Establishing a child rights, health equity, and social justice-based practice of pediatrics.

From the University of Florida, College of Medicine-Jacksonville, Jacksonville, FL; Program of Social Sciences and Health, FLACSO (Latin American School of Social Sciences), Buenos Aires, Argentina; Child Rights Education for Professionals (CRED-PRO), IICRD, University of Victoria, Victoria, British Columbia, Canada; Observatory of Child Rights, National University, Bogota, Colombia; Department of T he United Nations’ Convention on the Rights of the Child (CRC) came into force 25 years ago as the first human rights document focused solely on children. The articles of the CRC are concordant with the underlying precepts of pediatrics and public health. Yet, despite ongoing changes in the social-ecology of health, more than a halfcentury of enlightenment as to the relevance of human rights to the health and well-being of children, and rapid advances in social epidemiology and the life course sciences, the principles of human rights, health equity, and social justice have not been integrated into health professional training. Neither have they been incorporated into standards for the delivery of health care, development of health systems, and generation of public policy. To remain relevant, healthcare and health systems must function at the intersection of health and human rights. The availability of rights, equity, justice-based strategies and tools (Table I), and the principles and standards of numerous human rights documents—including the United Nations’ CRC (1979), Ottawa Charter for Health Promotion (1986), African Charter on the Rights and Welfare of the Child (1999), and United Nations’ Convention on the Rights of People with Disabilities (2006)—make this possible. However, global health systems remain focused primarily on selective strategies to promote child survival in low-income countries, and access to health care and biomedical approaches to health in midand upper-income nations. Global public and private sector health policies, systems, and practices have arguably not responded to the complexity of the social, economic, political-civil, environmental, and cultural factors that generate health. They have not engaged rights, equity, and justice-based approaches to health policy, systems, and practice. This chasm between knowledge and experience and policy and practice must be acknowledged and addressed through medical education and research that is informed by the principles of human rights, health equity, and social justice. Toward these ends, the following general principles are presented to serve as the foundation and framework for the formulation of a rights-, equity-, and justice-based approach to pediatrics. They reflect the norms and stan-