Visualizing Rights in Liberia. Kelly Gannon Elizabeth Glatfelter

Transcription

1 Visualizing Rights in Liberia Kelly Gannon Elizabeth Glatfelter Practicum in International Affairs Graduate Program in International Affairs The New School University Center for Economic and Social Rights Advisor: Sakiko Fukuda- Parr May 11, 2011

2 Visualizing Rights in Liberia Table of Contents 1. Introduction 1 2. Right to Education Outcomes 7 Policy Efforts Right to Health Outcomes 15 Policy Efforts Right to Food Outcomes 24 Policy Efforts Right to Water Outcomes 30 Policy Efforts Right to Work Outcomes 36 Policy Efforts Resources National Budget 42 Donor Aid Assessment 49 References 52 Appendix A: Organization of the Poverty Reduction Strategy 55 Appendix B: Public health expenditure in West Africa 56 Appendix C: National Budget of Liberia, Ministry of Finance 57 Appendix D: Total aid to Liberia, all sectors 61 Appendix E: Total aid to Liberia, by sectors 63

3 Visualizing Rights in Liberia Figures Figure 2.1: Less than sixty percent of Liberian students do not complete primary school Figure 2.2: Poor quality of education is exemplified by lack of trained teachers Figure 2.3: Regional inequality in the enjoyment of the right to primary and secondary education Figure 2.4: Inequality in literacy by region and gender Figure 2.5: Progress in the enjoyment of the right to education Figure 3.1: High under- five mortality rates in Liberia and among neighboring countries Figure 3.2: Lack of enjoyment of the right to health across West Africa Figure 3.3: Rural and urban inequality and the right to health Figure 3.4: Progressive realization with the right health Figure 4.1: High malnutrition prevalence shows failure to realize the right to health Figure 4.2: Urban and rural inequalities and the right to food Figure 5.1: Insufficient access to water in West Africa Figure 5.2: Insufficient access to sanitation facilities in West Africa Figure 5.3: Unequal access to water and sanitation between urban and rural regions in Liberia Figure 6.1: Insufficient availability of work in West Africa Figure 6.2: Severe poverty illustrates a failure of the realization of the right to work in Liberia Figure 6.3: Economic growth is insufficient to guarantee the right to work Figure 7.1: Liberia ranks lowest in allocation toward education Figure 7.2: Allocation of donor funds by sector, percent of total donor aid, 2005 and 2009 Figure 7.3: Allocation of donor funds for social infrastructure & services, 2009 Figure 7.4: Donor expenditure exceeds Liberian government expenditure Tables Table 2.1: School census by county, 2006 Table 3.1: Lack of health services in Liberian counties Table 4.1: Distance to market indicates inadequate food accessibility Table 5.1: Poor service coverage and the right to water Table 6.1: Women in Liberia are subject to highly vulnerable working conditions Table 7.1: PRS alignment of public expenditure for fiscal years 2008/2009 and 2009/2010 Table 7.2: Total donor aid disbursement to all sectors in Liberia in US$ millions Table 7.3: Top donors to all sectors in Liberia, in USD millions (and % of total donor aid)

4 Visualizing Rights in Liberia 1 1. INTRODUCTION This report examines the realization of economic and social rights in Liberia. According to the Universal Declaration of Human Rights, all people have a right to a life of dignity and a life worthy of a human being. Situations of poverty deny the individual a life of dignity. It aims to graphically illustrate the most recent statistical data available to help assess Liberia s compliance with the International Convention on Economic, Social, and Cultural Rights (ICESCR) and other international standards Liberia has adopted. This report focuses on five rights that are fundamental in achieving an adequate standard of living: health, education, food, water and sanitation, and work. International Covenant on Economic, Social and Cultural Rights, Article 2 1. Each State Party to the present Covenant undertakes to take steps, individually and through international assistance and co- operation, especially economic and technical, to the maximum of its available resources, with a view to achieving progressively the full realization of the rights recognized in the present Covenant by all appropriate means, including particularly the adoption of legislative measures. 2. The States Parties to the present Covenant undertake to guarantee that the rights enunciated in the present Covenant will be exercised without discrimination of any kind as to race, colour, sex, language, religion, political or other opinion, national or social origin, property, birth or other status. 3. Developing countries, with due regard to human rights and their national economy, may determine to what extent they would guarantee the economic rights recognized in the present Covenant to non- nationals. The report analyzes quantitative data on socioeconomic outcomes to assess rights enjoyments and key policy documents to analyze conduct of the state as the duty bearer. In addition it examines the conduct of the international community through donor aid. General Comment 3 of the ICESCR outlines the international, legally binding obligations of the state as the primary duty bearer responsible for upholding economic and social rights. 1 However, according to international law, international cooperation for development and thus for the realization of economic, social and cultural rights is an obligation of all States. It is particularly incumbent upon those States with are in a position to assist others in this regard. 2 Therefore, since the actions of these external actors affect the achievement of the full realization of rights, they should also be held accountable. Key Findings Dismal level of enjoyment of human rights. Only forty- percent of teachers are trained. 3 There is one doctor of every 71,000 person. 4 One in five children under five years are malnourished. 5 Seventeen percent of Liberians have access to improved sanitation facilities and sixty- eight percent have access to improved water sources. 6 Among Liberians who are employed, eighty- six percent are living below US $1 (PPP) per day. 7 1 Committee on Economic, Social and Cultural Rights (CESCR), General Comment 3. 2 CESCR, 1990, General Comment 3, paragraph World Bank, PRS, World Bank, World Bank, MDGs, 2010.

5 Visualizing Rights in Liberia 2 Aggregate Progress. Progressive realization is a human rights principle that assesses the movement toward improving the level of attainment for economic and social rights. In spite of poor results, government conduct shows significant efforts to prioritize human rights in Liberia. 8 The Poverty Reduction Strategy (PRS), Liberia s key policy document, includes objectives to improve availability, accessibility, acceptability, adaptability, and quality. For example, the government prioritizes increasing the numbers and training of healthcare workers, rehabilitating health infrastructure, and supporting information technological systems. Neglect of gender and regional disparities. Despite aggregate progress, across Liberia the state and donors have systematically ignored particular inequalities. Efforts to realize human rights have failed to adequately address achievements in gender gaps. Unacceptably, 75 percent of rural women are illiterate 9 and 990 women die in childbirth out of every 100,000 live births. 10 Additionally, disparities between regions marginalize the rural interior while resource allocation is focused on the urban coast. Twenty- five percent of Liberians living in urban areas have access to sanitation facilities and a deplorable 4 percent of Liberians living in rural areas have access. 11 Non- discrimination is an immediate and cross- cutting obligation of the state. Overlooking geographical and gender disparities perpetuate inequality in an already divided country. Significant donor resources, lack of accountability. The ICESCR, General Comments, 12 and Universal Declaration of Human Rights 13 obligate all states to resource poor nations through international cooperation. In Liberia total donor expenditure dwarfs that of the government, influencing social and economic rights achievements. International organizations and foreign country involvement prove their roles as duty bearers, as well. Just as the government is responsible to the Liberian people, so too are the external actors. In order to hold donors accountable, transparency of their policy efforts and resource allocation are necessary information for evaluation. Information deficit, lack of transparency. In order to hold actors accountable to the Liberian people, complete transparency is required. However, transparency requires that information be readily available. In Liberia, there is an information deficit with regard to disaggregated data. Both the state and donors are responsible for collecting and disseminating accurate information. Not only does this inform comprehensive policies, but it also provides a mechanism to evaluate conduct. Human rights principles The accountability at the national as well as international level is assessed based not only on results but also on conduct 14 through the obligations to respect, protect, and fulfill by the duty bearer. The obligation to respect human rights means that the state must not interfere with the enjoyment of the right; the obligation to protect means that the state is required to interfere against deprivation of a right 8 See SERF Index, DHS, World Bank, World Bank, See in particular, General Comment 3 on the Nature of States parties obligations and General Comment 2 on International technical assistance measures. 13 See article 22 in the Universal Declaration of Human Rights, 1948: Everyone, as a member of society, has the right to social security and is entitled to realization, through national effort and international co- operation and in accordance with the organization and resources of each State, of the economic, social and cultural rights indispensable for his dignity and the free development of his personality. 14 See Fukuda- Parr, Millennium Development Goal 8: Indicators for International Human Rights Obligations?

6 Visualizing Rights in Liberia 3 by a third party; the obligation to fulfill means that the state must facilitate access for the enjoyment of the rights by every individual and ensure the needs of the individual are secured when unmet by personal efforts. Furthermore, the duty bearer must respect, protect and fulfill these rights through progressive realization, the employment of maximum available resources, and meet minimum essential levels as outlined by the ICESCR and General Comment 3. Progressive realization recognizes that the full realization of all economic, social and cultural rights will generally not be able to be achieved in a short period of time. 15 States must, therefore, take steps toward full realization and cannot retrogress which requires the use of maximum available resources. The minimum core obligations as outlined in the individual rights articles of the ICESCR and their own general comments require the state to use all resources that are at its disposition in an effort to satisfy, as a matter of priority, those minimum obligations. 16 Included in the minimum obligations is the immediate responsibility to guarantee that all rights are upheld without discrimination. 17 Human rights are equal rights shared by all and therefore the provision of each right requires that the duty bearer must not discriminate among groups and individuals. 18 Non- discrimination is reflected in the legal framework and implementation of state policy, as an immediate and cross- cutting obligation. 19 In addition to the implicit requirement of non- discrimination, further criteria for the implementation of rights through state efforts are outlined through the principles of availability, accessibility, acceptability, adaptability, and quality (AAAAQ). The full realization of each of the rights highlighted by this report necessitates specific conditions that are interrelated and central to policy and implementation. The condition of availability implies adequate infrastructure and human resources, accessibility includes non- discrimination, physical accessibility, economic accessibility and information accessibility, acceptability includes cultural appropriateness, and quality seeks to ensure the highest standard possible. Methodology This analysis employs the OPERA methodology developed by the Center for Economic and Social Rights. Each right will be evaluated based on outcomes, policy efforts, and resources. Outcomes measure trends in the level of enjoyment of the right. This is accomplished by identifying key indicators that are consistent with the human rights principles of minimum core- obligations, non- discrimination and progressive realization. Policy efforts include three elements: identify legal and policy commitments, examine policy content and implementation, and analyze policy processes. Legal and policy commitments are identified in order to assess the obligation to take legislative and other appropriate steps. The examination of policy content and implementation employs the AAAQ criteria and the analysis of policy process addresses participation, transparency and accountability. Resources evaluate allocation, resource generation and budget processes. This step aims to highlight which population groups are benefiting from spending, contrasting spending disparities with disparities in human rights outcomes. 15 CESCR, General Comment 3, paragraph CESCR, General Comment 3, paragraph ICESCR, Article 2, paragraph See Donnelly Universal Human Rights in Theory and Practice, p CESCR, General Comment 20, paragraph 7.

7 Visualizing Rights in Liberia 4 Assessment identifies other determinants, takes into consideration the state s constraints by other international and non- state actors, and determines state compliance. Taken together, the steps of the methodology assess socio- economic policies and outcomes from a human rights perspective to evaluate social and economic rights in Liberia. Applying the human rights framework and OPERA methodology to Liberia, the information and data used to assess the rights situation comes from a variety of national and international sources. For outcomes, this report evaluates data measuring each of the five rights (education, health, food, water and sanitation and work) from international sources such as the World Bank s World Development Indicators, UNICEF and the Millennium Development Goal databases as well as information from national Liberian sources including individual county reports and the Demographic and Health Survey from This report draws from indicators identified by the Office of the High Commissioner for Human Rights (OHCHR). 20 Policy efforts analyzes the Poverty Reduction Strategy (PRS) which outlines the Government of Liberia s strategy to support growth and poverty reduction. The PRS identifies four core strategic areas: security, economic revitalization, governance and rule of law, and infrastructure and basic services. 21 The section on resources analyzes the Ministry of Finance of Liberia s national budget reports as well as data from donor and aid contributions. This report concludes with a final assessment surrounding state obligations and donor obligations with regard to the rights to education, health, food, water and sanitation, and work. The rights were selected because of they represent five key challenges in the struggle against poverty. The scope of this paper does not allow for complete analysis of all economic and social rights, thereby limiting the full visualization of human rights in Liberia. 22 Context War in Liberia crippled the economy, destroyed infrastructure, and has further perpetuated regional divides. Between , the conflict killed an estimated 270,000 people creating thousands of refugees and internally displaced persons. 23 The education sector suffered from destroyed schools leading to generations of people who were unable to get an education. Low literacy rates and a high pool of unskilled workers evidence this effect. Infrastructure suffered in that there was no electricity or piped water throughout the country during those fourteen years. 24 Most striking is the fact that GDP fell 90 percent between 1987 and The impetus for brutal conflict is twofold. First, a large portion of Liberia s population was marginalized and systematically excluded from political governance. 26 The consequence of this limited participation on the part of civil society led to a bloody military coup in 1980 followed by successive governments unable to manage the concerns of excluded portions of the population. Second, economic collapse also 20 In the 2008 Report on Indicators for Promoting and Monitoring the Implementation of Human Rights, the Office of the United Nations High Commissioner for Human Rights (OHCHR), identifies indicators established to measure compliance with international human rights instruments: outcome indicators capture attainments, individual and collective, that reflect the status of realization of human rights in a given context. It is not only a more direct measure of the realization of a human right but it also reflects the importance of the measure in the enjoyment of the right, OHCHR, 2008, p See chart on page 53 in Appendix A on the organizational and management structure of pillars and working groups. 22 Additional rights pertinent to a life of dignity in Liberia include the right to housing and the right to social security. 23 PRS, 2008, p PRS, 2008, p PRS, 2008, p PRS, 2008, p. 14.

8 Visualizing Rights in Liberia 5 contributed to the cause of conflict. 27 Economic gains were concentrated among the elite with little benefit for the majority of Liberians. As tensions rose during the 1980 s, civil war erupted in Divisions between Americo- Liberians and Native Liberians characterized the civil war and persist with the Americo- Liberians concentrated on the coast and the Native Liberians in the rural hinterland. After decades of civil conflict, Liberia s population struggles to build a country that is stable, secure, and honors human rights. Central to this struggle are Liberia s severely constrained resources. Thus, recovery needs have created an opportunity for donors to contribute humanitarian aid as assistance towards Liberia s development. Accountability and non- discrimination connect conflict, poverty, and human rights and need to be addressed in order to secure a life of dignity for Liberians. 28 Effort and dedication to implementing successful rehabilitation policies on the part of both donors and the national government can restore the realization of human rights. 27 PRS, 2008, p See Fukuda- Parr, et al

9 Visualizing Rights in Liberia 6 LIBERIA Population: 3,954,979* GDP (current US$): $876,300,028* GDP per capita PPP (current international $): $396* Aid to GDP ratio: 60%** SERF Rank: 32 out of 99*** SERF Index Value: 83.13*** Ratified Conventions: International Covenant on Economic, Social and Cultural Rights (ICESCR); International Covenant on Civil and Political Rights (ICCPR), International Convention on the Elimination of all Forms of Racial Discrimination (CERD); Convention on the Elimination of all Forms of Discrimination Against Women (CEDAW); Convention on the Rights of the Child (CRC). * World Bank, ** Calculated from DAC database and World Bank, *** SERF, Source: DHS, 2007.

10 Visualizing Rights in Liberia 7 2. RIGHT TO EDUCATION 1. The States Parties to the present Covenant recognize the right of everyone to education. They agree that education shall be directed to the full development of the human personality and the sense of its dignity, and shall strengthen the respect for human rights and fundamental freedoms. They further agree that education shall enable all persons to participate effectively in a free society, promote understanding, tolerance and friendship among all nations and all racial, ethnic or religious groups, and further the activities of the United Nations for the maintenance of peace. 2. The States Parties to the present Covenant recognize that, with a view to achieving the full realization of this right: (a) Primary education shall be compulsory and available free to all; (b) Secondary education in its different forms, including technical and vocational secondary education, shall be made generally available and accessible to all by every appropriate means, and in particular by the progressive introduction of free education; (c) Higher education shall be made equally accessible to all, on the basis of capacity, by every appropriate means, and in particular by the progressive introduction of free education; (d) Fundamental education shall be encouraged or intensified as far as possible for those persons who have not received or completed the whole period of their primary education; (e) The development of a system of schools at all levels shall be actively pursued, an adequate fellowship system shall be established, and the material conditions of teaching staff shall be continuously improved. ICESCR, 1976, Article 13. OUTCOMES With 80% of schools destroyed and entire generations that never attended school, the education system in Liberia was severely impacted by the fourteen- year civil conflict spanning two decades. 29 Literacy rates are low among adults, and despite increases in enrollment, access to secondary education is still very limited. The conditions of the school facilities are extremely poor, lacking water and sanitation facilities as well as desks, chairs and textbooks. Universal primary education is the first of the minimum core obligations to realizing the right to education. Despite current primary school gross enrollment rates 30 at about 90 percent (85 percent for females and 95 percent for males), the primary completion rate for School facilities and materials: 1/3 have functioning latrines 22% have sufficient seats 27:1 student to textbook ratio 300:1 students to classrooms in good condition ratio Source: PRS, is only 57 percent. 31 Compared to other countries in West Africa, Liberia falls in middle of its neighbors. 32 This suggests that Liberian children are receiving an inadequate quality of education, leading to a high rate of incompletion across the country. Low completion rates can be a result of poor facilities, lack of materials, physical inaccessibility, discrimination and other factors. With much of the physical structures of schools destroyed during the civil 29 UNICEF, Gross enrollment ratio is the ratio of total enrollment, regardless of age, to the population of the age group that officially corresponds to the level of education shown (UNESCO, 2005). 31 World Bank, Another method of comparison is the SERF Index which looks at the relationship between GDP per capita (PPP) and gross combined school enrollment and primary school completion rate. Liberia ranks second out of 144 core countries (excludes high income OECD countries) with a Core Country Right to Education Index value of (Fukuda- Parr, Lawson- Remer, and Randolph, The International SERF Index Dataset Version ).

11 Visualizing Rights in Liberia 8 conflict, it is not surprising that the quality of education would be affected. The PRS reported in 2008 that only one third of the schools had functioning latrines, one aspect that would not only affect completion and attendance rates but would also affect girls disproportionately compared to boys. Figure 2.1: Less than sixty percent of Liberian students do not complete primary school Sierra Leone Ghana Gambia, The Benin Mauritania Togo Liberia Mali Senegal Guinea Cote d'ivoire Burkina Faso Niger Chad Primary complekon rate, total (% of relevant age group) for West Africa, 2007 & 2008 Source: data from World Bank, Primary complekon rate, total (% of relevant age group) The availability and quality of education can be further demonstrated in indicators that evaluate the number and quality of educators. Teacher to student ratios are key measurements as to the availability of education at the primary and secondary level of education. However, the quality of education provided is shown not just in the number of teachers but also the percent of teachers trained. Of the total teachers in Liberia, only 40 percent are trained for primary education. 33 Among other West African countries, Liberia falls near the bottom of percent of total teachers trained in primary education as shown in figure 2.2. Figure 2.2: Poor quality of education is exemplified by lack of trained teachers Mauritania (2008) Cote d'ivoire (2008) Niger (2008) Burkina Faso (2008) Guinea (2008) Benin (2006) Sierra Leone (2007) Ghana (2008) Liberia (2008) Chad (2008) Trained teachers in primary educakon (% of total teachers) for West Africa (countries with available data) Source: data from World Bank, Percent of primary teachers trained 33 World Bank, 2011.

12 Visualizing Rights in Liberia 9 The Liberia Poverty Reduction Strategy reports that low salaries make teacher retention difficult and only 24 percent of public primary school teachers have the minimum primary school teaching certificate. 34 This low number of trained and reactivated 35 teachers in Liberia is a serious challenge for the education system, questioning the quality and standard of the school system. River Cess County, for example, lacks the data from the 2006 school census that the other counties report but does state that only one third of primary teachers have been trained. 36 Likewise in Maryland County only 33 percent of teachers have been trained while 40 percent are volunteers. 37 The lack of trained and certified teachers in Liberia are an example of limits to the availability and acceptability of education. While priorities to primary education follow human rights guidelines, tertiary education in the form of training teachers is also necessary to increase the availability and quality of education on all levels. TABLE 2.1: School census by county, 2006 Total number of Number of County students teachers Reactivated Trained and reactivated Bomi 11, Bong 800 Gbarpulu Grand Bassa Grand Cape Mount Grand Gedeh Grand Kru Lofa Margibi Maryland Monteserrado Nimba River Cess River Gee Sinoe Source: County Development Committees, The county reports confirm inequalities among regions within Liberia as well. The civil conflict was a result of disparity between the urban and costal population around Monrovia and the rural interior. Education data shows the continuation of inequality between the urban and rural regions of the country. Despite a 90 percent primary gross enrollment rate for the country, if the data is disaggregated by urban and rural regions, differences between the areas can be seen. According to the Demographic and Health Survey done in 2007, urban gross attendance ratio for primary schools was percent while in the rural region it was only 68.2 percent. 38 This shows a stark difference in resource allocation and accessibility with regard to the right to education for all children in the country. Students in rural regions have a significantly lower school attendance ratio which can, among many factors, be attributed to distance from school, income level affecting ability to pay school fees, illness, etc. The trend in inequality continues, not surprisingly, to secondary school attendance. While urban school attendance is 66 percent, its only 27 percent for rural secondary schools PRS, 2008, p The category of trained and reactivated is different from teachers who were simply reactivated as they may not have any formal training (Montserrado County Development Committee, 2008). 36 River Cess County Development Committee, Maryland County Development Committee, DHS, DHS, 2007.

13 Visualizing Rights in Liberia 10 Figure 2.3: Regional inequality in the enjoyment of the right to primary and secondary education gross anendance rako Gross anendance rako of primary and secondary schools, Urban 80 Rural Primary Secondary gross anendance rako Gross anendance rako for primary and secondary schools by region, Primary 80 Secondary Source: data from DHS The sharp decline from primary to secondary school attendance shows a failure to make secondary education generally available and accessible to all by every appropriate means. Furthermore, the disparity between rural access and urban access to secondary education demonstrates regional discrimination. Due to an already struggling education system, then crippled by 14 years of war, entire generations in Liberia never went to school. As seen in figure 2.4, the percent of adult men and women who are literate varies significantly between regions. For example, the population in Monrovia has a much higher literacy rate than the North Western region. Likewise the graph shows a wide gender disparity that increases outside of the urban center. In Monrovia 86.9 percent of men years old are literate while only 65.2 percent of women, years old, are literate. On average though, only 25.9 percent of women in rural regions are literate while 59.9 percent of men are literate. 40 The stark difference between men and women with regard to educational attainment shows clear gender discrimination throughout the country, with particular severity in the rural regions. Gender inequality demonstrates a failure in the area of fulfilling the obligation to provide education that is accessible for all members of the population. Figure 2.4: Regional and gender inequality in education attainment Percent literate Percentage literate of men and women in urban and rural Liberia, Urban Rural Source: data from DHS, Men Women Percent literate Percentage of literate according to region for men and women, Men Women 40 DHS, 2007.

14 Visualizing Rights in Liberia 11 While it might be argued that gender disparity in educational attainment is a result only of the civil conflict, years of inequality between male and female in school enrollment maintained this gap. However as seen in figure 2.5, this gap has decreased over the past thirty years, showing improvement in gender disparity for school enrollment. When the civil conflict began in 1989, it is clear to see the immediate effect on education as school enrollment decreased to a low of 35 percent. Since then, enrollment has increased significantly, with a gross enrollment rate of 113 percent in This high rate that decreases by 2008 may be explained by the number of children enrolled in primary school despite being above primary age given the high number of children who missed school during the war. The net enrollment for 2000 was only 75 percent, showing a significant difference between primary aged children enrolled and total children enrolled in school. 41 Figure 2.5: Progress in the enjoyment of the right to education 140 School enrollment, primary (% gross), Liberia 120 percent gross enrollment Male Female Total School enrollment, primary (% gross) Male Female Total Source: data from World Bank, World Bank, 2011.

15 Visualizing Rights in Liberia 12 POLICY EFFORTS The Committee on Economic, Social and Cultural Rights defines the right to education as, at all levels, to be available, accessible, acceptable and adaptable as well as of sufficient quality. Education is both a human right in itself and an indispensable means of realizing other human rights. As an empowerment right, education is the primary vehicle by which economically and socially marginalized adults and children can lift themselves out of poverty and obtain the means to participate fully in their communities. Education has a vital role in empowering women, safeguarding children from exploitative and hazardous labour and sexual exploitation, promoting human rights and democracy, protecting the environment, and controlling population growth. Increasingly, education is recognized as one of the best financial investments States can make. But the importance of education is not just practical: a well- educated, enlightened and active mind, able to wander freely and widely, is one of the joys and rewards of human existence. CESCR, 1999, General Comment 13. Availability of education, on all levels is a serious challenge for Liberia. Availability means functioning institutions and programs, buildings, sanitation facilities and safe drinking water, and trained teachers and materials. Accessibility refers to ensuring that educational systems are non- discriminatory, especially for the most vulnerable groups. It also refers to physical accessibility, the geographic location should be reasonable, and economic accessibility, primary education should be free and secondary education should be gradually made free. Acceptability refers to education that is in form and substance relevant culturally and of sufficient quality. Education should also be adaptable to society and responsive to changes in cultural and societal contexts. With over 46 percent of schools either destroyed or extensively damaged during the war and 35 percent of the population having never attended school, Liberia s education system faces serious challenges. 42 Through the PRS, the Government of Liberia identifies seven policy priorities in order to improve education. The first objective is to strengthen the curriculum. The Government plans to develop and introduce a compulsory core curriculum (language and arts, mathematics, science and social studies) that will be implemented nationwide, together with an optional/complementary curriculum with regional variations. The new curriculum will be adopted by September The curriculum reform follows the criteria of trying to meet the goals of acceptability, adaptability and quality. Furthermore, the PRS highlights that the social studies curriculum will include material on peacebuilding, human rights, HIV and AIDS, civic education and gender based violence. 44 This demonstrates efforts to include curricula that is relevant and that has adapted to the current situation in post- conflict Liberia by addressing present and significant topics. The second objective is to improve access to quality, safe and hygienic schools. According to the PRS, the government will construct new primary and secondary schools, rebuild or repair existing schools, build latrines and install wells and hand pumps, and provide chairs PRS, 2008, p PRS, 2008, p PRS, 2008, p. 112, footnote PRS, 2008, p. 112.

16 Visualizing Rights in Liberia 13 This shows efforts at meeting issues of availability with physical structures of quality and accessibility with geographic location. However, at the time of the March 2010 progress report, this too is not yet a deliverable. The policy however does not specifically address location. With huge disparities between urban and rural regions and between counties, the location of new schools, sanitation and materials is not addressed in the policy. Attention needs to be paid to address this issue in order to avoid regional discrimination. Third is the recruitment and training of qualified teachers: During the PRS period the Government will re- open three Regional Teacher Training Institutes to train between 650 and 1000 new teachers annually. It will extend the field- based in service training to five counties in 2008/2009, nine counties in 2009/2010 and fifteen counties in 2010/2011, and will construct 105 teacher houses in hardship locations. 46 The policy focuses not only on increasing the number of teachers but also the number of formally trained teachers which falls in line with education availability and quality. It is necessary for the realization of the right to education to have enough teachers with the necessary training to provide quality education to the students. This policy shows commitment to this aspect of the right to education and with the severe lack of trained educators, policy object three is very important. Furthermore by opening training institutes in each county, this objective addresses disparities between regions. However, specific information on the location of each training facility would be useful in determining if the policy is in fact, non- discriminatory and physically accessible. The fourth objective in the PRS is to improve learning achievement, school completion rates and the ratio of girls to boys in primary school and secondary school, in line with the Millennium Development Goals (MDGs). The government commits to purchasing and facilitating the publication of textbooks as well as providing in school meals for both genders and take- home rations for adolescent girls. 47 In this policy area, the Government includes availability through committing to provide materials such as textbooks. As seen in the outcomes section, the 2008 ratio was one textbook for every 27 children. 48 Clearly the quantity of education material is lacking, severely impairing the quality of education the children receive. Furthermore it is important that priority is given to gender equality by increasing the girl to boy ratio in both primary and secondary schools. One method is to offer incentives to enroll and retain adolescent girls by providing take- home rations. 49 Another method that addresses gender disparities is building new latrines and sanitation facilities, which is part of the first objective. The fifth policy objective is to strengthen the quality and accessibility of skills and vocational training. The Government intends to do so through a commitment to refurbish and equip four existing multi- lateral high schools, and the two existing vocational and technical institutions so that they can offer skills training; lend support to literacy and skills training in youth centers, including the training of young people as literacy and skills teachers in their communities; and increase the number of skills training center graduates PRS, 2008, p PRS, 2008, p PRS. 2008, p Take- home rations programs that provide basic food items, often including a sack of rice and a can of cooking oil, to families who send their daughters to school (WFP, meals). 50 PRS, 2008, p. 113.

17 Visualizing Rights in Liberia 14 Included in the right to education is also a provision for technical and vocational education as necessary to realize not just the right to education but also the right to work. 51 The aim here, as recognized in the PRS, is to provide training for the unskilled and unemployed youths, with specific attention to young women. With a significant proportion of the Liberian population without any education due to the war, vocational training and technical schools are critical for the enjoyment of the right to education. The sixth objective is to improve the quality of tertiary education. The Government, in this policy aims to ensure that all institutions of higher learning review and revise their curricula under the leadership of the MoE and the National Commission for Higher Education (NCHE); a revised national accreditation scheme is operational and being enforced by a strengthened NCHE; qualified and experienced faculty and administrators are trained and recruited; and arrangements are initiated for the establishment of at least one new institution of higher learning outside of Monrovia. 52 As noted in the PRS, focus on tertiary education, while also a right in itself, is important for the achievement of primary and secondary education as well with its role in teacher training, administrators and role in developing curriculum and textbooks. The priority of higher education demonstrates an effort for progressive realization as well. 53 The seventh and last objective in the PRS on education is to strengthen the overall governance, management and financial basis for the educational system. The Ministry of Education plans to upgrade the quality of the staff in planning, procurement, and financial management. One key action will be the continued reduction of ghost names on the sector s payroll and the establishment of a teacher database. 54 This particular objective is crucial in the fulfillment of the previous six objectives by recognizing the importance of continued governance and review of educational policies as an ongoing and necessary component to the educational system. General Comment 13 points out the importance of a state developmental strategy that must be continuously improved in order to promote, maintain and improve the overall accessibility, acceptability, adaptability and quality of education. The PRS addresses many of the obstacles in realizing the right to education especially given the outcomes seen in the previous section. However, despite the prioritization of these seven objectives, questions still remain. For example, the first objective gives priority to a new curriculum; how will the government ensure that the new curriculum is of the highest quality standard possible? The second objective shows efforts to increase and improve facilities and building structures, suggesting improved access but are these new schools and classrooms targeting regions that are already underserved? Is there enough oversight and monitoring of the quality of these structures? Another gap in the policy plan is lack of attention to adult educational opportunities. While there is focus on vocational training, basic education for the high percent of Liberians who are illiterate is not addressed, particularly with regard to rural women. Even with these challenges, the PRS policies give priority in their content to the human rights principles outlined in General Comment 13, especially with regard to the AAAQ criteria. 51 See CESCR, 1999 General Comment 13 on the Right to education, paragraphs and CESCR, 2005, General Comment 18 on the right to work. 52 PRS, 2008, p See CESCR, 1999, General Comment 13 on the Right to Education, paragraphs PRS, 2008, p. 113.

18 Visualizing Rights in Liberia RIGHT TO HEALTH (1) Everyone has the right to a standard of living adequate for the health and well- being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control. (2) Motherhood and childhood are entitled to special care and assistance. All children, whether born in or out of wedlock, shall enjoy the same social protection. The Universal Declaration of Human Rights, article 25. OUTCOMES Liberia continues to struggle with providing adequate health care to its population. While there has been a move away from emergency health care responses towards development of the health sector, many people remain without access to health services. For Liberia, attaining health as a human right requires that certain aspects of the health system be in place. According to the PRS, Liberians major concerns about the health sector revolve around their lack of financial and physical access to healthcare, as well as quality of healthcare delivery. In general, healthcare is more accessible and of better quality in urban areas than rural areas. 55 Infant mortality rates and under- five mortality rates are two of the most important indicators for measuring the right to health. 56 These indicators not only measure mortality rates from a statistical perspective, but also indicate the social and economic factors that contribute to the measurements outcome. For instance, high infant mortality and under five mortality rates suggest a lack of child and maternal health care, insufficient sexual and reproductive health services, inadequate water and sanitation infrastructure, and poor nutrition. 57 Health is a fundamental human right indispensable for the exercise of other human rights. Every human being is entitled to the enjoyment of the highest attainable standard of health conducive to living a life in dignity. The realization of the right to health may be pursued through numerous, complementary approaches, such as the formulation of health policies, or the implementation of health programmes developed by the World Health Organization (WHO), or the adoption of specific legal instruments. Moreover, the right to health includes certain components, which are legally enforceable. CESCR, 2000, General Comment 14, paragraph 1. In some counties pregnant woman walk hours to reach a health clinic to find that there are no medicines, no trained doctors, or no clean water. In a situation like this the woman is likely in poor health, jeopardizing the health of the infant. If the pregnancy involves complications, this can result in death for the infant when faced with health facilities that are unable to address emergency obstetric procedures. Therefore, measuring the infant and under- five mortality rates demonstrate more than just statistics; they demonstrate the realization of the right to health in Liberia. 55 PSP, 2008, p These three indicators are consistent with the Millennium Development Goals measurement of goal 4, reducing child mortality. 57 See CESCR, 2000, General Comment 14 on the right to the highest attainable standard of health.

19 Visualizing Rights in Liberia 16 Figure 3.1 displays the under- five mortality rates across countries in West African in 2009, showing that Liberia ranks twelfth in the region. While Liberia has a relatively lower rate than its neighbors, 112 deaths per 1,000, the right to health is still not being realized to the fullest extent. 58 Figure 3.1: High under- five mortality rates in Liberia and among neighboring countries Under- five Mortality Rates in West Africa, 2009 Chad Guinea- Bissau Sierra Leone Mali Burkina Faso Niger Guinea Nigeria Cote d'ivoire Benin Mauritania Liberia Gambia, The Togo Senegal Ghana Source: data from World Bank, Mortality Rate, Under- five (per 1,000) Another way to measure the outcome of the realization of the right to health is through the maternal mortality ratio. 59 Multiple reasons contribute to high rates of women dying during pregnancy and childbirth, for instance, inadequate healthcare facilities for emergency obstetric, shortage of trained doctors, and a lack of access to health care centers. Compounding these factors are common situations of poor nutritional status in pregnant women, high fertility rates, and high numbers of teen pregnancy. In this way, the maternal mortality ratio is an important indicator to measure health standards. Figure 3.2 compares GDP per capita and maternal mortality ratio to show the relationship between income and healthcare in West Africa. Liberia has the third highest maternal mortality ratio at 990 deaths per 100,000 live births but also has the lowest GDP per capita at US$ 391. Comparatively, Niger has a GDP per capita of US$ 704 and a lower maternal mortality ratio of 820 deaths per 100,000 live births. Togo, alternatively, has a much lower maternal mortality ratio of 350 despite a GDP per capita of only US $ It s not surprising that Liberia s low achievements in healthcare fall in line with low income. 61 Despite understandable rankings among neighboring countries, low income does not reduce the importance of a desperate need for improved health services. 58 World Bank, See Millennium Development Goal 5, Maternal Health. 60 World Bank, Taking the low GDP per capita into account, the SERF Index ranks Liberia 74 out of 136 Core Countries with a Right to Health Index value of out of 100. The Right to Health Index is calculated based on GDP per capita (PPP), percentage child (under 5) survival rate, percentage age 65 survival rate and contraceptive use rate (percentage couples age 15 to 65). (Fukuda- Parr, Lawson- Remer, and Randolph, The International SERF Index Dataset Version ).

20 Visualizing Rights in Liberia 17 Figure 3.2: Lack of enjoyment of the right to health across West Africa Maternal Mortality Rako per 100,000 live births Relakonship Between GDP per capita and Maternal Morality Rako, 2008 Liberia Niger Guinea- Bissau Sierra Leone Guinea While Liberia s health achievements are comparable to other West African countries, the struggle lies within the differences among regions of Liberia. For Liberians who live in counties where access to health services is limited, the under- five mortality rates and maternal mortality rates are likely higher. Figure 3.3 demonstrates the under- five mortality rates by regions. The South Central counties of Montserrado, Margibi, and Grand Bassas appear to have the highest under- five mortality rates of 182 per 1,000 births. 62 This indicates a lack of government commitment to providing needed health care resources and to invest in the realization of the right to health. Furthermore, it raises concerns about the need to provide adequate medical care in the form of doctors and nurses to support the right to health for women and children. Mali Chad Figure 3.3: Rural and urban inequality in the right to health Nigeria Burkina Faso Mauritania Benin Cote d'ivoire Togo The Gambia Ghana Senegal GDP per capita, PPP (current internakonal $) Source: data from World Bank, Under- five mortality Rates by Region South Central North Central North Western South Eastern A South Eastern B Monrovia Rural Urban Rates per 1,000 births Source: data from DHS, DHS, 2007.

21 Visualizing Rights in Liberia 18 The disparities between regions in Liberia highlight unequal access to healthcare, which requires priority attention of both national and donor policy makers. While the urban and rural rates do not vary dramatically, the difference suggests that there is a higher under- five mortality rate in rural areas than in urban areas. All people have equal rights to health services, therefore duty bearers must ensure that discrimination by region is eliminated. However, disaggregated data in Liberia is limited. Thus, other indicators provide additional measurement to illustrate the right to health across Liberia. Table 3.1 provides an overview of the available data regarding number of functioning hospitals and number of full- time doctors per county. Table 3.1: Lack of health services in Liberian counties County Population 63 Functioning Full- time county doctors hospital Bomi 84, Bong 333,481 6 Gbarpolu 83,388 1 Grand Bassa 221,693 Grand Cape Mount 127,076 Grand Gedeh 125, Grand Kru 57, Lofa 276, Margibi 209,923 2 Maryland 135, Montserrado 1,118, Nimba 462,026 River Cess 71, River Gee 66, Sinoe 102, Source: data from LISGIS and County Development Committees, PRS notes that there is approximately one physician for every 70,000 Liberians. 64 The table illustrates a general trend that there are less health services available to people living in more rural areas. For instance, there are zero full- time doctors in Grand Gedeh and River Cess, which are located in the rural region of South Eastern A; and in Grand Kru and River Gee, which are located in the rural region of South Eastern B. Likewise, in Montserrado County, there are 97 doctors for 6 functioning hospitals. While there is a much larger population in this urban county, there are far more doctors available to those people. Therefore, there are stark urban and rural disparities in the realization of the right to health that are consistent through both the available health care facilities and the number of full- time doctors. Drawing on disaggregated data by county helps explain the profound geographical disparity in realizing the right to health. For example, in Bong County, located in central Liberia, there is no formal system of health administration and of the 33 clinics, 26 are supported by international NGOs. 65 In the northern- most county of Lofa, all of the 53 health facilities were destroyed during the war and since then 49 have been rehabilitated and are managed by international organizations. 66 River Gee, in southeastern Liberia, has no doctors and inconsistently paid volunteers provide all health care. 67 Despite a struggling health care system, Liberia is making progress in achieving a reduction in infant mortality rates. This trend illustrates a clear alignment with civil conflict in Liberia as infant mortality increased between 1985 and Since the end of the war infant mortality rates have fallen by 50 percent. Figure 3.4 shows that the infant morality rate in 2009 was 80 per 1,000 live births in contrast to 63 National Population and Health Census, LISGIS, PRS, 2008, p Bong County Development Committee, Bong County Development Agenda. p Lofa County Development Committee, Lofa County Development Agenda. p River Gee County Development Committee, River Gee County Development Agenda. p. 23.

22 Visualizing Rights in Liberia 19 a rate of 165 per 1,000 in This improvement from the high rates during the war may be attributed to a shift away from emergency health care to development of the health sector. Figure 3.4 Taking steps to reduce infant mortality Infant mortality (per 1,000 live births) Mortality rate, infant (per 1,000 live births) Source: data from World Bank, While it is beyond the scope of this analysis to address all relevant indicators, it is useful to consider indicators like immunization rates and prevalence rates for HIV, to highlight the many factors that contribute to the realization of the right to health. The measles immunization rate is one example that progress has not been achieved. The 1999 immunization rate for Liberia was 69 percent of children ages months. However, in 2009 the measles immunization rate was only 64 percent of children months. 69 If progress were being made in the realization of health rights, immunization rates would be increasing over time. Presumably high immunization rates would indicate low death rates due to the prevention of disease. While the decline is not drastic, it is important to note that this health information affects the highest attainable standard of health. 68 World Bank, World Bank, 2011.

23 Visualizing Rights in Liberia 20 POLICY EFFORTS The Committee on Economic, Social, and Cultural Rights (ICESCR), maintains that the right to health should, at all levels contain the following interrelated and essential elements: availability, accessibility, acceptability, and sufficient quality. Health is a fundamental human right indispensable for the exercise of other human rights. Every human being is entitled to the enjoyment of the highest attainable standard of health conducive to living a life in dignity. The realization of the right to health may be pursued through numerous, complementary approaches, such as the formulation of health policies, or the implementation of health programs developed by the World Health Organization (WHO), or the adoption of specific legal instruments. Moreover, the right to health includes certain components which are legally enforceable. CESCR, 2000, General Comment 14, paragraph 1. Availability: Functioning public health and health- care facilities, goods and services, as well as programs, have to be available in sufficient quantities within the State party. They will include, however, the underlying determinants of health, such as safe and potable drinking water and adequate sanitation facilities, hospitals, clinics and other health- related buildings, trained medical and professional personnel receiving domestically competitive salaries, and essential drugs, as defined by the WHO Action Program on Essential Drugs. Accessibility: Health facilities, goods and services have to be accessible to everyone without discrimination and including physical, economic, and informational accessibility. Acceptability: All health facilities, goods and services must be respectful of medical ethics and culturally appropriate. Quality: Health facilities, goods and services must also be scientifically and medically appropriate and of good quality. This requires, inter alia, skilled medical personnel, scientifically approved and unexpired drugs and hospital equipment, safe and potable water, and adequate sanitation. Almost 40 percent of Liberian children are growth- stunted from poor nutrition and one in five deaths in children under- five is caused by malnutrition. 70 According to the Poverty Reduction Strategy, Liberia s health sector is moving away from an emergency phase, towards a development phase with ever- limited access to health services. 71 The Liberian government initiated the National Two- Year Transition Plan in 2006 and in 2007 developed a comprehensive National Health Policy and Strategic Plan. However, health challenges remain and there is a need for a secure and functioning health care system. Consistent with the AAAQ principles of the right to health, the overall goal of the new health policy is to expand access to basic health care of acceptable quality and establish the building blocks of an equitable, effective, responsive, and sustainable health care delivery system across Liberia. 72 To reach this goal, the government aims to ensure that 70 percent of health facilities provide basic health 70 PRS, 2008, p PRS, 2008, p PRS, 2008, p. 109.

24 Visualizing Rights in Liberia 21 Key Targets: - To ensure that 70% of health facilities in each county are providing the Basic Package of Health Services (BPHS) by December To further reduce the child mortality rate by 5-10 percent over the same period Source: PRS, services 73, reduce the child mortality rate by ten to fifteen percent, and reduce the maternal mortality rate by five to ten percent. 74 The first priority in an effort to accomplish two key targets is to build human resources. Specifically this looks at Liberia s ratios of physicians, nurses, and midwives. The Ministry of Health wants to identify, train, and retrain, qualified health personnel and to increase the number of personnel to approximately 6,000-8,000 healthcare workers over the PRS period of 2008 to The plan suggests that by suspending tuition and fees, providing scholarships for specialized health workers, and training 500 certified midwives, the work force of qualified health care professionals will be improved. They also plan to develop the National Human Resources Policy and Plan that will institute incentive schemes, retention programs, and performance measurement systems. 76 This shows attempts at improving the availability of medical care through increasing the number of medical personnel; not only training physicians, but also training other health professionals such as midwives and nurses. Training medical staff demonstrates efforts at achieving improved quality of health care. The second objective of the PRS includes expanding access to the Basic Package of Health Services (BPHS). This focuses on 6 national health priorities: maternal and newborn care, child health, reproductive and adolescent health, communicable disease control (including HIV and AIDS), mental health, and emergency care. Implementation of this health care package will be undertaken by the Liberian government and will be strategically spread to each county with the goal to provide effective and affordable health services to the largest number of beneficiaries. The government will also maintain the suspension of fees until the socio- economic situation improves and financial management systems perform at a level that ensures an even more poverty- focused utilization of revenues. 77 This objective address General Comment 14 s principle of accessibility by committing to expand health services across each county. Specifically, economic accessibility will be improved through the suspension of health service fees and quality increased through services targeting children and mothers as well as disease control, mental health and emergency care. The third priority listed in the PRS for overall improvement in the health sector is to rehabilitate health infrastructure with the construction of health facilities to reach the target of a quality facility within 10 km of every community. 78 During the PRS period, the government intends to rebuild and renovate 250 health facilities and construct rehabilitation centers for mental health and youth. This effort aims to increase availability of facilities and designed to target physical accessibility through strategic placement of new health facilities. However, it is important to recognize that there are no standards listed for the quality of the facilities being rehabilitated. In addition, there is no mention of 73 Basic health services as described in the Basic Package of Health Services policy in objective two of the PRS (2008, p. 110). 74 PRS, 2008, p PRS, 2008, p PRS, 2008, p PRS, 2008, p PRS, 2008, p. 110.

25 Visualizing Rights in Liberia 22 improving water and sanitation facilities within the health infrastructure, a crucial component to availability under General Comment 14. Objective four is to strengthen social welfare programs. Liberia s social welfare programs were not only negatively affected by the conflict, but the conflict created more people in need of the services that were damaged. The government will develop a National Social Welfare Policy and Plan to provide the vision and direction for the social welfare sector to address the needs of the vulnerable and excluded segments of the Liberian population Its will aim to strengthen mental health/trauma healing services under the Policy and Plan to help break the cycle of conflict. 79 This effort addresses non- discrimination with regard to marginalized populations and inequality in concert with General Comment 14 s call for strategies to target discrimination through economic accessibility. The services for mental and physical trauma are especially important to include in the health policy due to years of internal war and conflict. However, the objective leaves out comments regarding the quality of the health services. Many measures, such as most strategies and programmes designed to eliminate health- related discrimination, can be pursued with minimum resource implications through the adoption, modification or abrogation of legislation or the dissemination of information. The Committee recalls General Comment No. 3, paragraph 12, which states that even in times of severe resource constraints, the vulnerable members of society must be protected by the adoption of relatively low- cost targeted programmes. CESCR, 2000, General Comment 14, paragraph 18. The fifth strategic priority is to further develop support systems: The Government will introduce a computerized Health Management Information System (HMIS) by 2009, consisting of supply chain and logistics management systems that forecast demand, facilitate the procurement of medical supplies, and coordinate with county level systems. 80 Part of the intention in this policy plan is to decentralize management responsibilities of primary health services to local governments, while the central Government will be responsible for policies, planning, and standardization. 81 The fifth priority assumes a level of improved quality. Presumably with technological improvements and specialized responsibilities, both local authorities and the national government will be able to enhance their roles in providing better health services. Improved quality is also implicit in the establishment of a reference laboratory and blood bank, as their purpose is to increase the quality of health care. Lacking however is a communication strategy to share information between counties potentially reinforcing regional inequalities. The sixth and last health priority listed in the PRS is to strengthen health financing: the government will not be able to independently fund the health sector without sustained donor support and private provider participation for at least the next 10 years. The MoHSW will collaborate with its partners to develop a national health financing strategy that considers a range of financing mechanisms. In the interim, the Government is working to establish a pooled fund mechanism as a short- term intervention for partners to co- finance and better coordinate their support to the public health sector PRS, 2008, p PRS, 2008, p PRS, 2008, p PRS, 2008, p

26 Visualizing Rights in Liberia 23 This falls in line with health availability as the amount of money given to the public health sector determines the amount of health care available to the population. In addition to that, the amount of money spent of health care can also influence the quality of that care. In the Liberian Poverty Reduction Strategy Progress Report of 2010, there is little mention of exactly how Liberia has achieved the goals they set out to reach. Indicators to measure progress are absent from the document. Achievements include infrastructure rehabilitation, program strengthening, and architectural plans yet indicators to measure progress are absent from the document. 83 A few policy areas need to be developed further. One is the timetable; questions with regard to the feasibility of achieving the goals of improving the health sector need to be acknowledged. While these six priorities include availability, accessibility, and quality, none address acceptability. This raises questions about what guidelines are being followed in establishing for instance, a new rehabilitation center. Will it be culturally appropriate? Will it meet the needs of both genders? Will it reach the people who are in the most need? Will it respect medical ethics? In general, the policy priorities for health improvements in Liberia do address human rights issues as outlined in General Comment 14. With regard to these principles, there is a need for more attention to acceptability and perhaps quality. 83 The Government undertook actions to rehabilitate health infrastructure, strengthen social welfare programs, develop support systems, and strengthen health financing. The architectural standards for hospitals, health centers, and clinics have been developed. With the funding from the World Health Organization (WHO) in the amount of US$12,000, a National Social Welfare Policy and Strategic Plan has been developed and submitted to the Cabinet for endorsement The newly Health Management Information System Unit and the External Aid Coordination Unit are both functioning (Government of Liberia, 2010, p. 30).

27 Visualizing Rights in Liberia RIGHT TO FOOD 1. The States Parties to the present Covenant recognize the right of everyone to an adequate standard of living for himself and his family, including adequate food, clothing and housing, and to the continuous improvement of living conditions. The States Parties will take appropriate steps to ensure the realization of this right, recognizing to this effect the essential importance of international co- operation based on free consent. 2. The States Parties to the present Covenant, recognizing the fundamental right of everyone to be free from hunger, shall take, individually and through international co- operation, the measures, including specific programmes, which are needed: (a) To improve methods of production, conservation and distribution of food by making full use of technical and scientific knowledge, by disseminating knowledge of the principles of nutrition and by developing or reforming agrarian systems in such a way as to achieve the most efficient development and utilization of natural resources; (b) Taking into account the problems of both food- importing and food- exporting countries, to ensure an equitable distribution of world food supplies in relation to need. ICESCR, 1976, article 12. OUTCOMES Lack of food leads to a lack of adequate nutrition that leads to stunting and other health consequences in children. Food insecurity and malnutrition are often the result of inadequate water and sanitation facilities, inadequate access to health services, limited availability and accessibility to food, and the consumption of nutrient- poor food. High underweight 84 and stunting prevalence 85 are outcome indicators that suggest social and economic barriers of access to food. One explanation of high levels of malnutrition is a lack of food accessibility when food is too expensive and beyond the financial means of a family. Another is the quality of food that should meet the dietary needs of the population. A lack of clean water from wells or pumps compounds the situation of malnutrition. Furthermore, when access to food requires hours of walking, the right to food is not being realized. Malnutrition prevalence is a weight for age measurement looking at the percent of children under 5 years old. 86 According to the World Development Indicators (WDI), in Liberia the malnutrition prevalence for children under five years in 2000 was 22.8 percent and in 2007 it was 20.4 percent; these are the only two years for which data exist. 87 It appears that with a decrease in malnutrition prevalence, there have been improvements over time. However, data for two years are not nearly enough to draw accurate conclusions. This is precisely an area for which more information needs to be collected. 84 Underweight (WHO) Moderate and severe: Percentage of children aged 0 59 months who are below minus two standard deviations from median weight for age of the World Health Organization (WHO) Child Growth Standards; Severe: Percentage of children aged 0 59 months who are below minus three standard deviations from median weight for age of the WHO Child Growth Standards (UNICEF, 2010). 85 Stunting (WHO) Moderate and severe: Percentage of children aged 0 59 months who are below minus two standard deviations from median height for age of the WHO Child Growth Standards (UNICEF, 2010). 86 World Bank, World Bank, 2011.

28 Visualizing Rights in Liberia 25 Figure 4.1: High malnutrition prevalence shows failure to realize the right to health Niger Burkina Faso Mali Mauritania (2007) Togo Liberia (2007) Benin Guinea- Bissau Cote d'ivoire Gambia, The Ghana Source: data from World Bank, Malnutrikon Prevalence in West Africa, Malnutrikon Prevalence, weight for age (% of children under 5) Figure 4.1 shows that Liberia ranked sixth among eleven countries in West Africa who have available data for the malnutrition prevalence for children less than five years. 88 Even though Liberia s malnutrition prevalence is average for the region, 20 percent of children are underweight for their age. 89 This rate varies regional within the country, showing that Liberia s struggle lies within geographical inequality. Drawing from disaggregated data by county helps to explain the profound lack of provision of the right to food. However, malnutrition data are present in only one of the fifteen county reports. Grand Kru reports that they have the highest chronic child malnutrition rate at 47.3 percent. 90 Figure 4.2: Urban and rural inequalities and the right to food Regions in Liberia South Eastern A South Eastern B North Central South Central Monrovia North Western Malnutrikon Status of Children Under Five Years rural urban Source: data from DHS, Percent classified as malnourished based on weight- for- age indicator 88 Another method of comparison is the SERF Index which looks at the relationship between GDP per capita (PPP) and percentage children under 5 not stunted. Liberia ranks nineteenth out of 123 core countries (excludes high income OECD countries) with a Core Country Right to Food Index value of (Fukuda- Parr, Lawson- Remer, and Randolph, The International SERF Index Dataset Version ). 89 World Bank, Grand Kru County Development Committee, County Development Agenda, p. 22.

29 Visualizing Rights in Liberia 26 Figure 4.2 illustrates the weight- for- age measurement of under- five malnutrition prevalence in regions within Liberia. 91 Malnutrition in children under five, based on a weight- for- age measure, is worse among people living in rural areas, 20 percent, than in urban areas at 17 percent. 92 This is significant for various reasons. In spite of a higher density of people who are trying to access food, in urban areas there are more resources to accommodate those needs. However, as there is a geographical move away from Monrovia, health facilities and trained medical staff become scarce. A child in a rural area who is suffering from illnesses associated with malnutrition is less likely to be adequately treated than a child living in an urban area. Thus inequality across regions of Liberia is evident in that rural areas are at a disadvantage when it comes to availability and accessibility of access to food resources and health services. Liberia s County Development Agendas include alternative measurements that allow for analysis of the right to food based on the available indicators. The following table provides an overview of two indicators available to each Liberian county that measure the right to food. For instance the walking distance to a weekly market measurement indicates food accessibility. A person from Maryland, the southern- most county in Liberia, who has to walk nearly 4 hours to the market, takes a lot of time out of their day to buy and sell food. Not only do they devote a significant amount of time to reach markets, but also this is time that they are unable on other tasks such as childcare, education, or work. Moreover, this means that there is an absence of public transportation and people are carrying heavy loads for hours from the market. The burden and danger of traveling far disproportionately affects women, indicating an area of potential gender disparity. Table 4.1: Distance to market indicates rural and urban inequality County Average walking distance to market (in hours) Bomi 2.0 Bong Gbarpolu Grand Bassa 2.8 Grand Cape Mount Grand Gedeh 10.8 Grand Kru 3.3 Lofa Margibi 1.8 Maryland 3.9 Montserrado 1.6 Nimba 2.5 River Cess 2.7 River Gee 3.0 Sinoe 3.0 Source: data from County Development Agendas, Includes children who are below - 3 standard deviations (SD) from the International Reference Population median, meaning that both moderate and severe are included (DHS, 2007). 92 DHS, 2007.

30 Visualizing Rights in Liberia 27 POLICY EFFORTS General Comment 12 draws attention to the importance of honoring full respect for the right to adequate food. The right to adequate food is realized when every man, woman and child, alone or in community with others, has physical and economic access at all times to adequate food or means for its procurement. 93 The right to food should at all levels incorporate the following elements: Adequacy: Adequacy underlines a number of factors, which must be taken into account in determining whether particular foods or diets that are accessible can be considered the most appropriate circumstances for the purposes of article 11 of the ICESCR. Sustainability is linked to adequate food, recognizing the importance of ensuring food is accessible for both present and future generations. Adequacy is to a large extent determined by prevailing social, economic, cultural, climatic, ecological and other conditions. The Committee affirms that the right to adequate food is indivisibly linked to the inherent dignity of the human person and is indispensable for the fulfilment of other human rights enshrined in the International Bill of Human Rights. It is also inseparable from social justice, requiring the adoption of appropriate economic, environmental and social policies, at both the national and international levels, oriented to the eradication of poverty and the fulfilment of all human rights for all. CESCR, 1999, General Comment 12, paragraph 4. Availability: Food in a quantity and quality sufficient to satisfy the dietary needs of individuals, free from adverse substances and acceptable within a given culture. Accessibility: Encompasses both economic and physical accessibility. Acceptability: The need also to take into account, as far as possible, perceived non nutrient- based values attached to food and food consumption and informed consumer concerns regarding the nature of accessible food supplies. Food and Nutrition Survey of out of 5 children are growth- stunted - 81% of rural population is at least moderately vulnerable to food insecurity - Almost 20% of children are underweight - Chronic malnutrition rates reached 39% for children under 5 years. Source: PRS, 2008, p. 30, 61. Poor nutrition and high mortality rates suggest that food insecurity in Liberia is high. The Comprehensive Food Security and Nutrition Survey (CFSNS) conducted in 2006, found that two out of five Liberian children are growth- stunted and nearly 20 percent are underweight. 94 Forty percent of the rural population was found to be highly vulnerable to food insecurity. 95 Chronic malnutrition rates reached 39 percent for children under 5 years of age. 96 In Liberia, insufficient access to health, water and sanitation services, inadequate care of mothers and children, low agricultural productivity, and poor road infrastructure all contribute to food security issues and poor nutrition. 97 While agricultural production and economic revitalization are important components necessary to realize the right to food, it is not sufficient. In the revitalization plan the government plans to rebuild 93 CESCR, General Comment 12: The right to adequate food. 94 PRS, 2008, p PRS, 2008, p PRS, 2008, p PRS, 2008, p. 30.

31 Visualizing Rights in Liberia 28 basic infrastructure, especially roads, which should contribute to increased production within the agricultural sector, thereby improving food security for people. 98 Second, because agriculture provided the mainstay of the economy throughout the Liberian armed conflict and has accounted for over half of GDP in the post- war period, the economic policy includes strategies to boost agriculture with the aim of enhancing overall economic recovery, ensuring that growth is inclusive, promoting peace and stability and sustaining poverty reduction. 99 The central goal in revitalizing the agricultural sector during the PRS period is to contribute to inclusive and sustainable economic development and growth, and to provide food security and nutrition, employment and income, and measurable poverty reduction. 100 For instance, the Government will expand agricultural production by 3.6 percent during the first two years of the PRS period. This will take place in the food crop sector, such as rice and cassava and in the tree crop sector, such as cocoa, coffee, and oil palm. By the end of 2010, total agricultural production should expand by 6 percent. 101 The plan to achieve economic growth includes three strategic objectives. The first is to develop more competitive, efficient, and sustainable food and agricultural value chains and linkages to markets. 102 For instance, the government will begin to create a stable environment for private investments. There will be clarification on property rights and securing land tenure as well as a focus on farmer- based organizations with the aim of building the capacity of smallholders. 103 Achieving a more stable position in markets allows the government to redefine and develop a more efficient role in agricultural production. This goal relates to the economic accessibility of food. While the objective itself does not directly address economic accessibility as defined by General Comment 12, improvements proposed by the Government should theoretically affect economic accessibility at the individual level. For instance, the General Comment states that economic accessibility implies that personal or household financial costs associated with the acquisition of food for an adequate diet should be at a level such that the attainment and satisfaction of other basic needs are not threatened or compromised socially vulnerable groups such as landless persons and other particularly impoverished segments of the population may need attention through special programs. 104 Increasing growth in agricultural production is the second objective, which strives to improve food security and nutrition, especially for vulnerable groups, including pregnant and lactating women and children under five. 105 Food insecurity contributes to socio- economic deprivation when members of society are unable to work. Therefore, vulnerable groups will be targeted to both maximize levels of production and reduce malnutrition, thereby reducing poverty. This will take the form of social safety net programs for those who are unable to access emerging opportunities, improving access to markets by rebuilding roads, facilitating access to inputs, and increasing market efficiency PRS, 2008, p PRS, 2008, p PRS, 2008, p PRS, 2008, p PRS, 2008, p PRS, 2008, p CESCR, 1999, General Comment 12: The right to adequate food. 105 PRS, 2008, p PRS, 2008, p. 62.

32 Visualizing Rights in Liberia 29 The second objective speaks directly to the availability of food, particularly physical availability as well the principle of non- discrimination. In an effort by the Government to address the needs of vulnerable populations through a targeted social safety net program, they are increasing food availability to marginalized populations. This includes women, children, and the elderly and thereby addresses gender discrimination issues. The PRS states that the third objective in food security efforts is to strengthen human and institutional capacity. The aim is to establish functional institutions to provide services; for example farmer- based organizations. There will be a focus on agricultural research and the Government will take measures to increase the role of women. The government plans to expand existing production systems before introducing new ones. It will focus most immediately on food security. 107 In reference to the AAAQ framework, objective three addresses accessibility. While not explicitly stating that it will improve economic and physical accessibility, presumably when institutions are strengthened, the agricultural sector and thereby food security will be enhanced. In the Liberian Poverty Reduction Strategy Progress Report of 2010, the few lines dedicated to agriculture and food security indicate little measureable progress. During the first years of the PRS, deliverables for the food security sector were not planned and are due to be met in the third and forth years the PRS implementation process. 108 Through an analysis of the proposed policy on reducing food insecurity, it is evident that most of the attention was paid to economic growth and market advantage. Objective two targets vulnerable populations and in this way addresses securing the right to food, however, the other objectives focus on strengthening linkages to markets and institutional capacity. Clearly lacking are components of a policy that address sustainability over time. More importantly, a policy should address the nutritional content of food intake. As an extension of that, it might address who is getting adequate nutrition. This includes questions of quality, dietary necessities, free of adverse substances, and cultural appropriateness. In general, the policy priorities for food security in Liberia address many of the human rights principles outlined in General Comment 12. With regard to the particular elements of realizing the right to food, Liberia s policy has an economic agenda. This is a necessary component of expanding agricultural production and increasing the food supply such that malnutrition can be positively affected. However, it is important to consider a policy that addresses quality of food, acceptability of food, and adequacy of food. 107 PRS, 2008, p PRS, 2008, p. 62.

33 Visualizing Rights in Liberia RIGHT TO WATER Water is a limited natural resource and a public good fundamental for life and health. The human right to water is indispensable for leading a life in human dignity. It is a prerequisite for the realization of other human rights. The Committee has been confronted continually with the widespread denial of the right to water in developing as well as developed countries. Over one billion persons lack access to a basic water supply, while several billion do not have access to adequate sanitation, which is the primary cause of water contamination and diseases linked to water. CESCR, 2002, General Comment 15, paragraph 1. OUTCOMES Water is indispensible for leading a healthy and productive life. Moreover it is fundamental for the realization of other human rights. Central to this is the availability and quality of water. In Liberia, poor access to safe drinking water and sanitation services has adverse consequences for certain sectors of the population. People without safe drinking water run the risk of having health problems associated with contaminated or insufficient quantities. The same is true for a lack of sanitation facilities, which is particularly important for health and Figure 5.1: Insufficient access to water in West Africa hygienic reasons due to water Gambia, The Ghana Cote d'ivoire Burkina Faso Benin Guinea Senegal Liberia Guinea- Bissau Togo Nigeria Mali Chad Sierra Leone Mauritania Niger contamination. In Liberia, water and sanitation- related sicknesses put severe burdens on health services, keep children out of school, and undermine investment in agriculture and other economic sectors. 109 Using the World Bank indicator, improved water source 110, 68 percent of the Liberian population has access to water. 111 Average for West Africa, Liberia ranks eighth among sixteen countries. Figure 5.1 highlights Liberia s overall relative position among its neighbors. While this is an improvement from 1990 when 58 percent of Liberia s population had access to water, they are still struggling to reach better coverage PRS, 2008, p Access to an improved water source refers to the percentage of the population with reasonable access to an adequate amount of water from an improved source, such as a household connection, public standpipe, borehole, protected well or spring, and rainwater collection. Unimproved sources include vendors, tanker trucks, and unprotected wells and springs. Reasonable access is defined as the availability of at least 20 liters a person a day from a source within one kilometer of the dwelling (World Bank 2011). 111 World Bank, World Bank, Improved Water Source for West African countries, Source: data from World Bank, % of populakon with access 92

34 Visualizing Rights in Liberia 31 In 2008, Liberia ranked ninth among sixteen West African countries for the percent of the population with access to improved sanitation facilities. 113 Again, this is an improvement from the 11 percent of the population who had access to sanitation facilities in 1990 but this is hardly an impressive increase particularly when compared to other West African countries. 114 Senegal is able to reach 51 percent of their population and The Gambia is able to reach 67 percent. 115 In spite of a relative position among West African countries, the outstanding issue lies within rural and urban disparities for water and sanitation in Liberia. Figure 5.2: Insufficient access to sanitation facilities in West Africa Improved Sanitakon Facilikes for West African countries, 2008 Gambia, The Senegal Mali Nigeria Mauritania Cote d'ivoire Guinea- Bissau Guinea Liberia Ghana Sierra Leone Benin Togo Burkina Faso Chad Niger Source: data from World Bank, % of populakon with access Also evident from the available data is an issue of discrimination. Not only does the lack of water and sanitation need urgently addressed, but also the severity of the problem as it is further exacerbated by the regional disparities. There are drastic differences in access to water and sanitation services between urban and rural areas. Duty bearers are obligated to fulfill human rights and this apparent gap in the provision of the right to water and sanitation highlights a pressing need for increasing attention to the provision of basic needs. 113 Access to improved sanitation facilities refers to the percentage of the population with at least adequate access to excreta disposal facilities that can effectively prevent human, animal, and insect contact with excreta. Improved facilities range from simple but protected pit latrines to flush toilets with a sewerage connection. To be effective, facilities must be correctly constructed and properly maintained (World Bank 2011). 114 Another method of comparison is the SERF Index on housing rights, which looks at the relationship between GDP per capita (PPP) and percentage of population with access to improved sanitation and percentage of population with access to improved water source. Liberia ranks 114 out of 145 core countries (excludes high income OECD countries) with a Core Country Right to Housing Index value of out of 100 (Fukuda- Parr, Lawson- Remer, and Randolph, The International SERF Index Dataset Version ). 115 World Bank, 2011.

35 Visualizing Rights in Liberia 32 Table 5.1: Poor service coverage and the right to water County Population 116 Number of wells Bomi 84,119 Bong 333, Gbarpolu 83,388 Grand Bassa 221, Grand Cape Mount 127,076 Grand Gedeh 125,258 Grand Kru 57, Lofa 276, Margibi 209, Maryland 135, Montserrado 1,118,241 13,000 Nimba 462,026 River Cess 71, River Gee 66, Sinoe 102, Source: data from County Development Committee, Water is central to the health of a child; consequently, when there is an insufficient quantity or quality, this compounds the issue of malnutrition. The number of wells indicates water accessibility, a crucial element in healthy growth and development, particularly in children under five years. While there is no indication of the quality of water, the number of wells alone illustrates availability and adequacy. Again in Maryland, roughly 136,000 people are using 265 wells, which means that approximately 513 people are using one well. This leads to questions surrounding the distance to the well, the physical burden of carrying water, the opportunity costs of this activity, and sufficient quantity. As there is a move away from Monrovia and therefore a move away from the urban center to rural areas, the well to population ratio increases. For example, in Montserrado there is one well per 98 people 117 while in the southeastern county of Maryland there is one well per 513 people. 118 Figure 5.3: Unequal access to water and sanitation between urban and rural regions in Liberia Improved water source, (% populakon with access) Water Access in Urban and Rural Areas Urban 60 Rural Improved sanitakon facilikes, (% of populakon with access) 100 Sanitakon Access in Urban and Rural Areas Urban Rural Source: World Bank, National Population and Health Census, LISGIS, Montserrado County Development Committee, Maryland County Development Committee, 2008.

36 Visualizing Rights in Liberia 33 People living in rural areas have far less access to water sources and sanitation facilities than do people living in urban areas. For example, in 2008, while 25 percent of the urban population has access to improved sanitation facilities, just 4 percent of rural Liberia has access to adequate sanitation. 119 Additionally, figure 5.3 illustrates both progression and retrogression in the realization of the right to water in Liberia. Between 1990 and 2008, an additional 17 percent of people living in rural areas gained access to water sources, while the number of people living in urban areas with access to water dropped 7 percent. 120 For improved sanitation facilities, the percentage of people living in both urban and rural areas went up between 1990 and However, people living in rural areas, are again, far behind the access for people in urban areas. 119 World Bank, World Bank, 2011

37 Visualizing Rights in Liberia 34 POLICY EFFORTS The Committee on Economic, Social and Cultural Rights defines the right to water to be sufficient, safe, acceptable, physically accessible and affordable for all. The human right to water entitles everyone to sufficient, safe, acceptable, physically accessible and affordable water for personal and domestic uses. An adequate amount of safe water is necessary to prevent death from dehydration, to reduce the risk of water- related disease and to provide for consumption, cooking, personal and domestic hygienic requirements. CESCR, 2002, General Comment 15, Paragraph 2. Availability refers to water supply that must be sufficient and continuous for personal and domestic uses. Furthermore, the quantity of water for each person should be consistent with World Health Organization guidelines. Quality of water for each individual should be safe and of an acceptable color, odor, and taste. Accessibility includes overlapping elements: physical accessibility, economic accessibility, non- discrimination, and information accessibility. 121 The Poverty Reduction Strategy recognizes water and sanitation services in their section addressing the rehabilitation of infrastructure and delivering basic social services. A major obstacle to the realization of the right to water in Liberia is setbacks due to the civil war, for example: Monrovia s water supply fell from 18 million gallons daily to just 1 million gallons. 122 Liberia improved water and sanitation services between 1990 and 2008 indicating that since the war ended in 2003 the government increased services of water and human waste collection. However there are still large portions of the population that have very little access to water and sanitation facilities. According to the PRS, the Liberian Government established 120 waste collection points and created a community- based household collection system, providing new job opportunities while reducing environmental and health. Yet, there remains no landfill site in Monrovia. It follows that waste treatment facilities and disposal systems are urgently needed compounded by the fact that these services are donor- funded. 123 With respect to water and sanitation, the overall goal of the Government is to diminish water and sanitation- related diseases in Liberia. To achieve this, the government plans to take the following actions: Rehabilitate damaged water and waste collection/disposal facilities, and construct new facilities as needed; Establish water quality testing facilities nationwide with trained staff and necessary equipment; Scale- up hygiene promotion in schools and communities in all fifteen counties; Carry out standardization and quality control for all equipment and facilities; Establish a theft control mechanism for water and sanitation assets; Develop or procure improved hydro- geological information systems; Develop a national solid waste management policy; Undertake plans for the Mount Barclay landfill facility in Monrovia CESCR, 2002, General Comment PRS, 2008, p PRS, 2008, p PRS, 2008, p. 107.

38 Visualizing Rights in Liberia 35 The PRS policy to rehabilitate water and sanitation facilities and increase infrastructure points to the principle of availability in sufficient quantities. Additionally the government address water quality through testing facilities, staff training, and the development of a standardization of control. Excluded from this policy are actions directed to reduce the discrepancy between urban and rural regions. It could be argued that since the goal is to reduce disease burden, perhaps government plans are best directed towards water quality and the rehabilitation of facilities. However, the disease burden is likely worse in rural areas where access to water and sanitation are severely limited. Therefore, in order to meet the principle of accessibility, the water and water facilities in Liberia must be within safe physical reach for all sections of the population. The majority of government plans laid out in the PRS address the quality standard of the General Comment on the right to water. This is critical for improving the health of the population, as it is associated with waterborne diseases and takes steps toward securing the realization of the right to water for the Liberian people.

39 Visualizing Rights in Liberia RIGHT TO WORK 1. Everyone has the right to work, to free choice of employment, to just and favorable conditions of work and to protection against unemployment. 2. Everyone, without any discrimination, has the right to equal pay for equal work. 3. Everyone who works has the right to just and favorable remuneration ensuring for himself and his family an existence worthy of human dignity, and supplemented, if necessary, by other means of social protection. Universal Declaration of Human Rights, Article 23. OUTCOMES With an economy devastated by civil war and most employment in the informal sector, the right to work is important as a human right as well as for economic stability. General Comment 18 states that the right to work is essential for realizing other human rights and forms an inseparable and inherent part of human dignity. Every individual has the right to be able to work, allowing him/her to live in dignity. The right to work contributes at the same time to survival of the individual and to that of his/her family. 125 The right to work includes all forms of work, from independent to formal wage- paid work. Additionally the work must be decent work, in that it is of acceptable conditions and provides an income to support themselves and their families. 126 Economic growth alone cannot ensure that the right to work is achieved. Investment in agriculture, industry and other economies may have the potential to increase employment, but it is not enough to realize the right to work. Therefore, the OHCHR recommends indicators to measure the right to work that include access to decent and productive work, just and safe working conditions, training and professional development, and protection from forced labor and unemployment. 127 In Liberia, however, data is extremely lacking and misleading in the area of work, a result of the large informal sector, which employs up to four times the rate as the formal sector. 128 A high percentage of the population is dependent on unregulated employment, leaving people vulnerable to poor working conditions, low wages, and little protection from other abuses. Despite an employment to population ratio of around 65 percent, comparable to most other West African countries as seen in figure 6.1, poverty levels in Liberia are much higher. 129 The proportion of employed people living below $1 (PPP) per day is 86.2 percent. 130 While other west African countries have a high proportion of employed people living on less than $1 per day, Liberia s extremely high rate is well above the average as seen in figure 6.2. Senegal and Ghana both have similar employment rates, yet the proportion living on less than $1 for Senegal is 44.4 percent and for Ghana is 37.6 percent. 131 Liberia s high proportion suggests a number of shortcomings in realizing the right to work such as 125 CESCR, 2005, General comment CESCR, 2005, General Comment, paragraph OHCHR, 2008, Report on Indicators for promoting and monitoring the implementation of human rights. 128 PRS, 2008, p World Bank, MDGs, MDGs, 2010.

40 Visualizing Rights in Liberia 37 insufficient compensation and precarious employment such as fixed term, and casual or seasonal employment. Unstable work with low wages demonstrates a failure of the duty bearer to protect workers from unjust employment, and consequently impairing the individual s ability to provide for his or her household. Figure 6.1: Insufficient availability of work in West Africa Employment to populakon rako, 15+ years old, total (%), West Africa, 2008 Burkina Faso Guinea Gambia, The Benin Chad Guinea- Bissau Senegal Liberia Ghana Sierra Leone Togo Cote d'ivoire Niger Mauritania Source: data from World Bank, Figure 6.2: Severe poverty illustrates a failure of the realization of the right to work in Liberia Proporkon of employed people living below $1 (PPP) per day (%), West Africa, countries with available data Ghana (2005) Gambia (2003) Senegal (2005) Togo (2006) Benin (2003) Mali (2006) Burkina Faso (2003) Sierra Leone (2003) Guinea (2003) Niger (2005) Liberia (2007) Source: data from MDGs, This precarious employment situation is further exacerbated through gender inequality. While the employment- to- population ratio for men was 79 percent in 2008 and has remained around this level since 1991, for women the rate is approximately 52 percent. 132 This significant difference between men and women shows a lack of attention to gender disparities and discrimination. Furthering the gap is the type of employment men and women hold. While accurate data is missing on differences between 132 World Bank, 2011.

41 Visualizing Rights in Liberia 38 genders in formal and informal employment, the DHS survey collected data on the type of employment for women. Table 6.1 shows that 86 percent of employed women are self- employed and only 5 percent are employed by a non- family member. 133 Agricultural work is the most common occupation, employing 55 percent of employed women, and it is the highest category for unpaid work at 46 percent. 134 Table 6.1: Women in Liberia are subject to highly vulnerable working conditions Percent distribution of women age employed in the 12 months preceding the survey by type of earnings, type of employer, and continuity of employment, according to type of employment (agricultural and non- agricultural), Liberia EMPLOYMENT CHARACTERISTIC AGRICULTURAL WORK NONAGRICULTURAL WORK TOTAL Type of earnings Cash only Cash and in- kind In- kind only Not paid Missing Total Type of employer Employed by family member Employed by non- family member Self- employed Missing Total Continuity of employment All year Seasonal Occasional Missing Total Source: data from DHS, This high level of informal employment and unpaid work clearly reflects an unstable working environment that fails to realize the right to work. Obstacles blocking access to formal employment whether through physical accessibility or non- discrimination and the acceptability and quality through working conditions or sufficient wages show the serious limitations for employment. Even if the economic situation in Liberia is taken into context, rates of employment have not changed significantly in the last twenty years. Through the years of civil war and now during a period of economic 133 DHS, DHS, The number of surveyed women, employed, was 4,648 total with 2,572 in agriculture and 1,963 in nonagricultural work (DHS, 2007).

42 Visualizing Rights in Liberia 39 revitalization and peace building, the employment to population ratio has been a consistent 65 percent. 136 While investment in the various industries can help with economic growth, it is clear that these changes are not enough to affect employment and the right to work. Figure 6.3 illustrates that despite fluctuations and an increase in GDP per capita over the years, employment has remained at the same rate. Figure 6.3: Economic growth is insufficient to guarantee the right to work 250 GDP per capita (US $) and employment to populakon rako (%), Liberia 100 GDP per capita (US $) Employment to populakon rako, 15+ years, % GDP per capita (current US$) Employment to populakon rako, 15+, (%), total Source: data from World Bank, The OHCHR also recommends looking at indicators measuring safe working conditions, distribution of labor force by education and reported cases of violations to the right to work (such as unlawful termination, discrimination, forced labor and child labor). 137 However, data for these measurements is lacking, showing a large gap in information. Liberia s industries of agriculture, mining, and forestry are sectors that often have potential for work related accidents or occupational diseases. Without surveys and data on this, the standards of safe and just working conditions are unknown. This can also be carried over to vocational training and protection from forced labor and unemployment, demonstrating a serious need for more information and data. 136 World Bank, OHCHR, Report on Indicators for promoting and monitoring the implementation of human rights.

43 Visualizing Rights in Liberia 40 POLICY EFFORTS The right to work includes the right of everyone to the opportunity to gain his living by work which he freely chooses or accepts, and will take appropriate steps to safeguard this right. 138 Following the similar AAAQ model in availability, accessibility, acceptability and quality, the right to work includes recognition of technical and vocational training and programs, favorable working conditions, remuneration such as fair wages, a decent living, healthy work conditions, equal opportunity and reasonable working hours. 139 The PRS identifies the goal to promote productive employment that will reduce poverty, ensure peace and stability and enhance the overall wellbeing of the Liberian people. 140 The Government of Liberia aims to achieve this goal through three policy objectives. The first objective is to strengthen the overall labor policy and administration. The labor laws were outdated and administration of labor weak with poor communication between employees and employers. The targeted actions are: Formulate a National Employment Policy (NEP) and submit for enactment by December 2009 Establish NEP implementation, monitoring, and evaluation responsibilities at Ministry of Labor by December 2009 Organize a national labor conference to review and reform existing labor laws by March 2008 Formulate a draft labor code and submit for enactment by April 2008 Strengthen the participation of the National Tripartite Committee by training and providing equipment to committee members by December 2011 Conduct sensitization and awareness campaigns on labor code by June 2008 Review and set national minimum wage by December 2008 Train labor commissioners, inspectors and staff of Ministry of Labor divisions by June 2011 Develop a labor market information system for planning and decision making by June This policy objective notes the lack of labor laws to protect workers and thus aims to draft and implement labor policy and increase the administrative monitoring capacity. However, drafts of these new policies need to be analyzed for inclusion of human rights principles. Attention needs to be paid to ensuring just and safe working conditions, limiting hours, and protecting from unemployment. Laws with regard to child labor and forced labor should also be addressed in the formation of new labor laws. The second policy objective is to create more and better jobs for Liberian men, women and youth. The PRS notes that labor administration programs have had little to no impact and lack coordination. Therefore the following actions are to: Establish an institutional framework for the Liberia Employment Action Program (LEAP) by July 2008 Decentralize LEAP activities and train regional staff by November 2009 Promote community- based job creation through labor intensive public works projects by June 2011 but also ongoing Establish agricultural and MSME 142 programs such as management training and skills development to create employment opportunities for youth, women and the vulnerable as an ongoing project implemented by June ICESCR, 1976, article CESCR, 2006, General Comment PRS, 2008, p PRS, 2008, p Micro, Small, and Medium Enterprise (PRS, 2008).

44 Visualizing Rights in Liberia 41 Provide skills training for MSMEs to promote the transition from the informal to the formal economy as an ongoing project but implemented by June 2011 Develop vocational training opportunities for youth linked to labor market projections and other youth livelihood schemes, ongoing by June 2011 Formulate a National Workplace Policy on HIV and AIDS and conduct sensitization campaigns by December 2009 Conduct 30 workshops (2 in each county) on HIV and AIDS in the workplace by June 2011 Train peer educators and tripartite constituents on HIV and AIDS in the workplace by June Following the human rights principles, the second policy objective prioritizes vocational training and services to identify and find employment, which impact both accessibility and availability of work. Furthermore, education on AIDS and HIV are important in realizing non- discrimination. The decentralization of LEAP and training of regional staff show a commitment to physical accessibility and non- discrimination based on region. However, while non- discrimination is addressed in the area of HIV/AIDS, it does not address gender discrimination or other divisions within the population. The third policy objective is to develop a National Labor Market Information System. Due to the limited data available on the labor market and capacity to generate and manage the data, the Government identifies actions to: Conduct training for SPSS and CSPro software by September 2009 Establish a data repository system for labor market information by September 2008 Provide computers and accessories for Statistical Bureau by December 2008 Conduct labor force survey by September 2008 Conduct manpower survey by September 2008 Conduct occupational injury survey by June This final objective is important in the realization of the right to work, as information and data networks are critical in identifying the accessibility and quality of labor. The policies and administration as identified in the first two objectives can only be effective if there is knowledge of the current work force and labor market. Without more knowledge and awareness of the issues facing Liberians in the area of employment, further programs and policies cannot target the necessary sectors. While these three policy areas address productive employment and several of the key human rights principles with regard to the right to work, there are still gaps and challenges in the PRS. There is no mention of regional disparities or urban and rural issues. Some policies, such as transportation are targeted toward facilitating physical access but new labor policies should also be aware of these concerns. Additionally as new labor laws are drafted and new processes established, how are the employers and workers organizations involved? Transparency and participation are necessary aspects in upholding the right to work in the formation of new policies. Furthermore an enforcement system is needed to ensure that workers are protected and guaranteed legal standards. 143 PRS, 2008, p PRS, 2008, p. 82.

45 Visualizing Rights in Liberia RESOURCES NATIONAL BUDGET An analysis of Liberia s budget provides a platform for evaluating the resource allocation and prioritization of rights. This section highlights the budget by relevant sectors according to the provision of economic and social human rights. The purpose is to view the budget from the perspective of the amount assigned to core obligations within each sector. This display of resource allocation and resource generation reveals Liberia s capacity to uphold their responsibility human rights. Liberia s total expenditure for the fiscal year was approximately US $ million, showing serious constraints on their national fiscal resources and ability to spend on sectors that target social and economic rights. 145 However, even with this taken into consideration, the budget policy and allocation can still be assessed in order to observe the government s prioritization of rights. An evaluation of expenditures across West Africa provides a visualization of Liberia s position among its neighboring countries. Figure 7.1 illustrates total public spending on education in 2008 across countries in West Africa. According to the World Bank, 12 percent of Liberia s government spending went toward education. These results indicate that among the West African countries with available data, Liberia ranks the lowest in public spending on education. One the other hand, according to the Ministry of Finance, the percent of government expenditure allocated for education in the subsequent years increases (see figure 7.1). For the fiscal year, budget reports indicate that 13 percent of expenditure, or US $ 32.5 million went toward education and in , despite a decrease in spending to US $ 28.5 million for education, it was actually an increase in the percent of total government expenditure to 15.1 percent. 146 However, even with the percent increase in expenditure, 15 percent still places Liberia at the bottom of West African countries in the area of education expenditure. Figure 7.1: Liberia ranks lowest in allocation toward education Total public spending on educakon (% of government expenditure), West Africa, countries with available data, 2008 Cote d'ivoire Burkina Faso (2007) Mali Guinea Senegal Togo (2007) Benin (2007) Mauritania Niger Liberia Percentage of government expendture for educakon Source: data from World Bank, Ministry of Finance, April See also Appendix C on page Ministry of Finance, April 2010.

46 Visualizing Rights in Liberia 43 Government expenditure on public health does not, at first glance, follow the same trend as education. According to data from the World Bank, Liberia spent 16.6 percent of the 2007 government budget on public health which would be much higher than most neighboring countries. 147 In West Africa, the public health expenditure as a percent of total government expenditure falls between 13 percent for Chad and 4 percent for Guinea- Bissau. 148 However, according to the Ministry of Finance and the national budget reports, Liberia only spent approximately 5.5 percent for the fiscal year. 149 For fiscal years and , expenditure increases as percent of government expenditure but only to 7.6 percent and 6.3 percent respectively (see table 7.1). 150 This stark difference between the World Bank s numbers and Liberia s Ministry of Finance s reports may be explained through donor funds and grants. The Ministry of Finance s number is calculated without funds from external actors while the World Bank s data includes some of the grants or loans. Table 7.1 draws on data from the Ministry of Finance in Liberia to highlight budget appropriations and commitments for fiscal years and It is organized according to sector within pillars of the Poverty Reduction Strategy. Pillar II addresses economic revitalization with the highest percent of expenditure going toward growth and macro framework. However, Pillar II also allocates funds for food and agriculture as well as labor and employment. Pillar IV addresses infrastructure and basic services and for this the government has allocated money according to sector: roads and bridges, education, health, and water and sanitation among others. Government spending on health, education, food, water and sanitation, and work are central to the provision of human rights consistent with ICESCR and the evaluation of maximum available resources. Table 7.1: PRS alignment of public expenditure for fiscal years 2008/2009 and 2009/ Fiscal Year Fiscal Year US $ millions % of total expenditure US $ millions % of total expenditures Pillar I. Peace & Security (total) Pillar II. Economic Revitalization (total) Food & Agriculture Labor & Employment Pillar III: Governance & Rule of Law (total) Pillar IV: Infrastructure & Basic Services (total) Roads & Bridges Education Health Water & Sanitation Total PRS- related expenditure Total expenditure Source: data from Budget Framework Paper by the Ministry of Finance, April See chart in Appendix B (page 54) on public health expenditure as percent of government expenditure for 2007, comparing West African countries. This chart shows Liberia ranking number one in percent expenditure. 148 World Bank, Ministry of Finance, April Ministry of Finance, April See appendix X for the full chart from the Ministry of Finance s Budget Framework Paper, April 2010

47 Visualizing Rights in Liberia 44 According to the April 2010 Budget Framework Paper, none of the five sectors experienced an increase in actual expenditure commitments between fiscal years 2008 and Food and agriculture spending was reduced from US$ 8.1million to US$ 4.2million; expenditure on labor and employment was reduced from US$ 2million to US$.9million; expenditure on education went from US$ 32.5million to US$ 28.5million; the actual budget commitment for health between fiscal years , went from US$ 19million to US$ 12million; and expenditure on water and sanitation decreased from 0.5 million to 0.4 million. Each of these five sectors involves the realization of human rights. The decrease in expenditures points to a situation where the state as the duty bearer is not following through with the responsibility to ensure progressive realization of human rights across Liberia. While none of the aforementioned sectors outlined by pillars of the PRS experienced an increase in actual budgetary commitments, the education sector increased in percent of total expenditure allocated. In fiscal years , the percent of the total expenditures on education was 13 percent and in , it went up to 15.1 percent. This points to an improvement in the conduct of the state toward the right to education despite the decrease in overall funds allocated to education. 152 DONORS AND AID With Liberia s total expenditure for the fiscal year at approximately US $ million, donor contributions play a major role in overall expenditure in Liberia. The OECD reports that the total bilateral and multilateral disbursement to all sectors in Liberia was US $ 518 million in 2009, which is down from US$ 1,570 million in Donors, therefore, are a critical actor impacting resource allocation for social, economic and government spending throughout the country. The outcomes illustrated in the previous sections are a result not only of national policy strategies and fiscal expenditure but also are dependent on external actors. Despite focus on the state as the primary duty bearer responsible for ensuring the enjoyment of human rights within their own country, these international organizations and foreign country involvement prove their roles as duty bearers as well. Changes in total donor aid over the last five years show significant fluctuation in the available resources dedicated toward economic and social sectors. As seen in figure 7.2, priority in 2005 shows a focus on emergency relief and humanitarian aid, a result of the end of the civil conflict. By 2009, there is an apparent shift towards supporting and rebuilding infrastructure and services across the sectors, evidenced by donor aid dropping from 49 percent to 7 percent. 154 The overall expenditure toward economic and social sectors with regard to the rights to education, health, food, water and sanitation and work are significantly higher than that of the national government s spending in these areas. 152 Ministry of Finance, April OECD, OECD, 2011.

48 Visualizing Rights in Liberia 45 Table 7.2: Total donor aid disbursement to all sectors in Liberia in US$ millions Sector(s) I. Social Infrastructure & Services I.1. Education I.2. Health I.3. Population Pol./Progr. & Reproductive Health I.4. Water Supply & Sanitation I.5. Government & Civil Society I.6. Other Social Infrastructure & Services II. Economic Infrastructure & Services III. Production sectors III.1. Agriculture, Forestry, Fishing III.2. Industry, Mining, Construction III.3. Trade Policies & Regulations IV. Multisector/Cross- cutting VI. Commodity Aid/General Program Assets VI.1. General Budget Support VI.2. Dev. Food Aid/Food Security Assets VII. Action Relating to Debt VIII. Humanitarian Aid IX. Administrative Costs of Donors X. Support to NGOs XI. Refugees in Donor Countries XII. Unallocated/Unspecified Total Aid To All Sectors Source: Data from OECD, DAC database. Figure 7.2: Allocation of donor funds by sector, percent of total aid, 2005 and 2009 Source: Data from OECD, DAC database.

49 Visualizing Rights in Liberia 46 Education - According to the OECD DAC database, the education sector received US$ million from international donors toward education infrastructure and services. Of the million dollars, US$ million was earmarked for basic primary education. 155 However, these numbers contrast with data from the Ministry of Finance of Liberia. In the Aid Management Unit Report for 2009/2010 fiscal year, the Ministry of Finance reported that the education sector received US$ million with the United States as the largest contributor. The World Food Program allocated US$ 3 million for school feeding projects in five food insecure southeastern counties while UNICEF s US$ 2.78 million were allocated for accessing quality primary education and gender parity. 156 Donor contribution is similar therefore to that of the national government. The question remains though how the public education system works with the schools funded by outside donors. Figure 7.3: Allocation of donor funds for social infrastructure & services, 2009 Source: Data from OECD, DAC database. Figure 7.4: Aid dwarfs government resources US$ in millions Government and donor expenditure for educakon and health in Liberia, Educakon Health Government Expenditure Donor Expenditure Source: data from Ministry of Finance, April Budget Framework paper and from OECD, DAC Database. Health - While expenditure on health infrastructure and services by the national government is significantly less than education, donor contributions toward health are strong. The total funds disbursed from donors toward health was US$ million in 2009, up from US$ 39.6 million in 2008 and US$ 9.66 million in Unlike education where donor and national contributions are almost equal, there is a significant difference between the two contributions for the health sector. In 2009 the national government spent approximately US $ 12 million while collectively, total donor aid equaled almost US $ 40 million. 158 Food - While the Government of Liberia s total expenditure on food and agriculture for the 2009/2010 fiscal year was US$ 4.2 million 159, the total donor expenditure according to the DAC database for 2009 was US$ million for food aid alone and US$ million for agriculture. 160 The Ministry of Finance 155 OECD, Ministry of Finance, October OECD, Ministry of Finance, April Ministry of Finance, April OECD, 2011.

50 Visualizing Rights in Liberia 47 reported that in 2009/2010 the total disbursement from donors for food and agriculture was US$ million with the largest contributor being the World Bank through two programs: Agriculture and Infrastructure Project and Emergency Food Crisis Response. 161 Water and Sanitation - Consistent with the trend in spending for food and health, the majority of funds allocated toward water and sanitation are coming from donor countries as well. While the Government of Liberia spent only US $ 0.4 million 162 on water and sanitation facilities, total donor contributions equaled US $ 13.1 million for the same year. 163 Work - With the right to work being perhaps one of the more complicated rights with regard to spending, it is still clear that international contribution toward economic infrastructure and services as well as production sectors could potentially have a significant impact on employment and the right to work. However, as seen with the national government s conduct and resource allocation toward the right work, economic growth and investment in industry is not sufficient for ensuring the realization of the right to work. With almost US $ 70 million going toward economic infrastructure and services, how it is impacting employment and working conditions is necessary information that is not available. 164 With such a considerable portion of financial support toward health coming from international actors, it brings to question the ability of the national government to have a significant impact on the outcomes of each right. This raises the issue of joint responsibility between the Government of Liberia and the various donor countries and organizations. Additionally, coordination is lacking among the numerous actors as each has its own policy and agenda. The outcomes illustrated are results not only of national conduct but also donor conduct. Each donor operates independently of the government and also from each other, reflecting a complicated array of actors responsible for the rights of Liberians. Table 7.3 Top donors to all sectors in Liberia, in USD millions (and % of total donor aid) Donor(s) EU Institutions 53.0 (23.6%) 44.2 (17.7%) 39.5 (17.7%) 48.6 (3.1%) 59.5 (11.5%) Germany 1.3 (0.6%) 9.0 (3.6%) 10.0 (3.6%) (20.2%) 28.1 (5.4%) IDA (0.5%) (0.5%) 4.6 (0.3%) 42.5 (8.2%) Italy 0.02 (0.0%) (0.1%) 75.4 (14.6%) Norway 7.14 (3.2%) 8.94 (3.6%) (3.6%) (2.2%) (3.0%) IMF* (20.4%) 27.8 (5.4%) Sweden 14.8 (6.6%) 15.2 (6.1%) 19.8 (6.1%) 26.3 (1.7%) 42.0 (8.1%) UN System** 15.2 (6.8%) 16.9 (6.8%) 23.5 (6.8%) 36.8 (2.3%) 24.4 (4.7%) United Kingdom 7.5 (3.4%) 15.3 (6.1%) 12.4 (6.1%) 32.4 (2.1%) 33.4 (6.4%) United States 86.4 (38.5%) 88.4 (35.3%) (35.3%) (17.6%) 96.9 (18.7%) Source: data from OECD, DAC Database * IMF includes Structural Adjustment Facility (SAF), the Enhanced Structural Adjustment Facility (ESAF) and Poverty Reduction and Growth Facility (PRGF) ** UN System includes UNAIDS, UNDP, UNFPA, UNHCR, UNICEF, UNTA, WFP Some of the top donors that have made considerable contributions to Liberia include the International Monetary Fund (IMF), the European Union (EU), and the United States Agency for International 161 Ministry of Finance, October Ministry of Finance, April OECD, OECD, 2011.

51 Visualizing Rights in Liberia 48 Development (USAID). While the overall contributions are significant and important for expenditures in Liberia, their country reports do not provide data reflecting precisely where they allocated the funds. For instance, the IMF very briefly addresses donor assistance in their 2006 Article IV Consultation and Staff- Monitored Program. This document highlights that donor funds are spent completely outside of the government s budget and are allocated through the coordination efforts the Governance and Economic Management Assistance Program (GEMAP). The only mention of the IMF s contribution to Liberia is to show that the IMF and the World Bank coordinate their work on expenditure management. The IMF takes the lead in tax and customs administration and financial sector issues. 165 Excluded from this small summary are any indication of service allocation and how the monetary contribution is allocated by sector. Furthermore, absent from this document are mentions of regional distribution of funds or priorities related to reducing inequalities. Similarly, the EU s Country Strategy Paper for the period , details priorities that are aligned with the PRS and the Millennium Development Goals (MDGs). 166 This is particularly present in the Linking Relief, Rehabilitation and Development (LRRD) flexible approach strategy. The aim is to reduce poverty through improvements in education and health of the population. 167 There are several sections that detail what sectors will be targeted, however there are profound gaps in what needs to be included. For instance, beyond the sectors, there is no mention of geographic disbursement in the donor budget. The information does not speak to the populations most in need of donor contributions, nor does it address reductions in inequalities. USAID summarizes their contributions to Liberia in the U.S. Foreign Assistance Performance Publication of This overview focuses specifically on the creation of economic and social conditions at the community level. Their target areas are: strengthening the local government capacity; rehabilitating farms and forestry; investing in people through education and health initiatives. 168 This assessment measures attempts to improve the realization of the economic and social rights. USAID has marked progress in the way they allocate their contributions through documenting broad accomplishments. 169 However, in spite of relatively detailed descriptions of how funds are being used by sector, there is no mention of target populations by geographical location. This particular document alludes to their work within counties, but they do not identify in which counties they are working, nor do they indicate what led them to work with that particular county. Drawing on these three donor country reports, it is clear that there is a need for donors to not only expand on where and how their funds are being allocated, but to explicitly state in which regions they are working and why. The lack of this information perpetuates the unequal distribution of funds regionally. With donors contributing significantly more financial resources than the national government, they should be held accountable for the progressive realization of social and economic rights across and within the counties. With no clear statement of how donor funds are addressing rural and urban inequality, transparency and mechanisms of accountability are undoubtedly needed. 165 IMF, European Commission, 2008, p European Commission, 2008, p USAID, For instance, USAID s education program in 2008 supported literacy classes for over 6,000 adults and distribution or purchase of nearly 1 million new and used books for schools USAID also supports 107 clinics in 7 counties serving at least 750,000 people (USAID, 2009, p. 4).

52 Visualizing Rights in Liberia ASSESSMENT The quantitative data illustrated in the previous sections, the economic and social rights conditions in Liberia shows that the vast majority of people are not attaining a decent standard of living. In a low income country recovering from 14 years of civil war, much of the education and health systems were destroyed, the vast majority of jobs are in the informal sector, there are high levels of food insecurity, and access to water and sanitation is extremely limited. While minimum core obligations are still not being met and conditions are deplorable, relative to West African countries the level of enjoyment of rights is comparable. Aggregate Progress Given the obvious constraints of resources and post- conflict challenges, Liberia must be evaluated based on conduct as well as results. Progressive realization is a human rights principle that assesses the movement toward improving the level of attainment for economic and social rights. States have an obligation of non- retrogression and must make efforts, given the maximum available resources to respect, protect, and fulfill each right. The PRS, as the country s main policy plan, makes efforts to prioritize human rights. By highlighting specific sectors through the pillars of security, economic revitalization, governance and rule of law, and infrastructure and basic services, combined with crosscutting working groups that address gender equity, peacebuilding, environmental issues, HIV and AIDS, children and youth, and monitoring and evaluation, the PRS attempts to increase stability while addressing economic growth and poverty reduction. The government states in the PRS that in addition to their objectives of establishing stability, promoting economic growth, and creating responsible institutions of justice and governance, there is also a focus on advancing human rights. 170 The objectives for each sector in education, health, food, water and sanitation and work attempt to build policy and programs that incorporate some of the basic human rights principles. Poor Record on Combating Non- Discrimination One obvious trend throughout all five of these rights is the issue of discrimination, particularly with regard to urban and rural conditions and among regions. Despite attention given to some of the human rights principles, the principle of discrimination is neglected. The PRS points out that one of the overall objectives is to move beyond the divisions, marginalization, and exclusion of the past and to create circumstances where differences are discussed, not fought over and that the benefits from growth and the provision of basic health and education services are spread much more equitably throughout the population. 171 Even though this acknowledgement of inequality is in the overall goal of the PRS, regional disparities are not specifically addressed in the action plans for each sector. The International Covenant on Economic, Social and Cultural Rights states in article 2, paragraph 2 that the state is obligated to guarantee that rights enunciated in the present Covenant will be exercised without discrimination of any kind. 172 Furthermore, not only does each right have a component of non- discrimination, it is an immediate and crosscutting obligation. The disparity of rights enjoyed between regions clearly shows an absence of policy efforts and resources toward rural regions. For example, in Monrovia 87 percent of men years old are literate and 65 percent of women, years old, are literate compared with only 60 percent of men and 26 percent 170 PRS, 2008, page PRS, 2008, p ICESCR, 1976, article 2, paragraph 2.

53 Visualizing Rights in Liberia 50 of women who are literate in rural regions. 173 Likewise, in healthcare, the already low ratio of physicians to population is compounded by an extreme lack of full time doctors located outside the capital. 174 However, none of the policy objectives in the health sector address discrimination and inequality of services by region or county. With regard to water and sanitation access, clear urban and rural inequality persists. While 79 percent of the urban population has access to an improved water source, only 51 percent of the rural population has access. Access to sanitation facilities is much worse with 25 percent of urban residents having access to improved sanitation facilities while just 4 percent of the rural population has improved sanitation. 175 Clearly the disparity between urban and rural regions reflects a lack of attention toward the population outside of Monrovia. Despite efforts to improve overall enjoyment of each of these rights, ignoring geographic differences is perpetuating inequality in an already divided country. Donor Accountability External actors further reinforce this division between regions with regard to inequitable distribution of economic and social rights. Considering the fact that donor financial contribution is more than twice that of the national budget, these international actors are impacting economic and social rights in Liberia. The outcomes illustrated in the previous sections are a result not only of national policy strategies and fiscal expenditure but also are very much dependent on external actors. Despite focus on the state as the primary duty bearer responsible for ensuring the enjoyment of human rights within their own country, these international organizations and foreign country involvement prove their roles as duty bearers as well. Donors contribute financially and programmatically to services and infrastructure in Liberia, impacting to the government s policy and efforts. Insofar as the state of Liberia is accountable for how its conduct affects its own people, donors are accountable to the Liberian people as well. In order to hold the donors accountable, transparency of their policy efforts and resource allocation are necessary information for evaluation. Despite the state s accountability to its own people, donors act independently to pursue their own agenda, raising the question of who is holding them accountable to the Liberian people Information Deficit Accountability requires transparency and transparency requires information. For instance, detailed information on individual donor programs in Liberia is unavailable, thus making this lack of transparency difficult to hold donors accountable. Each of the general comments put out by the Committee on Economic, Social, and Cultural Rights involves a component that addresses the right to information. Currently available data is insufficient for a thorough assessment of the enjoyment of human rights in Liberia. Furthermore, current policies are drafted based on incomplete information. Therefore, according to obligations of the state, what is urgently needed in order to hold actors accountable and to create effective policies is accurate data collection. Donor agencies are also responsible for collecting data because their funding either matches or exceeds the Liberian national budget. Of particular importance is the collection of disaggregated data. Data by county sheds light on discrimination and inequalities within the realization of human rights. For example complete data on the number of health care workers, schools, wells, or hospitals by county allows for the ability to accurately allocate resources. 173 DHS, County Development Committees, See page 16, Table 3.1: Lack of health services in Liberian counties. 175 Reflects data from 2008, World Bank, 2011.

54 Visualizing Rights in Liberia 51 The combination of incomplete and inaccurate data, nontransparent donor actions and regional discrimination leads to insufficient policy measures and programs, affecting the level of enjoyment of social and economic rights. In Liberia, the outcomes illustrate that rights are not being realized. The state, as the primary duty bearer, is responsible for respecting, protecting and fulfilling each indivisible and interrelated right. However, lack of resources limits their ability to fulfill economic and social rights. Therefore states accountability includes not just evaluating results but assessing conduct as well. Additionally, donor involvement in Liberia reflects joint responsibility and obligations on the part of the donor organizations and countries. Liberia is at risk of further dividing an already divided country by neglecting regional inequalities. In order to provide a life of dignity for every Liberian, the state s and donors conduct must include a transparent and progressive approach toward the full realization of economic and social rights.

55 Visualizing Rights in Liberia 52 REFERENCES Abaka, Charlotte, Advisory Services and Technical Cooperation in the Field of Human Rights: Situation of human rights Liberia. Report of the independent expert on the situation of human rights in Liberia. Economic and Social Council, United Nations, January. Abaka, Charlotte, Advisory Services and Technical Cooperation in the Field of Human Rights: Situation of human rights Liberia. Report of the independent expert on technical cooperation and advisory services in Liberia. Economic and Social Council, United Nations, February. Committee on Social, Economic and Cultural Rights (CESCR), General Comment 3, The Nature of State Parties Obligations Under Article 2(1). 1999, General Comment 12, The Right to Food. 1999, General Comment 13, The Right to Education. 2000, General Comment 14, The Right to Health. 2002, General Comment 15, The Right to Water. 2005, General Comment 18, The Right to Work. 2009, General Comment 20, Non- discrimination in Economic, Social and Cultural Rights. County Development Committee, Bomi County Development Agenda. 2008, Bong County Development Agenda. 2008, Gbarpolu County Development Agenda. 2008, Grand Bassa County Development Agenda. 2008, Grand Cape Mount County Development Agenda. 2008, Grand Gedeh County Development Agenda. 2008, Grand Kru County Development Agenda. 2008, Lofa County Development Agenda. 2008, Margibi County Development Agenda. 2008, Maryland County Development Agenda. 2008, Montserrado County Development Agenda. 2008, Nimba County Development Agenda. 2008, River Cess County Development Agenda. 2008, River Gee County Development Agenda. 2008, Sinoe County Development Agenda. Demographic Health Survey (DHS), Liberia Institute of Statistics and Geo- Information Services (LISGIS). Donnelly, Jack, Universal Human Rights in Theory & Practice. Cornell University Press, 2d ed., Ithaca. European Commission, Country Strategy Paper and Indicative Programme for the period , Republic of Liberia European Community. Fukuda- Parr, Sakiko, Millenium Development Goal 8: Indicators for International Human Rights Obligations? Human Rights Quarterly 28 (2006) by The Johns Hopkins University Press.

56 Visualizing Rights in Liberia 53 Fukuda- Parr, Sakiko, Juan Alberto Fuentes, Arjuna Parakrama, Brian Ruane, Viet Tu Tran, Integrating Human Rights into National Poverty Reduction Strategies: the challenge of development with equity and the Liberia iprs. UN/OHCHR Liberia Field Assessment Mission Report, January, p Fukuda- Parr, Sakiko, Terra Lawson- Remer, and Susan Randolph, SERF Index Methodology: Version , Technical Note Fukuda- Parr, Sakiko, Terra Lawson- Remer, and Susan Randolph, The International SERF Index Dataset Version International Covenant on Economic, Social and Cultural Rights (ICESCR), Office of the United Nations High Commissioner for Human Rights, IMF, Liberia: 2006 Article IV Consultation and Staff- Monitored Program- Staff Report; Public Information Notice on the Executive Board Discussion; and Statement by the Authorities of Liberia. IMF Country Report No. 06/166, May. Liberia Institute of Statistics and Geo- Information Services (LISGIS), National Population and Health Census, Ministry of Finance, Republic of Liberia, April Liberia Budget Framework Paper. Ministry of Finance, Republic of Liberia, October Aid Management Unit (AMU), Annual Donor Fiscal Outturn Report. Fiscal year 2009/2010. Poverty Reduction Strategy (PRS), Government of Liberia. Poverty Reduction Strategy Progress Report, (PRS), Government of Liberia. IMF Country Report No. 10/194, October. Organization for Economic Co- operation and Development (OECD), OECD DAC database, UNESCO, Glossary from Education for All: The Quality Imperative Report, the- international- agenda/efareport/reports/2005- quality/. UNICEF, Basic Education and Gender Equality Factsheet. UNICEF, State of the World s Children, Table 2: Nutrition, United Nations, Report on Indicators for Promoting and Monitoring the Implementation of Human Rights. Office of the United Nations High Commissioner for Human Rights, June. United Nations, Millennium Development Goals (MDGs). New York: United Nations. USAID, Overview of USAID Programs in Liberia.

57 Visualizing Rights in Liberia 54 World Bank, World Development Indicators (WDI), catalog/world- development- indicators. World Food Program, School Meals, meals.

58 Visualizing Rights in Liberia 55 Appendix A: Organization of the Poverty Reduction Strategy Source: PRS, 2008, p. 44.

59 Visualizing Rights in Liberia 56 Appendix B: Public health expenditure in West Africa (% of government expenditure), World Bank Public health expenditure (% of government expenditure) 2007 Liberia Chad Burkina Faso Niger Senegal Mali Gambia, The Ghana Benin Sierra Leone Togo Equatorial Guinea Nigeria Mauritania Cote d'ivoire Guinea Guinea- Bissau Percentage of government expenditure on public health Source: data from World Bank, 2011.

60 Visualizing Rights in Liberia 57 Appendix C: National Budget of Liberia, Ministry of Finance PRS alignment of public expenditure in 2008/09 Source: Ministry of Finance, April Liberia Budget Framework paper.

61 Visualizing Rights in Liberia 58 PRS alignment of public expenditure in 2009/10 Source: Ministry of Finance, April Liberia Budget Framework paper.

62 Visualizing Rights in Liberia 59 Actual and forecast revenue growth in 2009/10 Source: Ministry of Finance, April Liberia Budget Framework paper.

63 Visualizing Rights in Liberia 60 PRS alignment of public expenditure in 2010/11 Source: Ministry of Finance, April Liberia Budget Framework Paper.