A Heuristic Governance Framework for the Implementation of Child Primary Health Care Interventions in Different Contexts in the European Union

Abstract

To adopt and implement innovative good practices across the European Union requires developing policies for different political and constitutional contexts. Health policies are mostly decided by national political processes at different levels. To attain effective advice for policy making and good practice exchange, one has to take different models of governance for health into account. We aimed to explore which concepts of governance research are relevant for implementing child health policies in a European Union context. We argue that taking into account the insights of good intersectoral and multilevel governance in research and practice is essential and promising for future analyses. These governance concepts help to understand what actors and institutions are potentially of relevance for developing and implementing child-centric health care approaches not only within health care but also outside health care. The framework we developed has the potential to advise on and thus support effectively the spreading and implementation of good practices of child-centric health policy approaches across the European Union. With this heuristic framework, the variety of relevant stakeholders and institutions can better be mapped and taken into account in implementation processes. Also, the normative side—particularly stressing values that make governance “good governance”—is to be taken into account.

Operationalising children’s rights principles: an indicator framework for policy analysis

“…Several attempts have been made by scholars, UN agencies, and NGOs to create a comprehensive list of human rights principles. Generally, the central principles of a human rights-based approach (HRBA) can be captured by the acronym P.A.N.E.L, meaning participation, accountability, non-discrimination, empowerment, and linkage to human rights (UNESCO and UNICEF 2007;Vandenhole 2013;Gabel 2016).…”

“…For example, the provision of childhood services and educational opportunities for children is premised on the recognition that children have a right to those services, instead of justifying such investments or provisions by constructing children as social capital (Tobin 2011). Therefore, the analysis should define the problem that the public policy of interest aims to solve as violations of children's rights in accordance with international and regional children's rights laws and instruments, the national constitution, and national laws and regulations, recognizing children as primary rights-holders and states as responding duty-bearers (Gabel 2016). At the same time, the principle of interdependence and indivisibility of rights, which highlights the equal status and the inclusion of economic, social and cultural rights alongside civil and political rights, should also be applied as a lens for looking at public policies and children's rights violations (UN Committee on the Rights of the Child 2003).…”

“…child rights-based approach to food marketing (UNICEF 2018) or evaluation tool for anti-violence initiatives, including policy programmes (Paré and Collins 2017). There are also rights-based frameworks specifically designed to address children's rights and children's well-being, for example a rights-based approach to children health (Cadge 2011), rights-based approach to monitoring children well-being (Kennan et al 2011), rights-based programming for children in conflict-affected areas (Seitz 2012), policy imperatives for children's well-being (Kickbusch 2012). In addition to all that, a number of practical guidelines and toolkits with a focus on mainstreaming children's rights have been developed, such as the EU-UNICEF Child Rights Toolkit (UNICEF 2014) in which many child rights-integrated instruments are proposed to ensure that children's rights are given priority by policy makers throughout the political and decision-making agendas and processes.…”

“…Despite many efforts, a full and comprehensive framework for a children's rights-based approach to policy analysis is missing (Byrne and Lundy 2019) and this is exactly the gap that this paper aims to address. In fact, building on some existing frameworks (Save the Children 2007 and2011;UNICEF 2009 and2014;Kickbusch 2012;Gabel 2016), this work aims to operationalise specific indicators in order to capture the extent to which children's rights principles are respected, protected and promoted in states' processes of implementing and realising children's rights. More precisely, the proposed framework can be applied to public policy and programmes to assess whether they have progressed, regressed, or had no effects on the realisation of children's rights, as well as to evaluate whether both the process and outcomes of public policy are aligned with children's rightsbased principles.…”

“…However, with an ambition to capture the extent to which children's rights principles are respected, protected and promoted in states' processes of implementing and realising children's rights, this article aims to develop indicators for cross-cutting principles building on and compiling existing frameworks. These include the frameworks of child rights programming developed by Save the Children ( 2007), UNICEF ( 2009), Save the Children Sweden (2011), and UNICEF ( 2014), the work on policy imperatives for children's well-being (Kickbusch 2012), and Gabel's work on a rights-based social policy analysis (Gabel 2016). An analysis of practice across 12 countries by Lundy, Kilkelly, and Byrne (2013) identified a tendency in both law and policy to merely focus on the four 'general principles', 'best interest of a child', 'right to life, survival, and development', 'non-discrimination', and 'participation' as stipulated respectively by Articles 3.1, 6, 2 and 12 of the CRC.…”