Defending Dignity A Manual for National Human Rights Institutions on Monitoring Economic, Social and Cultural Rights UPDATE FROM AHN Ahn reviews the notes she took from her key informant interviews with health workers and administrators, as well as the focus group discussions with indigenous women’s groups. On the basis of these notes, she develops a power map showing how different actors relate to one another. For example, many indigenous women noted that their husbands and mothers-in-law were the primary decision makers with regard to health care. She also makes a list of the capacity gaps that these different actors face, as well as the other contextual factors that impact on them. For example, she heard many comments that women’s ill health during pregnancy is often due to poor diet; changing weather patterns had made it harder to grow traditional crops. The health administrators she speaks with note that local politicians have a lot of discretion about how community health initiatives are funded, particularly when the funding comes from international donors. This leads to a situation where their supporters and allies are privileged in procurement decisions, public-private partnerships and programme funding. She also conducts some additional desk research, finding secondary literature from academics focused on health economics. These articles describe how decentralization of the health care system has concentrated power within the health sector and fostered corruption. EXERCISES 1. Review the measurement tools outlined above (Worldwide Governance Indicators, Resource Governance Index, Global Corruption Barometer). How does your country perform on their most recent rankings? 2. Compare each of the measurement tools. How would you assess them in terms of how clearly defined the indicators are, how relevant and legitimate they are, and how transparent their data sources are (see Chapter 4 for a discussion of these criteria)? 3. Can you suggest any other indicators that measure the broader contextual factors discussed in this chapter? REFERENCES AND FURTHER READING This chapter is based on The OPERA Framework: Assessing compliance with the obligation to fulfil economic, social and cultural rights, published by CESR in 2012. The following references are also recommended for further reading: CESR (2012), Assessing fiscal policies from a human rights perspective: Methodological case study on the use of available resources to realize economic, social and cultural rights in Guatemala Department for International Development, United Kingdom (2009), Political Economy Analysis How To Note Swedish International Development Cooperation Agency (2013), Power Analysis: A Practical Guide University of Sydney [VIDEO], Mapping for Human Rights and Social Justice Violations 136