Rights Based Approaches and Social Accountability: Citizen Monitoring by Indigenous Women in Peru

Session: Applying Human Rights Based Approaches to Preventing Maternal Mortality and Morbidity: Strategies, Challenges and Lessons from Civil Society Experiences in Four Countries

Presenter: Ariel Frisancho, Catholic Medical Mission Board / ForoSalud

Building on the citizen monitoring model in Puno, political advocacy led to launching of National Policy Guidelines for the Promotion of Citizen Monitoring of Health. However, following elections, the current National government (mid-2011 onwards) is not facilitating citizen monitoring, and the Peruvian Ministry of Health has initiated a health sector reform process focusing more on extension of public and private health insurance to cover as much as population as possible, than on quality or rights-respecting mechanisms. A prolonged strike by protesting medical doctors has led to shrinking of spaces to dialogue for other civil society organizations as well.  ForoSalud as a national movement has decided to implement strategies for institutionalizing social accountability through citizen monitoring of maternal health services, especially by the marginalized women who are reporting to the Ombudsman’s office. The purpose is to inform ways in which the OHCHR TGN could be implemented at the sub-national and local level through monitoring of availability, accessibility, acceptability and quality of health services, especially for indigenous women.  ForoSalud organized a regional workshop with decision makers to disseminate a “people friendly” leaflet on health services users’ rights and entitlements. A training programme was planned for health personnel in collaboration with the office of the Ombudsman to build knowledge on health services users’ rights and disseminate the “people friendly” version of the TGN. However the standoff between the Ministry of Health and the medical doctors impeded interventions at the national level. Nonetheless, it was possible to strengthen the linkages with the regional authorities and rural indigenous women engaged in citizen monitoring and reporting to the Ombudsman’s office. This has led to the promoting of human rights based approaches using the lessons brought in from this social accountability process.