Working with Right Holders and Duty Bearers to operationalize Right Based Approaches to Health: The experience of CARE in Peru

Human rights, and in particular, the right to the health, are at the heart of CARE International's work. CARE's understanding is that people are often trapped in a cycle of poverty not mainly due to lack of assets and skills, but because of systemic social exclusion, marginalization, and discrimination, set within a context of systems and structures that perpetuate poverty. Poverty stems from political, social, economic, and environmental factors at the community, regional (sub-national), national and global levels. Supporting the realization of the right to health for the poor requires not only direct actions to improve their health status, but also addressing the underlying and systemic factors and power imbalances that impact on health, including ensuring changes in public policies. It requires working with both rights-holders – the poor and marginalized, and their representative organizations - and duty-bearers, from the state (authorities, Congress, public officers and health workers) and private sector, including other cooperation agencies and key stakeholders (i.e. political parties). The presentation will give a view on the way CARE is applying this approach in practice, with examples drawn mainly from CARE's work in Peru, where two of the authors have been working over recent years. It outlines CARE's framework for rights-based approaches and gives examples of application in its health program in Peru. The presentation comments on evidence that a rights-based approach can lead to increased impact of work to tackle poverty and social exclusion, as well as some principal lessons learned and remaining challenges.