CREATE: Introduction

A children’s rights curriculum for health workers

The CREATE curriculum is designed to provide health workers in Ethiopia, Kenya, Tanzania and Uganda with a general introduction to children’s rights and their application to day to day work practice. It has been developed through a partnership between the MS Training Centre for Development Co-operation based in Arusha, the Open University in the UK and Child Rights Education for Professionals (CRED-PRO), an international programme committed to strengthening understand and application of children’s rights in professional practice. It was produced with the active engagement of 10 authors from the four participating countries, including representatives from government, academia, professional practice and the NGO sector. The material in the curriculum has also been reviewed by a broad range of experts from all four countries. Funding for the programme was provided by the Oak Foundation in Geneva with additional support from Opito.

All four countries have ratified both the UN Convention on the Rights of the Child and the African Charter on the Rights and Welfare of the Child. However, to date, relatively little training has been introduced to help health workers understand children’s rights and their implications for their daily work. The Committee on the Rights of the Child, the international body established to monitor how well governments are doing in implementing children’s rights, has recommended to the governments of Ethiopia, Kenya, Tanzania and Uganda that they should ensure that all professionals working with children are trained in the Convention on the Rights of the Child. This curriculum is seeking to contribute to that goal. A culture of respect for children’s rights will only be achieved if all relevant professionals have a strong knowledge of what rights children have, and how to apply this knowledge in their day to day practice.

The curriculum is available online at The Open University Open Learn website. It can also be downloaded as a pdf. It can be used by individuals wishing to learn more about children’s rights or it can be used by tutors, teachers, or lecturers wishing to incorporate children’s rights into their professional courses. It is an open educational resource, with few copyright restrictions, so can be adapted to accommodate the needs of particular students, or for relevance to other countries. It can be used as a complete course or taken in parts to complement other learning. A tutor guide has also been developed to provide guidance on how to use the materials and incorporate them into training courses.

The curriculum comprises 5 modules each containing between 2-4 study sessions. Each study session provides the student with:

• a focus question that sums up what is being addressed in the session
• key words that needs to be understood by the end of the session
• a short introductory overview
• learning objectives for the session
• basic information on the topic
• a series of learning activities to help the student apply the knowledge gained as they go through the session
• self-assessment questions at the end of the session
• suggested reading or additional resources

The content of the curriculum is as follows:

Module One: Childhood and children’s rights

• Study Session One: Understanding childhood explores the nature of childhood and how it is understood differently in different cultures. This session examines how childhood is understood in East Africa, values and attitudes towards children in the region, and how those attitudes differ towards different groups of children.
• Study Session two: Child development looks at the different stages of development that a child goes through as they mature from birth to 18 years, and the characteristics of children at each stage in terms of physical, social, emotional, mental and moral development. It also highlights the significance of the individual experiences of children in informing their development. Understanding these factors helps guide the health worker in acknowledging and respecting children’s evolving capacities and the levels of protection they need to ensure their optimum well-being.
• Study Session Three: Children’s needs, rights and responsibilities focuses on the broad range of different needs children have if they are to experience safe and healthy childhoods and be enabled to develop fully as they grow up. This session examines what these needs are and introduces the idea that children’s rights provide the basis for the achievement of these needs.

Module Two: Children’s right and the law

• Study Session One: International and regional law introduces the United Nations Convention on the Rights of the Child (UNCRC) and the African Charter on the Rights and Welfare of the Child (ACRWC). It provides guidance on the key rights that they contain, and the principles that need to inform how they are implemented. It highlights how and why these are relevant for health workers.
• Study Session Two: National laws and policies looks at the measures that have been introduced in Kenya, Uganda, Tanzania and Ethiopia to implement children’s rights into national laws. All four countries have introduced legislation which incorporates the key rights and principles in the UN Convention on the Rights of the Child and the African Charter into their own national legal framework. This session will focus on those areas of the legislation which are of particular relevance to health workers. This knowledge will help health workers understand how to respect children’s rights in their day to day work, and how to recognize and take action if their rights are not being respected by others.
• Study Session Three: The right to health explains what the right to health actually means and its implications. It highlights the importance of a holistic approach to health, recognising that children’s right to health can only be fully realized if all other rights are respected. It will also outline the responsibilities of governments, health services and individual health workers to ensure that the right to health is fully realized.

Module Three: Children’s rights and health practice

• Study Session One: The child as an active participant outlines one of the fundamental rights contained in the UN Convention: the right of children to express their views and have them taken seriously, commonly described as the right to participation. The session will help health workers to appreciate the capacity of children to influence decisions pertaining to their health, by exploring different ways in which children can be actively involved in decision making.
• Study Session Two: Best interests of the child and non-discrimination explores two key principles in the provision of appropriate and effective health services to children: the need to give consideration to the best interests of the child when making any decision that affects that child, and the requirement to ensure that no child is ever discriminated against in relation to accessing health care. It provides guidance on how health workers can apply these principles in their practice.
• Study Session Three: Addressing violence against children explores the nature of violence against children and looks at the impact of neglect, physical, sexual and emotional violence and abuse on children. It explains why it is important for health practitioners to understand about the risk factors for violence against children, and to recognise key signs and indicators for abuse.
• Study Session Four: Child friendly health facilities introduces the idea of health facilities which are designed with children in mind and describes how they can be developed to promote children’s right to be heard, to be inclusive, and to support their best interests in relation to their health. It provides information on suggested standards that should guide the design of health facilities for children and how to produce a charter for children’s rights.

Module Four: Children’s rights in the wider environment: role of the health worker

• Study Session One: Social determinants of health introduces the idea that health is not simply a medical issue based on natural and biological factors and medical interventions, but is also a social issue. Where and how you live, levels of income, and social status, along with many other social and economic factors can have a dramatic impact on children’s health. This session will help the health worker explore these social determinants and understand how they affect children’s health and other rights.
• Study Session Two: Advocating for children’s rights introduces the concept of advocacy and highlights the potential role for health workers in advocating for child rights within and across the communities in which they live. Advocacy is a way to bring about real and positive change in children’s lives.
• Study Session three: Mobilising the community: practical strategies helps health workers understand community mobilization in relation to children rights. It explores the skills and understanding necessary to enable health workers to mobilize a community and promote community participation.

Module Five: Children’s rights: planning, monitoring and evaluation

• Study Session One: Monitoring and evaluation in your practice introduces the concept of monitoring and evaluation to help analyse what is happening to children in local communities. It is a means of helping the health worker measure actions taken to improve children’s right to health and to see if they are making a difference. Monitoring and evaluation are tools that can help workers gain a more detailed picture, to identify patterns, to understand which challenges are common and to understand what kinds of actions are effective in response to these challenges.
• Study Session Two: Action Planning and Implementation looks in more detail at two parts of the monitoring and evaluation process: making and implementing plans. It demonstrates how these processes can be used to help to advance children’s rights. It defines and explores the relationship between objectives, plans and measures of success. In addition, the session highlights the importance of involving children and others in developing plans, to ensure that they are relevant to children’s needs, more likely to be implemented, and more likely to deliver the results that health workers want.