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Session Two An Introduction to the Convention on the Rights of the Child

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Title: Session Two An Introduction to the Convention on the Rights of the Child


1
Childrens Rights and Childrens Health
Anne E. Dyson Annual Meeting, 2005 An
Introduction to the United Nations Convention on
the Rights of the Child Jeff Goldhagen, M.D., MPH
2
Aims of the Workshop
  • To raise awareness of the Convention on the
    Rights of the Child
  • To increase understanding of the Conventions
    application to health and health care policy and
    practice
  • To promote insight into how policy and practice
    can be improved to effect greater respect for the
    rights defined in the Convention
  • To raise awareness of the relationship between
    public policy and the health rights of children,
    and encourage a commitment to the development of
    an advocacy role by professionals in respect of
    childrens rights
  • To introduce methods for teaching childrens
    rights

3
Millennial Morbidities
  • Poverty Violence
  • Marginalization Lack
    of Education
  • Food Availability
    Emerging Diseases
  • Disabilities
    Displacement
  • Abuse and Exploitation
    Environmental Ecosystems
  • Access to Medical Care Public
    Policies
  • Genomics Mental Health Parity
  • Globalization

4
Responding to the Millennial Morbidities
5
Discrimination ---- Response
  • Discrimination
  • Race
  • Gender
  • Sexual Orientation
  • Animal
  • Victims
  • Voting
  • Patients
  • Children
  • Response
  • Civil Rights
  • Womens Rights
  • Gay Rights
  • Animal Rights
  • Victims Rights
  • Voting Rights
  • Patients Rights
  • Childrens ______

6
Rationale for a Rights-Based Approach to
Childrens Health
  • Childrens health and development is best
    promoted by the fulfillment of all their human
    rights.
  • The Convention provides a comprehensive framework
    of rights which will facilitate a holistic
    approach to promoting the well being of children.
    Respect for all the rights embodied in the
    Convention will help achieve this goal.
  • All children have rights by virtue of being
    human. In addition, all children have needs.
    The Convention on the Rights of the Child
    establishes international recognition that
    children have a right to have these needs met.

7
What is the UN Convention on the Rights of the
Child
8
The UN Convention on the Rights of the Child
  • The universal rights of children have been
    codified into an international human rights
    treaty, the UN Convention on the Rights of the
    Child (1989).
  • The Convention introduces binding obligations on
    all governments to protect and promote the rights
    of children that are necessary to fulfill their
    needs.

9
The Convention
  • The Convention on the Rights of the Child defines
    the full range of childrens needs and provides a
    practical framework for addressing these needs in
    an integrated and holistic way. 
  • It poses a challenge to traditional approaches to
    children that views them as incompetent, passive
    objects of adult protective care. Instead, it
    acknowledges them as both capable of and entitled
    to active participation in decisions that affect
    their lives.

10
The Convention
  • It provides a universal set of standards against
    which to measure and improve the treatment of
    children. 
  • It provides an opportunity for all those involved
    in childrens health and well being to work
    together toward improving childrens living
    standards by advancing childrens rights. 
  • Implementation of the rights contained in the
    Convention would herald a fundamental change in
    the status of children in all societies in the
    world and ensure their health and development and
    optimal fulfillment of potential.

11
The Six United Nations Human Rights Treaties
  • International Covenant on Civil and Political
    Rights (1966)
  • International Covenant on Social, Economic and
    Cultural Rights (1966)
  • International Convention on the Elimination of
    All Forms of Racial
  • Discrimination (1966)
  • Convention on the Elimination of All Forms of
    Discrimination Against Women (1979)
  • Convention against Torture, and Other Cruel,
    Inhuman and Degrading Treatment (1984)
  • Convention on The Rights of the Child (1989)

12
What Does the Convention Do
13
What the UN Convention on the Rights of the Child
Does 
?   It Promotes a philosophy of respect for
children?   It Recognizes children as subjects
of legal rights?   It Challenges traditional
views of children as passive recipients of
care and protection?   It Insists that children
are entitled to have their needs met and
thereby imposes obligations on adults
14
The Convention Establishes an Emerging View of
Children
  • The Convention encourages a culture of respect
    for
  • children within communities and families.
  • Children are listened to and their views are
    taken seriously.
  • There is increasing recognition given to
    childrens abilities to make decisions for
    themselves as they grow older.
  • Parents and society must consider childrens best
    interests when making decisions that affect them.
  • Recognition is given to the fact that childrens
    interests will not always coincide with those of
    their parents.

15
What Rights does the Convention Contain?
  • Social Rights
  • Economic Rights
  • Cultural Rights
  • Protective Rights
  • Civil and Political Rights
  • These rights are indivisible and universal.
  • There is no hierarchy of rights.

16
What it Contains
  • Social rights. The right to life and optimal
    survival and development, to the best possible
    health and access to health care, to education,
    to play, to family life unless not in the childs
    best interests  
  • Economic rights. The right to an adequate
    standard of living for proper development, to
    benefit from social security, the right to
    protection from economic exploitation 
  • Cultural rights. The right to respect for
    language, culture and religion, to abolition of
    any traditional practices likely to be
    prejudicial to the childs health
  •  
  •    

17
What it Contains
  • Protective rights. The right to promotion of the
    childs best interests, to protection from sexual
    exploitation, from armed conflict, from harmful
    drugs, from abuse and neglect, to rehabilitative
    care following neglect, exploitation or abuse
  •  
  • Civil and political rights. The right to be
    heard and taken seriously, to freedom from
    discrimination in the exercise of rights on any
    grounds, to freedom of expression, to privacy, to
    information, to respect for physical and personal
    integrity and freedom from all forms of violence,
    or cruel, inhuman or degrading treatment

18
Implications of Childrens Rights to Health
Professionals
  • Reorients the individual relationship between the
    health professional and the child
  • Establishes new policies and approaches to the
    delivery of health care services
  • Defines the role of health professionals as
    advocates for children by advocating for and
    advancing childrens rights

19
Underlying Principles
20
Underlying Principles in the Convention on the
Rights of the Child
  • Article 2. All the rights in the Convention
    apply to all children without discrimination on
    any grounds.
  •  
  • Article 3. In all actions affecting children
    their best interests must be a primary
    consideration.
  •  
  • Article 6. All children have the right to life
    and optimal survival and development.
  •  
  • Article 12. All children capable of expressing a
    view have the right to express that view freely
    and to have it taken seriously in accordance with
    their age and maturity.

21
Other Specific Rights
  •  
  • The Convention contains many other rights that,
    if respected, will result in better health and
    development for children
  •  
  • The right to protection from all forms of
    violence and sexual abuse
  • The right not to be separated from parents
  • The right to education and play
  • The right to protection from arbitrary detention
  • The right to knowledge of identity
  • The right not to suffer cruel or inhuman
    treatment or punishment

22
Underlying Principles
  • Is the Convention anti-family or anti-parent?
  • The Convention emphasizes that growing up within
    a caring family environment is crucial to
    childrens healthy development.
  • The Convention recognizes parental rights and
    responsibilities to provide direction and
    guidance to their children.
  • Parental rights and responsibilities exist in
    order to protect and promote childrens rights.
  • The Convention promotes a culture of respect for
    children in families by listening to them and
    taking them seriously.
  • The Convention does not diminish or undermine the
    role of parents, but it does imply a more open
    democratic approach to child rearing.

23
Concern for Parental Rights
  • Article 5 recognizes parents rights and duties
    to provide direction and guidance to children.
  • Article 9 stresses the right of children not to
    be separated from their parents unless necessary
    for their best interests.
  • Article 18 stresses the obligations of
    governments to provide support and help to
    parents in order to help them fulfill their role
    of promoting and protecting their childrens
    rights.

24
Teaching Childrens Rights
25
The Curriculum
  • Module 1 Childrens Needs and Rights
  • Module 2 Highlights of the UN Convention on the
    Rights of the Child
  • Module 3 Respecting Childrens Rights in
    Pediatric Practice
  • Module 4 Health Policy and Health Services
  • Module 5 The Health Professional as Advocate

26
Module 1. Childrens Needs and Rights
27
Relationships Between Childrens Needs and Rights
  • All children have needs, the fulfillment of which
    will facilitate their health and development.
  •  
  • Needs extend beyond the physical to encompass
    social, economic, cultural, intellectual,
    emotional and psychological needs.
  •  
  • Children cannot fulfill these needs without adult
    support.

28
Relationships Between Childrens Needs and Rights
  • These needs can only be fulfilled if adults
    accept responsibility for meeting them.
  •  
  • Acceptance of responsibility for the needs of
    children by adults gives children an entitlement
    or right to have their needs met.
  •  
  • Recognition that children have rights in respect
    of all their needs demands an approach in which
    children become active participants in the
    decisions and actions which affect them, not
    merely recipients of adult intervention and
    protection.
  •  

29
Activities
30
Activity 1.1Defining Childrens Needs
This exercise is designed to develop an
understanding of the needs of children to ensure
their optimal health and well being.
31
Activity 1.1
  • Please identify what a child needs in order to
    fulfill his or her full potential in one of the
    following three broad and overlapping categories
  •  
  • Physical needs
  • Social and cultural needs
  • Intellectual, psychological and emotional needs
  • Approach this task in general terms. It is not
    necessary to define the exact
  • detail of the needs that you are describing.

32
Activity 1.1
  • Give consideration to 
  • What age do you consider to be included within
    childhood?
  • Do children have different needs at different
    ages?
  • Are there needs of children that relate both to
    their present age and to their future role as
    adults?
  • Are these needs universal?

33
    Examples of Physical Needs
  • Shelter
  • Health care
  • Adequate clean water and sanitation
  • Protection from environmental pollution
  • Adequate food
  • Adequate clothing
  • Protection from violence, exploitation and abuse

34
Examples of Social and Cultural Needs
  • Knowledge of and respect for own language
    religion and culture
  • Stable social and economic environment
  • Recognition of and respect for emerging
    competencies
  • Access to appropriate guidance and support
  • Access to play and friendships
  • Respect for privacy
  • Freedom from discrimination and prejudice

35
Examples of Intellectual, Psychological and
Emotional Needs
  • A stable and loving family environment
  • Access to education
  • Age appropriate information and stimulation
  • Opportunities to be listened to and taken
    seriously

36
Activity 1.2 Characteristics of Childrens Needs
This exercise is designed to develop an
understanding of the characteristics of
childrens needs.
37
Activity 1.2Characteristics of Childrens Needs
  • Respond to these questions, as you consider the
    needs of children in
  • your practice, your community, nation and the
    world.
  •  
  • 1. Which needs apply to all aspects of a childs
    development?
  • 2. What inter-relationships and
    inter-dependencies exist between needs and
  • rights?
  • 3. How do childrens needs (rights) change at
    different stages of their
  • development?
  • Do these needs extend to all children in all
    societies, irrespective of their countrys wealth
    or stage of development?
  • 5. Who is responsible for meeting childrens
    needs?

38
Key Points
39
Key Points
  • The Convention on Rights of the Child defines the
    full range of childrens needs and rights, and
    provides a practical framework for addressing
    these needs in an integrated and holistic way.
  • All children have rights that emanate from their
    humanity. In addition, all children have basic
    universal needs.
  • These needs form a basic set of common standards
    necessary for optimal health and development.
  • Children are entitled to be treated according to
    these common standards.
  • These standards impose obligations on adults to
    ensure their fulfillment.
  • A commitment to fulfilling these obligations
    creates rights for children to have their needs
    met.

40
Key Points
  • 2. The Convention poses a challenge to
    traditional
  • approaches that view children as incompetent,
    passive objects of adult protective care.
    Instead, it acknowledges children as both capable
    and entitled to active participation in decisions
    that affect their lives.

41
Key Points
  • 3. It is legally binding on all countries that
    have ratified it. Governments are required under
    international law to take all necessary measures
    to implement its provisions. It provides a
    universal set of standards against which to
    measure and improve the treatment of children.
  • 4. There are no formal sanctions that can be
    brought against governments for failing to comply
    with its provisions or the process of reporting
    to the Committee on the Rights of the Child. It
    is nevertheless an invaluable mechanism for
    monitoring how a government is complying.

42
Key Points
  • 5. It provides an opportunity for all those
    involved in childrens health and well being to
    work together toward improving standards.
  • 6. Full implementation of the rights contained in
    the Convention would herald a fundamental change
    in the status of children in all societies in the
    world and ensure their optimal health and
    development and fulfillment of potential.

43
Module 2Highlights of the UN Convention on
the Rights of the Child
44
Activity 2.1
Exploring the Concept of Rights for Children
45
Activity 2.1
  • This exercise is designed to encourage you to
    explore the concept of rights for children, what
    those rights are and to reflect on how different
    rights are treated in respect of children.

46
Activity 2.1. Consider as many questions as
time allows
  • 1. What rights do you think are violated or
    neglected for children in your country?
  •  
  • 2. Are there particular groups of children who
    are more discriminated against in the exercise of
    their rights?  
  • 3. Are there any groups of rights that are
    complied with less than others? Why do you think
    that might be? 
  • 4. How does the concept of the best interests of
    the child inform the work of health
    professionals?

47
1. Are there shared perceptions about the extent
to whichrights are complied with or violated?
Discussion Questions
  • Is there agreement in your community as to
    whether the right to protection from all forms
    of violence is respected?
  • Is there agreement in your community as to
    whether children are listened to and taken
    seriously?
  • Is there consensus about how far certain groups
    of children are discriminated against in the
    exercise of their rights, such as girls, disabled
    children or minority groups?

48
2. If rights are not being respected, where does
the problem lie?
Discussion Questions
  • Is it governments who are breaching those rights?
  • Is it parents?
  • Is it professionals working with
    childrendoctors, teachers etc?
  • Is the disrespect active or passive?
  • Are childrens rights being breached by
    defaultthrough
  • lack of awareness or resources, or through
    active repudiation of those rights?

49
3. Is there explicit legislation requiring
professionals to consider the best interests of
children?
Discussion Questions
  • If so, how does this impose these requirements?
  • If not, is it a concept that is implicitly
    applied in respect of service delivery? How do we
    know it is being applied consistently?
  • Can you think of examples where the principles of
    best interests of the child ought to apply but
    does not?

50
Activity 2.2
Barriers to the Best Possible Child Health
51
Barriers to the Best Possible Child Health
This exercise is designed to highlight how
accomplishing the best possible health requires
meeting a breadth of childrens rights.
52
Activity 2.2Barriers to the Best Possible Child
Health
  • Consider the following 2 issues
  • 1. Identify and list barriers to the
    implementation of the right to the best possible
    health for any group of children.
  • 2. Next, identify ways of overcoming each of the
    barriers listed.

53
Examples of Barriers
54
Barriers to Childrens Right to the Best
Possible Health
  • Parents and childrens lack of information about
    how to protect childrens health
  • Child poverty
  • Discrimination against certain groups of children
  • Politicians failure to prioritize childrens
    health
  • Resistance towards changing attitudes and
    practices toward childrens health and child
    rearing
  • Invisibility of children
  • Lack of democratic traditions

55
Ways of Overcoming Barriers to Childrens Rights
to the Best Possible Health
  • Introduce protective legislation
  • Monitor implementation of the Convention
  • Give priority to making environments child
    friendly
  • Scrutinize national budgets
  • Run public information campaigns
  • Develop informed and effective public policy

56
Childrens Rights to the Best Possible Health
  • Article 2. All the rights in the Convention
    apply to all children without discrimination on
    any grounds.
  •  
  • Article 3. In all actions affecting children
    their best interests must be a primary
    consideration.
  •  
  • Article 12. All children capable of expressing a
    view have the right to express that view freely
    and to have it taken seriously in accordance with
    their age and maturity.

57
Childrens Rights to the Best Possible Health
  • Key articles related to health
  • Article 6. The right to life and optimum
    development
  • Article 24. The right to the best possible health
    and access to health services

58
Childrens Rights to the Best Possible Health
  • Article 5. The right of children to respect for
    their evolving capacities
  • Health professionals are obligated to explore
    with the child their level of understanding of
    any proposed treatment, their views on it and
    their
  • competence to make a decision on whether or not
    to consent to the
  • treatment.
  • Health professionals must work collaboratively
    with both children and their parents to involve
    them as fully as possible in the treatment being
    offered and in any decisions that need to be
    taken.
  • Due regard must be given to the childs
    competence to give or refuse consent to a
    treatment when the parent takes an opposing view.

59
Childrens Rights to the Best Possible Health
  • Article 12. The right of children to be listened
    to and taken seriously.
  • All children capable of expressing a view are
    entitled to do so.
  • Children are entitled to do so on all matters
    affecting them, it is not restricted to any
    aspect of a childs life.
  • Childrens views must be given due regard, there
    is little point in listening to children if there
    is no commitment to give consideration to what
    they say.
  • The weight given to their views must be in
    accordance with their age and maturity.

60
Childrens Rights to the Best Possible Health
  • Article 16. The right of children to privacy and
    respect for confidentiality.
  • Respecting confidentiality will encourage
    adolescents to seek medical help.
  • There is a need to develop and promote explicit
    policies on who is entitled to confidential
    advice and information.
  • There is a need for clarification on laws
    relating to confidential treatment of minors and
    to develop policy accordingly.

61
Implementing Childrens Rights in Practice
  • Formally adopt the Convention as a framework
    for developing policies and practices
  • Develop systems for consulting with children in
    the development, delivery, monitoring and
    evaluation of services
  • Work with staff, parents and children in
    developing a Childrens Charter establishing what
    children are entitled to expect with they seek
    health care.
  • Develop systems for analyzing the degree to which
    health services and expenditures benefit
    children and whether they reflect their assessed
    levels of need

62
Implementing Childrens Rights in Practice
  • Establish effective collaborative planning to
    ensure consistency and comprehensiveness in the
    development of services for children
  • Provide training to staff and parents
  • Encourage the appointment of a childrens
    ombudsman who can monitor how effectively
    childrens rights to health are being protected.

63
A Childrens Rights Charter
  • If I am seeking, needing or receiving services, I
    have the right to the following
  • To the best possible treatment and care
  • To be listened to and have my views taken
    seriously
  • To be given information that will help me
    understand my treatment
  • To ask for advice, information and support
  • To be asked before anyone touches me
  • To respect for my privacy
  • To treatment and care, regardless of my sex,
    abilities or disabilities, color, race, religion
    or sexual orientation
  • To not be hurt or humiliated

64
Key Points
65
Key Points
  • The Convention on the Rights of the Child defines
    the full range of childrens needs and provides a
    practical framework for addressing these needs in
    an integrated and holistic way.

66
Key Points
  • It poses a challenge to traditional approaches to
    children that view them as incompetent, passive
    objects of adult protective care. Instead, it
    acknowledges children as both capable and
    entitled to active participation in decisions
    that affect their lives.

67
Key Points
  • It is legally binding on all countries that have
    ratified it. Governments are required under
    international law to take all necessary measures
    to implement its provisions. It provides a
    universal set of standards against which to
    measure and improve the treatment of children

68
Key Points
  • There are no formal sanctions that can be brought
    against governments for failing to comply with
    its provisions, the process of reporting to the
    Committee on the Rights of the Child
  • It is nevertheless an invaluable mechanism for
    monitoring how a government is complying.
  • It provides an opportunity for all those involved
    in childrens health and well being to work
    together toward improving standards.
  •  

69
Key Points
  • Implementation of the rights contained in the
    Convention would herald a fundamental change in
    the status of children in all societies in the
    world and ensure their optimal health and
    development and fulfillment of potential.
  •  

70
Module 3
  • Respecting Childrens Rights in Pediatric Practice

71
Activity 3.1
  • Scenarios Extending Childrens Rights in
    Clinical Practice

72
Activity 3.1 Scenarios Extending Childrens
Rights in Clinical Practice
  • Think of a recent case where one of the following
    has been a
  • question
  • Whether or not to involve a child in a medical
    decision
  • Overriding the wishes of a competent child
  • Breaching the confidentiality of a child

73
Activity 3.1Describe A Case
  • 1. Outline the circumstances of the case
  • 2. Highlight the nature of the decision to be
    made
  • 3. Describe who was involved and why
  • 4. State the outcome and how it was reached

74
Discussion Questions
  • Were the childs rights fully respected in this
    case?
  • If not, why not?
  • What could have been done differently?

75
Examples of Case Scenarios Childrens Rights
in Clinical Practice
  • A 13 year old wanting contraception but unwilling
    for her parents to be informed
  • A 10 year old diagnosed with likely-to-be-terminal
    cancer, who is refusing surgery that could offer
    temporary alleviation of pain
  • A child who has HIV, transmitted from the mother.
    Should the child be told? If yes, what are the
    implications for the mothers privacy
  • A school vaccination programme. Should individual
    children be consulted and asked for permission?
  • A six year old who refuses a necessary injection

76
Activity 3.2

When a Childs Rights Might Conflict with
Parents Rights
77
Activity 3.2
  • Identify cases that you have encountered in
    which conflicts existed between the rights of
    children and those of their parents
  • Address these questions and consider their
    relevance to the cases you chose to discuss
    and/or others you have encountered.
  • Which rights were at stake for the child? For the
    parent?
  • Which rights would you prioritize? Why?
  • How might you resolve the potential conflict?

78
When a Childs Rights Might Conflict with the
Parents Rights
  • Case examples
  • A teenage girl, who has been brought by her
    mother to see you, turns out to be pregnant
  • A ten year old boy needs treatment for a chronic
    condition, but his parents refuse to give their
    consent
  • A disabled child refuses a painful corrective
    treatment, that the parents want undertaken
  • A child reveals that she is being abused by a
    family member
  • A mother with HIV/AIDS wants to breast feed her
    baby

79
Discussion Questions
  •  
  • 1. Which rights were at stake for the child? For
    the parent?
  • 2. Which rights would you prioritize? Why?
  • 3. How might you resolve the potential conflict?

80
Key Points
81
Key Points
  • Children are entitled to be actively involved in
    their own health
  • care from the earliest possible ages.
  •  
  • 2. Involvement means providers and parents
  • listen to children and take their views
    seriously,
  • respect their evolving competence to take
    responsibility for themselves, and
  • and recognise the importance of confidentiality,
    particularly for adolescents.
  •  

82
Key Points
  • Participation of children is important in
    principle. All people are entitled to be
    consulted over decisions that affect them. The
    practical benefits enhance both the quality of
    care and the childs general well-being.
  • Implementing a commitment to involving children
    necessitates considerable changes in practice
  • Train all medical and paramedical staff who deal
    with children
  • Make time to listen and talk with children
  • Provide child-friendly information, and
  • Develop codes of practice and polices to promote
    good practice.

83
Key Points
  • Implementing a culture of respect for children
    should be undertaken through a process of
    consulting with children themselves on which
    issues matter to them, on what they would like to
    see change, and how.

84
Module 4
  • Health Policy and Health Services

85
Activity 4.1
  • Strategies to Ensure the Right to the Best
    Possible Health

86
Activity 4.1
  • This exercise is designed
  • To help you reflect on the extent to which the
    right to the best possible health is being
    protected for children in your practice and
    community
  • To explore what strategies might be developed to
    address those areas that require change in order
    to raise standards

87
Activity 4.1
  • Consider the following questions
  • Is the right to the best possible health being
    protected for all children?
  • If not, which children are losing out and how?
  •  
  •       

88
Activity 4.1
  • Can you identify examples of specific breaches of
    childrens rights in existing health policy and
    practice? 
  • Can you think of ways to discover from children
    what they think about services, what services
    they would like developed, how they would like
    services changed?

89
  • Examples
  • failures to introduce or follow child protection
    procedures
  • physical abuse of children by staff
  • detention of children in mental health
    institutions without proper safeguards
  • research undertaken without proper consideration
    of childrens best interests?

90
Activity 4.2
  • How Child-Friendly are Health Centers, Clinics
    and Hospitals?

91
Activity 4.2
  • This exercise is designed
  • To help you see the world that children
    experience
  • To help you consider ways to ensure the
    experience of children in health facilities
    respect their rights

92
Activity 4.2How Child-Friendly are Health
Centers, Clinics and Hospitals?
  •  
  • Imagine you are either a seven-year old ethnic
    minority boy or a 14-year old girl who is
    confined to a wheel chair. You are visiting a
    hospital or health centre for treatment.
  •  
  • How might you, as either of these children,
    experience the services you receive, and what
    might be done to make the environment and the
    services more child-friendly?

93
Key Points
94
Key Points
  • Children have the right to life and the best
    possible health, and access to the best possible
    health care services.
  • It is not enough simply to assume that services
    are promoting childrens health and development,
    providing them with the best possible health
    services and ensuring the best possible health
    outcomes. It is necessary to scrutinise services
    to ensure they actually protect and promote
    childrens rights.

95
Key Points
  • 3. Key principles in the Convention can be used
    as a means of monitoring whether standards are
    being met for all children. For example, can all
    children access services equally, are services
    designed for children or for the interests and
    convenience of adults, are childrens views
    sought as a means of improving services, are
    children protected from all forms of violence and
    abuse?

96
Key Points
  • 4. Giving consistent priority to promoting the
    best interests of children can be helped by
    introducing and institutionalizing systems for
    raising standards throughout the service delivery
    system, including training, consultation,
    analysis of budgets, integrated planning of
    services, etc.

97
Key Points
  • Important questions to ask when developing and
  • implementing childrens services include,
    but are not limited to the following. 
  • Can all children access services equally?
  • Are services designed for children, or for
    adults interest and convenience?
  • Are childrens views sought as a means of
    improving services?
  • Are children protected from all forms of violence
    and abuse?

98
Implementation of the Best Possible Health -
Summary
  • Formally adopt the Convention as a framework for
    developing policies related to your practice
  • Develop systems for consulting with children
  • Develop a Childrens Charter in consultation with
    children and families
  • Develop systems for analyzing health service
    expenditures
  • Establish effective interdepartmental planning to
    ensure consistency and comprehensiveness in the
    development of services for children
  • Train staff on the implications of the Convention
  • Appoint an ombudsman

99
Module 5
  • The Health Professional as Advocate

100
Activity 5.1
  • Advocating for Changes in Public Policy
  • and Practice

101
Activity 5.1Advocating for Changes in Public
Policy and Practice
  • This exercise is designed
  • To explore the potential role of health
    professionals as advocates for childrens right
    to the best possible health.
  • To identify an aspect of public policy that has a
    detrimental impact on childrens optimal health,
    and develop a strategy for advocating the
    necessary changes to legislation, policy,
    practice or resources in order to better protect
    children.

102
Advocating for Changes in Public Policy and
Practice 
  • Choose an aspect of legislation or public policy
    that you feel is having a particularly harmful
    impact on childrens right to the best possible
    health. It may be one of those listed on the
    Table in your handout, or it may be something of
    particular interest to you and those in your
    community.
  •  
  • Now consider the following questions
  •  

103
Advocating for Changes in Public Policy and
Practice
  • What rights for children are being breached and
    what are the implications of those breaches?
  •  
  • What changes would be necessary in order to
    protect childrens rights to health more
    effectively?
  •  
  • To what extent are the changes needed related to
    health policy and practice and to what extent do
    they need wider reform?

104
Advocating for Changes in Public Policy and
Practice
  • Do you consider that pediatricians and other
    health professionals have a role to play in
    seeking change on this issue? What unique
    contribution can you make as a result of your
    direct experience?
  •  
  • How might you develop a strategy to highlight
    your concerns and seek to achieve the changes
    necessary to protect childrens health?
  •  
  • How might you involve children themselves in such
    a strategy?

105
Advocating for Changes in Public Policy and
Practice
  • The following questions may help frame this
    discussion.
  •  
  • Why do children need advocates?
  • How can you prioritize childrens issues?
  • How can you develop a strategy for advocacy?
  • How can you involve children and elicit their
  • views?

106
Key Points
107
Key Points
  • Childrens rights to the best possible health
    cannot be fulfilled simply through the provision
    of effective health care services. The social,
    economic and physical environments in which they
    live can and do have powerful influences on their
    well-being.
  • Children lack the democratic rights available to
    adults with which to fight to protect their
    rights. Accordingly, they need adults willing to
    act as advocates on their behalf.

108
Key Points
  • Pediatricians and other health professionals have
    a unique experience with respect to how
    childrens lives and their right to the best
    possible health are affected by their
    environment, and how the actions and inactions of
    governments contribute to the failure to protect
    their right to health.
  • By advocating as a body, health professionals can
    tackle the barriers to childrens rights to the
    best possible health, rather than simply treating
    the consequences.

109
Key Points
  • Children themselves have a contribution to make
    to their own protection alongside adult
    advocates.
  • A greater recognition of childrens rights in
    individual professional practice, and the
    delivery of supportive health services and public
    policy are needed if the optimal development and
    well-being of all children are to be protected
    and promoted.
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