Most children die in low and middle-income countries as a result of
structural injustice, and while it may not be possible to prove causality
between economic policies and breaches of rights, it is possible to audit
policy and practices through the lens of human rights. Child health
advocates need to highlight the fact that technical interventions, in the
absence of action on structural injustice, cannot address the fundamental
causes of poor health. It could even be said that we collude in the fallacy
that injustices can be solved with technical solutions. The determinants of
health, water, food, shelter, primary education and health care are
minimum core human rights, are the rights required for survival and today
should be available to every child (and their families) in all countries.
However, there are national and global limitations on the ability of
countries to determine policy and generate the revenue required for core human rights. The authors conducted a review of the literature on the
main leakages from government revenues in low and middle-income
countries to identify obstacles to children enjoying their right to survival.
Based on the review the authors suggest a framework for an upstream
audit that can be carried out, country by country, to identify barriers in
terms of policies and the generation, allocation and utilisation of revenues.
This audit involves systematically screening the policies and practices of
the main actors: national governments, high-income country partners,
multinational enterprises, and international organisations, for possible
influence on the realisation of human rights. Human rights advocates and
child health associations could lead or commission an upstream audit on
behalf of children in their countries in order to identify the fundamental
causes and real remedies.