Another strength is that the study presents evidence on the distinction between International Covenant on Economic, Social and Cultural Rights and The Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW) and that CEDAW ratification does not affect women’s rights.

Introduction

Human rights, health and economic development have distinct long histories, which gained attention during the decolonisation in the 1960s and the end of the Cold War in the 1990s.1 Some practical examples of health, human rights and development pertain to HIV/AIDS as well as reproductive and sexual health concerns.2 3 The definition of development as a qualitative change in environmental, social and economic principles has close links with human rights and the value of being human. Both civil and political rights (CPR) and economic and social rights (ESR) are deeply interrelated with the right to development.

The Millennium Development Goals (MDG) were created to eradicate several looming problems that threatened progress internationally for optimal health and development in a 25-year plan. After ending the MDG in 2015, the follow-up Sustainable Development Goals (SDGs) aim to maintain growth and reach those countries with low health and development rates. This is done by targeting human rights-oriented goals. In fact, the need for a SDG arose from the lack of emphasis on human rights in the MDG. For instance, Goal 3 of the SDG, ‘Ensure healthy lives and promote well-being for all at all ages’, Goal 5, ‘Achieve gender equality and empower all women and girls’ and Goal 10, ‘Reduce inequality within and among countries’.4 In doing so, the SDG assumes two components of human rights, the CPR and the ESR. Furthermore, these goals extend to women. Thus, altogether combined, the SDG manages to truly impact the promotion of women’s rights and development.

Civilly, there are many charters and documents that acknowledge women’s rights. These include the ‘Maputo Protocol’, the Arab Charter on Human Rights, the Inter-American Convention on the Granting of Civil Rights to Women, the Inter-American Convention on the Granting of Political Rights to Women and the International Covenant on Civil and Political Rights.5 6 Many of the regions in the world have progressed economically through participation in multiple organisations whose objective often omits women as a crucial factor in their plans.7 8 Thus, women’s ESR (WESR) is often stagnated in many of the countries in these regions. Despite their contributions, WESR and CPR seem to be often overlooked. This has a severe impact on women’s health and development.

Promotion of CPR is not sufficient in paving the way for health and development. Of the 30 countries with greater than 30% female parliament members, regional Africa hosts a third of those nations.9 One would assume a state with a high indicator of women’s CPR (WCPR) would also have a high ranking in development and WESR. Yet, despite this, the region of Africa does not share the developmental progress its indicators foreshadow. Limited accessibility to the three capitals: financial capital, human capital such as skills and experience, and social capital such as networks and communities could deprive women of the opportunities they need in order to impact the sustainable development of the nation.10 While states with history of WCPR can find change in WESR to be more easily facilitated,11 a greater cooperation between states and the UN agencies is necessary for new policies to make health and development a global priority with respect to WESR. In this respect, a turning point was the 1994 International Conference on Population and Development. Correspondingly, United Nations Population Fund (UNFPA) links human rights with sexual and reproductive health and reproductive rights. The UNFPA approach is centred on the view that human rights system is related with reproductive health.12 Given that women make up approximately half of the population, and their higher morbidity rates on average,13 a lack of ESR also prevents optimal health and retards them from partaking in a nation’s gross domestic product, social services and, in turn, injures development.

In redesigning health policies with these implementations, it is important to know the extent to which different human rights issues impact health outcomes and development. For example, it is important to know whether one set of human rights issues, such as ESR, have greater impact on health than another set of human rights issues such as CPR. Furthermore, one must understand the gender disparity on the protection of women with respect to ESR and CPR so their ramifications on health and development can be explored. This may provide states a framework in structuring and placing special emphasis on certain women’s rights policies for enhanced progress of health outcomes and development.

Interestingly, many countries have legal documents enshrining women’s rights. However, despite these legislative tasks, WESR are still left wanting. The Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW), an international bill of rights for women, consists of 30 articles that define what constitutes as discrimination against women alongside setting up regulations against such actions in an attempt to alter the gender disparity with limited success.14 Discrimination against women is noted as any distinction, exclusion or restriction made on the basis of sex that impairs the recognition, enjoyment or exercise by women. The states that ratified CEDAW are required to ensure gender equality into their legislation, repeal all discriminatory provisions and must take steps to eliminate all forms of gender discrimination.13

The strengthening of female rights would be in the best interest of men and society, due to the complex relationships that connect men and women. Ratified by 187 nations, the CEDAW has not influenced awareness on the importance of women’s rights. To this extent, the SDG should take into consideration the benefits reaped from fulfilled women’s rights and learn from the shortcomings of the MDG and CEDAW. It is imperative to understand the relative impact of different human rights issues on health outcomes and development. Concerning the global issues pertaining to reproductive and sexual health, women have been instrumental in making the connections between health and human rights.

This study aims to contribute to the larger field of human right empiricism in global health. The field began with an article in the Lancet a decade ago,15 after which the human rights community criticised the methodology of the study.16 The works eventually gave rise to the Hunt and Bustreao monograph.17 The monograph was only the start of a larger effort to examine the public health impact of human rights and a stream of literature exists on correlation of health and human rights. For a brief review on the current literature, see, for example, Todres18 and Forman, Kenyon and Brolan.19 The aim of this study is to contribute to the larger literature on human rights and health by specifically examining the correlation between protection of WESR and health outcomes in comparison to ESR and CPR. The aim is to investigate the correlation of women’s rights separate from the role of ESR and CPR on achieving improvements in health outcomes.