Description
Social accountability for development governance is now widely acknowledged as significant for international development research and practice. But, how can a human rights-based approach to accountability be meaningful to the enhancement of the right to health and social inclusion of the most marginalised in society? This paper turns the attention to what we identify as a performance gap in terms of what the right to health as a normative framework and national policy encourages states to do and institutional arrangements and power relations that underpin everyday practices affecting the lived experience of the right to health by citizens. The performance gap suggests that despite availability of health services, the way they are discharged generates negative relations between citizens/community and the services if these are of substandard quality, inaccessible or without due respect. We explore this in Brazil despite existing legal specificity, the fulfilment of the right to health is contingent on eliminating structural and cultural barriers that affect individual dignity and the enjoyment of rights of disadvantaged social groups in society, particularly women in rural, poor settings. We argue that the tensions between provision of health services and the ground of the duty (dignity of a person) limit SDGs on health and gender equality and thus we call for a more meaningful discussion about rights-based accountability for inclusive development.
