ASUNCION / GINEBRA (7 October 2015) - The United Nations Special Rapporteur on the right to health, Dainius Pūras, urged Paraguay to demonstrate a sustained commitment to human rights in its public health policies and practices, and to remove barriers for the effective realization of the right to health.
“There are good opportunities to achieve the progressive realization of right to health in Paraguay, but public policy should address structural factors that hamper the way forward,” Mr. Pūras said at the end of his first official visit* to the country.
The human rights expert cautioned that there are large number of sectors in Paraguayan society which still face serious discrimination, including in healthcare services, such as women, girls and adolescents people living with HIV/AIDS; people who use drugs; lesbian, gay bisexual and transgender persons; and those with psychosocial and other disabilities.
The Special Rapporteur commended Paraguay for the improvements in the life expectancy of certain sectors of the population, the reduction of maternal and child mortality rates over the past decades, and the introduction of successful vaccination campaigns nationwide. He also welcomed recent social reforms, including the expansion of primary health care through family health units established in rural areas.
However, during his visit, he identified numerous challenges related to structural factors that obstruct progress in the realization of the right to health. Main factors include deep inequalities and widespread discrimination. According to this expert, these factors are associated with a regressive tax structure that does not allow for the necessary public investment; lack of effective decentralisation; endemic institutional weaknesses, and corruption at all levels.
“Violence against women and girls is an epidemic in Paraguay and remains one of the major public health threats,” the UN expert stated. Of special concern is the criminalization of abortion, which contributes to high rates of early pregnancies and unsafe abortions, main causes of maternal mortality and morbidity.
Hundreds of young girls every year are forced into unwanted pregnancies and motherhood. This “indicates a serious gap in the protection of children from sexual violence, and the persistence of a systemic pattern of violation of their right to physical and mental health and integrity,” he added.
Children and adolescents are exposed to high levels of violence, both in families and society at large and they do not get the necessary protection. Adolescents lack friendly health services, and comprehensive health education and information in schools, including sexuality education. “These gaps should be addressed without delay to protect children and to promote their holistic development, including in the emotional and social domains,” Mr. Pūras noted.
The mental health care system relies heavily on outdated policies and practices and requires a shift of paradigm. Most persons with mental health conditions, including psychosocial disabilities, have no access to comprehensive and user-friendly community based services which should be used to protect their rights.
“I strongly support the recommendations made by the UN Committee on the Rights on Persons with Disabilities and urge authorities to move forward and apply modern standards of protection of the rights of persons with psychosocial and developmental disabilities,” he said.
The expert underlined that the healthcare system suffers from fragmentation and changes are needed to improve its performance. But this requires political commitment from the highest levels of governance. Measures should include increased investment in primary care and the promotion of participation by users and health care professionals in decision making processes.
Mr. Pūrassees potential for further engagement by Paraguayan society, including individuals, families, communities and civil society in advancing the realization of the right to health.
“I encourage the promotion of the participation of everyone without exception, including those in most vulnerable situations. This would reinforce the accountability and transparency of the system, which are crucial for realization of the right to health and related rights,” the expert concluded.
(*) Check the end-of-mission statement by the Special Rapporteur: http://www.ohchr.org/EN/NewsEvents/Pages/DisplayNews.aspx?NewsID=16566&LangID=E
The Special Rapporteur is an independent expert appointed by the UN Human Rights Council to help States, and others, promote and protect the right to the highest attainable standard of health (right to health). Dainius Pūras(Lithuania) is a medical doctor with notable expertise on mental health, child health, and public health policies. He is a Professor and the Head of the Centre for Child Psychiatry Social Paediatrics at Vilnius University, and teaches at the Faculty of Medicine, Institute of International Relations and Political science and Faculty of Philosophy of Vilnius University, Lithuania. Learn more, visit: http://www.ohchr.org/EN/Issues/Health/Pages/SRRightHealthIndex.aspx
The Special Rapporteurs are part of what is known as the Special Procedures of the Human Rights Council. Special Procedures, the largest body of independent experts in the UN Human Rights system, is the general name of the Council’s independent fact-finding and monitoring mechanisms that address either specific country situations or thematic issues in all parts of the world. Special Procedures’ experts work on a voluntary basis; they are not UN staff and do not receive a salary for their work. They are independent from any government or organization and serve in their individual capacity.
OHCHR Country page – Paraguay: http://www.ohchr.org/EN/countries/LACRegion/Pages/PYIndex.aspx
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