The Public Health Foundation of India

10 million children under 5 die each year globally.  These children need vaccines and primary health care. The supply and distribution of both is problematic.  This is where the rule of law becomes important.  Why?

 1-At the individual level: 4 billion people are without the support of the rule of law globally. (Commission on Legal Empowerment of the Poor, Making the Law Work for Everyone)

According to the Commission on Legal Empowerment of the Poor, many children in poor countries do not have a legal identity. They are not registered.  They are not counted.  They do not have a birth certificate.  They are not eligible for vaccines.

 2-At the community level:  Most NGOs workers in urban slum areas do not know how to help families gain legal access. (Public Health Foundation of India)

NGO workers learn the law in order to help those in need get access to community primary care, including vaccines.  They work with local police and other law enforcement officers.  Legal literacy is a major issue.

3-At the national level:  There is a need for information about the rule of law in order to improve health outcomes. (World Health Organization) 

"If the health system is not governed well, health workers are absent, patients pay illegal fees, and basic inputs are stolen without any consequences for those who mismanage or corrupt the system, performance of health services will be poor and population health will suffer... Better country level data can help in diagnosing the problem." (Maureen Lewis, Center for Global Development)

The Public Health Foundation of India

 The World Justice Project has an Opportunity Fund which currently supports 36 projects.  One of the projects is responding to the legal and health needs of slum dwellers in Delhi, India.  The project is led by the Public Health Foundation of India.  They realize the need for their target populations to know appropriate laws and rights in order to secure basic health services.  Their goal in the WJP Fund project is the legal empowerment of the urban poor and they have two major foci:

The project is currently working with Action India, Navjyuoti India Foundation, CARENIDHI, the National Human Rights Commission, the Urban Health Resource Centre, and other civil society organizations.  The outcomes of the Project will be measured in terms of the legal empowerment of the poor in two districts in Delhi which have the largest urban poor populations and are growing at the fastest rates.  Based on outcomes data, the dissemination of best practices will be done throughout the metro area.  The World Justice Project will aid in dissemination globally through its website and its global and regional multidisciplinary meetings.

Cross-country Information on the Rule of Law Can Improve Health Outcomes

The World Justice Project has a Rule of Law Index that has been designed to measure the extent to which individual countries adhere to the rule of law and provide governments, businesses, nongovernmental organizations and civil society with a tool to plan targeted, effective reforms. This information is critical to improve health and other social outcomes in Africa and other developing countries:

 "...simply having benchmark countries with which to compare countries would strengthen the cross country evidence. Acceptable indicators, benchmarks and additional attention to systemic issues would enable more robust indicators of overall performance, which in turn would inform policymakers and donors of challenges and opportunities for improving health institutions."

 Maureen Lewis. Governance and Corruption in Public Health Care Systems. Working paper no. 78. Jan. 2006. Center for Global Development. <www.cgdev.org>.

 "Action on the social determinants of health to improve overall health outcomes and reduce health inequities will be much more effective if basic data systems are in place, nationally and internationally, and there are mechanisms to develop more effective interventions. These processes are essential for knowing the magnitude of the problem, for understanding who is most affected and whether the situation is improving or deteriorating over time, and for assessing entry-points for intervention and evaluating the impact of policies. Well presented data can provide a stimulus for political action."

 CSDH (2008). Closing the gap in a generation: health equity through action on the social determinants of health. Final Report of the Commission on Social Determinants of Health. Geneva, World Health Organization.

  "Today, the problem of readily available expired drugs is still prevalent in most communities in Africa, partly because there are no quality-assurance mechanisms codified in national laws. Enforcement of the law is also lax in many instances. Compounded with this problem is the lack of national strategies for increasing and sustaining public awareness about the quality and expiration of drugs, including the prohibition of hawking of drugs by street vendors."

 Bience Gawanas, Commissioner of Social Affairs, Africa Union Commission.    "African Union and health care challenges in Africa: Strategies and Initiatives on Health Care Delivery". African Renaissance, July/August 2006.

 "The social determinants of health agenda is fundamentally political and hence requires political action. Evidence is, however, vital."

 CSDH (2008). Closing the gap in a generation: health equity through action on the social determinants of health. Final Report of the Commission on Social Determinants of Health. Geneva, World Health Organization.