and indicators



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C. Key targets and indicators


Target 1: All people to have access to adequate and affordable primary health care

Indicators:

  • Life expectancy at birth

  • Proportion of public expenditure on primary health care

  • Proportion of poor people not covered by any kind of pre-payment mechanisms, by non-discretionary interventions (e.g., exemption schemes, cash subsidies, vouchers) in relation to health user fees, or by privately funded health insurance

  • Number of primary health care units per thousand population

  • Number of doctors per thousand population

  • Proportion of poor people with access to affordable essential drugs

Target 2: To eliminate avoidable child mortality

Indicators:

Target 3: To eliminate avoidable maternal mortality

Indicators:

  • Maternal mortality ratio

  • Proportion of births attended by skilled health personnel

  • Proportion of mothers with access to pre- and post-natal medical care facilities

Target 4: All men and women of reproductive age to have access to safe and effective methods of contraception

Indicator:

  • The rate of use of safe and effective methods of contraception among poor couples of reproductive age who wish to use contraceptives

Target 5: To eliminate HIV/AIDS

Indicators:

Target 6: To eliminate the incidence of other communicable diseases

Indicators:

  • Prevalence and mortality rate associated with communicable diseases

  • Proportion of people with access to clean, safe drinking water

  • Proportion of people with access to adequate sanitation

  • Proportion of people immunized against communicable diseases

Target 7: To eliminate gender inequality in access to health care

Indicators:

  • Sex ratio (overall, birth and juvenile)

  • Disability-adjusted life years lost for men and women

  • Ratio of women and men treated in medical institutions

D. Key features of a strategy for realizing the right to health


  1. States should improve the supply of personal health services and make them more accessible to the poor by:

(a) Targeting delivery to the poor by providing tailor-made services for groups whose access to health services may raise particular challenges, such as women, the elderly, children, indigenous peoples, minorities, slum-dwellers, labour migrants and those living in remote rural communities, via outreach clinics;

(b) Ensuring that resource allocation favours the poorer geographical regions;

(c) Ensuring that resource allocation favours the lower tiers of service delivery, i.e., primary care;

(d) Prioritizing reproductive, maternal (prenatal as well as post-natal) and child health care;

(e) Identifying diseases and medical conditions, such as malaria, tuberculosis and HIV/AIDS, that have a particular impact on the poor and, by way of response, introducing immunization and other programmes that are specifically designed to have a particular impact upon the poor;

(f) Ensuring that all services are respectful of the culture of all individuals, groups, minorities and peoples, and are sensitive to gender and of good quality;

(g) Providing essential drugs as defined by the WHO Action Programme on Essential Drugs.


  1. States should improve the supply and effectiveness of public health interventions to the poor by:

(a) Introducing and implementing basic environmental controls, especially regarding waste disposal in areas populated by the poor;

(b) Ensuring the provision of clean, safe and accessible drinking water;

(c) Regulating health service provision, for example with a view to eliminating the marketing of unsafe drugs and reducing professional malpractice;

(d) Providing education and information about the main health problems in local communities, including methods of prevention and control.




  1. States must reduce the financial burden of health care and health protection on the poor, for example by reducing and eliminating user fees. This can be done either by moving away from user fees and introducing other pre-payment mechanisms (e.g., national insurance or general taxation) or by keeping user fees and introducing non-discretionary, equitable and non-stigmatizing interventions for the poor (e.g., exemption schemes, direct cash subsidies and vouchers).




  1. States should promote policies in other sectors that bear positively on the underlying determinants of health, entailing particular benefits for the poor, for example by supporting agricultural policies that have positive health outcomes for the poor (e.g., food security), by identifying measures that address the negative impact of agricultural policies on them (e.g., health and safety risks to agricultural labourers), and by generally promoting their income-generating activities.




  1. States must ensure that the poor are treated with equality and respect by all those involved in health care and health protection. Accordingly, States should provide all relevant health staff with anti-discrimination training in relation to disability and health status, including HIV/AIDS.



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