In addition to preparing a general collection of access to justice indicators for social rights, specific indicators should also be included for dealing with particular rights contained in the Protocol.


I. Policies on access and removal of financial and other obstacles






- Recognition of the right of access to justice in the legal system of the state. Scope.


- Enforceability and justiciability of the social rights recognized in the protocol. Scope.


- Recognition of indigenous systems of justice.


- Relevant case law of federal and state superior courts on the enforceability of social rights.


- Relevant case law of federal and state superior courts on access to justice.


- Training programs for judges and lawyers. Thematic and jurisdictional coverage, frequency and requirements.


Signs of progress







- Estimated litigation cost of a social rights case, including court costs and attorneys’ fees.


 - Estimated litigation cost of a labor case.


- Estimated litigation costs of a social security, environmental, consumer, and land dispute case.


- Existence of mechanisms for exemption of court costs. Eligibility requirements for this benefit.

- Changes in the national budget allocated to government legal services and programs to ensure access to justice in the area of social rights.


- Number of litigants who benefit from the full or partial exemption of court costs in proceedings on social rights.


- Total percentage of litigants in proceedings before social courts.


Signs of progress

- Table comparing movements in average salaries between public defenders and prosecutors and judges.






- State-organized, comprehensive, free legal services for protection of rights.


- Existence and availability of free legal services organized by non-state actors (e.g. Pro bono services)


- Nature of the legal services in place:


·    Public service

·    Government social policy

·    Welfare services

·    Other. Specify


- Legal aid in social rights claims. Scope and outcomes.


- Plans or policies for removal of financial, material, or cultural obstacles that prevent access to the courts. Jurisdiction and territorial scope. 


- Government agencies that generate information, assessments, and policies on access to justice.


- Public offices that provide mediation or conciliation services to resolve social rights disputes in the country.


- Structure and jurisdiction of the justice administration system for social rights (tribunals for labor, social security, land, environmental, and consumer disputes).


- Existence of tribunals for agrarian and indigenous land disputes. Jurisdiction.


- Special rules of procedure adopted by social courts. Indicate if they provide for any of the following:


·    Prosecution ex officio;

·    Official experts;

·    Waiver of costs;

·    Informality;

·    Mediation and conciliation.

- Territorial and population coverage of legal services and programs.


- Physical accessibility and population coverage of the state’s legal aid program.


- Physical accessibility and population coverage of legal aid.


- Number of social rights cases processed by the public defender’s office since ratification of the protocol.  Number of persons represented.


- Average duration of cases processed by the public defenders office compared to average duration of the type of case in question (pensions, evictions, labor).


- Training programs on social rights for legal aid attorneys and public defenders. Type, contents, duration, and mechanisms.


- Coverage of translation services in indigenous and ethnic minority languages.


- Territorial coverage and physical accessibility of public mediation offices with jurisdiction over social rights.


- Existence of coordination mechanisms between federal and subnational governments on access-to-justice policies. Scope and responsibilities.



Signs of progress


- Existence of studies on effectiveness of and user satisfaction with legal aid, public defenders, and access-to-justice programs.



II. Due process in administrative proceedings







- Acknowledgement by the legal system of the application of the standards of legal due process in administrative proceedings.


- Indicate in connection with each of the social programs, plans, and services reported in accordance with article 19 of the protocol:


i) if benefits and services are determined based on stable, objective, and previously disclosed criteria;

ii) if the social plans, programs, and services reported target a predetermined group of beneficiaries or users;

iii) if benefits or services are granted on the basis of reasoned decisions;

iv) if beneficiaries or users may appeal or challenge the denial of benefits or services;

v) if they have the possibility of presenting evidence or submissions on facts and legal arguments;

vi) if challenges must be disposed of within a reasonable time;

vii) if they have the possibility to invoke a review of an administrative decision in a judicial proceeding or by an independent administrative body.


- Measures on each social program, plan, and service reported have been adopted to improve the promptness and effectiveness of administrative proceedings. Scope.


- Measures used to ensure that beneficiaries and users of the services are properly apprised of the criteria for their award and the processing requirements in applying for them.


- Measures to define and circulate information on the rights of beneficiaries and users of the social plans and services reported by the state. Scope and characteristics.


- Measures to improve access to and coverage of the social programs, plans, and services implemented. Scope and characteristics.


- Affirmative action measures to ensure access to plans and services for vulnerable or disadvantaged sectors (for example, incentives for public transport systems). Scope, characteristics, and evaluation.


Signs of progress


- existence of user/beneficiary satisfaction/ perception surveys on the social programs, plans, and services reported.






- Estimated cost to users of administrative procedures necessary to become eligible for the benefits and services reported. Indicate a figure.


- Existence of means testing or poverty screening to determine eligibility for benefits or services.



Signs of progress







- Existence of independent public agencies to protect users and consumers of public services, such as water, electricity, and transport.  Characteristics and jurisdiction.


- If so, are these agencies empowered to receive user complaints and imposed punitive measures on service providers? Provide details.



- Existence of independent public agencies with authority in the area of environmental protection. Describe their characteristics and jurisdiction.


- If so, are these agencies empowered to receive user complaints and imposed punitive measures on companies? Scope and limits.

- Reliable record-keeping mechanisms for beneficiaries and users. Characteristics, scope and coverage.


- Measures or policies implemented for integration or coordination of the various social plans, programs, and services reported. Scope, operation and outcomes.




- Linkage policies among federal, provincial, and local governments on the social plans, programs, and services reported. Scope and operating characteristics.


- Number of cases processed by user and consumer protection agencies.


- Number of punitive measures imposed on providers.


- Number of cases processed by environmental protection agencies.  Punitive measures imposed on polluting companies.



Signs of progress


- Operation assessments of agencies and linkage policies between different levels of government.  Main outcomes.


- Assessments of linkage strategies among social programs and services. Main outcomes.



- Application of the following procedural guarantees in judicial proceedings for the determination of social rights:


i)       Independence and impartiality of the tribunal

ii)     Reasonable time

iii)    Egalité des armes

iv)   Res judicata

v)     Right of appeal to a higher court to review the judgment


- Average duration of judicial proceedings in social cases based on the standards of the inter-American system.


- Statistical information on trends in proceedings on labor, social security, environmental, consumer, agrarian, and indigenous land dispute cases.


- Average duration of the judgment enforcement process in labor and social security matters versus the state.


Signs of progress


- Opinion polls on how the justice administration system operates.


- Existence of perception studies on the independence and effectiveness of the justice system.

BASIC FINANCIAL CONTEXT AND BUDGETARY COMMITMENTS Indicator - Should special tribunals exist: amount of budgetary resources allocated to the maintenance of social, labor, social security, environmental, and consumer Tribunals?    
  Signs of progress      





- Existence of special rules of procedure for labor matters. Characteristics, scope and limits.


- Procedural prerogatives or special privileges for the state in proceedings of this type. Scope and limits.


- Existence of special rules on enforcement of judgments against the state. Scope and limits.

  Signs of progress      







- Existence in the legal system of simple and prompt procedures to protect social rights. Type and characteristics. 


- Existence in the legal system of precautionary or provisional measures procedures to avert irreparable harm to social rights. Type and characteristics.


- Existence of requirements for standing to bring actions of this type.


- Standing to sue on behalf of groups or collectives whose social rights have been violated (examples of cases in which environmental, consumer, or other collective rights have been affected). Scope and limits.


- Standing of unions to sue on behalf of workers in individual or collective disputes. Scope and limits.


- Standing of third parties to present amicus curiae submissions in cases of this type. Scope and limits.


- Existence of class actions. Scope and limits.


- Existence of special public interest actions or procedures. Characteristics, definition of public interest (including if it recognizes social rights) and limits.

- Average duration of actions to protect social rights.


- Existence of a statutory time limit on procedures of this type. Please state.


- Average duration of precautionary measures procedures.


- Existence of a statutory time limit on procedures of this type. Please state.


- Judicial statistics available on the number and effectiveness of actions of this type in the federal and state justice system.




Signs of progress


- Existence of studies on the effectiveness of the aforementioned actions. Main outcomes.





- Approximate cost of precautionary or provisional measures procedures, including court costs and attorneys’ fees.

- Existence of government measures or policies to reduce the litigation cost of public interest cases. Main characteristics and scope of application.


Signs of progress

- Table comparing the salaries of social tribunal judges (should they exist) with judges of equal rank in other tribunals, by sex.






- Existence of public agencies, ombudsmen, government attorneys, attorney general, etc., with standing to sue on behalf of collective interests or groups whose social rights have been violated. Scope and limits.


- Types of judicial remedies that judges or tribunals can adopt in collective suits:


i) declaratory judgments,

ii) remand rulings

iii) remedies of a structural nature


- Existence of open proceedings and public hearings in the aforementioned protection lawsuits. Scope and limits.

- Policies or measures that encourage public interest litigation on social rights. Characteristics, scope and main outcomes.


- Measures to encourage action on the part of nongovernmental organizations that litigate public interest cases to protect social rights, such as groups involved in the following fields: environmental protection, users’ rights, justice and gender, and protection of indigenous peoples. Scope and limits.


- Training programs on international human rights law for judges and justice operators that center on class action suits and public interest litigation. Characteristics, frequency, content.


Signs of progress





C.         Access to information and participation


77.              The third crosscutting issue for progress indicators concerns access to information and civil society participation in public social policy.


78.              The Committee on Economic, Social and Cultural Rights has drawn attention to the State obligation to produce information bases with which to validate indicators and, in general, access to many of the guarantees covered by each social right.  Accordingly, this obligation is essential for the enforceability of these rights.


79.              Dissemination of information in a democratic society enables the citizenry to monitor the activities of the authorities to whom they have entrusted the protection of their interests.  It follows from the above that the State has a positive obligation to provide that information to the citizenry, particularly when it is in its possession and there is no other way to access it. The foregoing is without prejudice to special limits previously established by law and subject to the principles of proportionality and need.


80.              Adequate access to public information is a key tool for citizen participation in public policies that implement rights enshrined in the Protocol.  Hence the need to have a flow of available information to provide the elements necessary for appraisal and oversight of policies and decisions that directly affect them.  Paradoxically, despite the fact that most countries in the region have ratified the main international instruments recognizing civil rights, very few have in place laws on access to public information or domestic rules that surpass the minimum legal standards on in this area.


81.              Valuable documents have recently been prepared that seek to determine the scope of the fundamental right to information in the possession of the State enshrined in international human rights law.  One particularly important document is that prepared by the Office of the Special Rapporteur for Freedom of Expression of the Inter-American Commission on Human Rights dealing with Article 13 of the Convention. Said document is important because it sets the benchmark to be met by laws on access to information adopted by the countries in the region.  The document provides that the right of access must be ensured by states and, therefore, is not subject to limits or restrictions except on exceptional grounds that shall be examined according to a strict standard.  Openness of public information is, therefore, the norm and confidentiality shall be the exception subject to a strict interpretation. The document also mentions that the State is not only required to observe the right by permitting access to files and databases, but also by discharging a positive obligation to disclose information in certain situations.  In some cases, circumstances are recognized as generating the obligation to produce information on the exercise of rights by sectors that have traditionally suffered exclusion and discrimination.[53] We should also mention the obligation of states to enact laws to ensure the exercise of this right, which must meet certain basic requirements: the principle of maximum disclosure of information, the presumption of openness of meetings and key documents, broad definitions of the type of information that is accessible, short time limits and reasonable costs, independent review of denials of information requests, penalties for failure to provide requested information, and an appropriate procedure for establishing exceptions to access.[54] 


82.              One successful strategy to improve the adequacy and pertinence of social policies and services and, therefore, the progressive realization of social rights, is to guarantee a say in the design and implementation of government strategies for civil society organizations, nongovernmental organizations with technical resources and expertise, and groups that represent the sectors targeted by the policies and services. Participatory rulemaking mechanisms, public hearings, consultative councils, and participatory social budgets are ways that have been tried by several countries in the Americas to channel that participation.  Another practice considered appropriate for improving transparency and accountability is to increase forums for social participation in evaluation, oversight, and responsibility mechanisms. This document suggests a number of indicators and signs of progress to measure the level or degree of social participation in these processes.


83.              As mentioned, once a state ratifies the Protocol it is incumbent upon it to monitor the observance of the rights enshrined in said instrument.  Accordingly, indicators and signs of progress should be adopted that measure access to public information and participation from that point forward and have the following scope.


Access to information and participation



Access to information







- Existence of a law or administrative provisions that recognize the right of access to public information.  Jurisdictional, territorial, and thematic scope and competence.


- Characteristics of national, provincial, regional, or local statistics systems.  Jurisdictional, territorial and thematic coverage. 


- Existence of the following sources of statistical information:


a) National population and housing census

b) National agricultural census

c) National economic census

d) Permanent household surveys

e) Household spending survey

f) Surveys of immigrants and ethnic groups, refugees, asylum seekers, internally displaced persons, and stateless persons

g) Violence surveys

h) Time use surveys

i) Living standards survey

j) Special modules for immigrants, persons of Afro-descendents, and indigenous peoples in any or all of the foregoing.

k) Others. State which.


- In all cases mention sample coverage, periodicity, availability, agency responsible, and jurisdictions responsible.


- Type of information provided by the statistics system in the country, disaggregated by sex, ethnicity, language, socioeconomic status, nationality, legal status (refugee or stateless person), jurisdiction (provincial, local), and other factors.


- Frequency of censuses and surveys. Mention periodicity


- Existence of gender indicators by type of information sources and coverage (population, territorial, thematic).


- Existence of information and data sources on racial and cultural differences.  Coverage, frequency, characteristics.


- Existence of information disaggregated by political and administrative divisions and/or by regions. Scope and limits.


 - Existence of inter-sectoral and interagency information system operating measures (for users and for the state). Scope and limits.


 - Indicators of dissemination of microdata from censuses or surveys;

-          Number of visits to online databases by jurisdiction.



Signs of progress


- Mechanisms by which the state informs the population of progress, changes and/or policy with respect to social issues:


a) Government public awareness campaigns

b) Public awareness and action campaigns by civil society organizations

c) Community-based measures

d) Print media

e) Broadcast media

f) Other media

g) Mail shots

h) Other








- budget of statistics agencies and/or the statistics departments of each ministry.


- Budget for collection and production of information in other areas of the state apparatus.


- entity or agency (public, private, or mixed) in charge of data collection and household survey processing.


- idem for other information sources mentioned supra.




Signs of progress








- Existence of coordination mechanisms (formal or informal) for statistical data collection among different jurisdictions. Scope and limits.


- Existence of oversight bodies to monitor statistics agencies. Scope and limits.


- Number of internal audits and measures to verify compliance with production of statistical information




- Number of complaints received alleging lack of access or availability of public information.




Signs of progress

- Production in any state department of qualitative research or studies. Characteristics, scope and limits.

- training for statistics production staff. Characteristics, frequency, agents and agencies covered.


 Access to Participation







 Existence of laws or administrative provisions that recognize the right of participation in public affairs.  Jurisdictional, territorial, and thematic scope and competence.


- Existence of any of the following social participation mechanisms:


i) Participatory rulemaking;

ii) Public hearings.

iii) Consultative councils or bodies on social services and policy.

iv) Economic and social councils.

v) Users and consumers councils.


- Existence of legislative or other measures that encourage the organization of users and beneficiaries of social services and policies.


- Existence of legislative or other measures that encourage the formation of nongovernmental organizations in the area of social development, services and policy.


Statutory recognition of indigenous peoples' right to consultation.


- Incorporation in domestic law of ILO convention 169.  Effectiveness.


- indicate whether consultation and social participation processes were implemented in connection with the policies, programs, or services reported on. Scope of those processes.


- Existence of relevant case law recognizing the participation and consultation rights of indigenous peoples.


 - Existence of relevant case law recognizing the right to participation and consultation on environmental issues, as well as the rights of users and consumers.




Signs of progress


- Assessments of the level of social participation in the social services and policies reported on.




- Are there participatory processes for the preparation of budgets directly or indirectly used for social spending?


- Are there mechanisms in place to enable NGOs and citizens to participate in the design, approval, and implementation of social spending budgets?





Signs of progress






- Existence of public agencies that promote citizen participation policies, in particular in social services and policies.

Scope and coverage of programs and strategies to promote citizen participation.



Signs of progress







84.              The IACHR suggests a number of guidelines to evaluate implementation of the rights to social security and health (Articles 9 and 10 of the Protocol). These rights were selected based on the experience garnered by the IACHR from its system of cases on these rights as well as developments in standards in the United Nations system. The indicators presented in this section could be considered for the design of progress indicators on other rights contained in the Protocol.[55]


A.         Right to Social Security


85.              On the matter of social security, Article 9 of the Protocol provides that “Everyone shall have the right to social security protecting him from the consequences of old age and of disability which prevents him, physically or mentally, from securing the means for a dignified and decent existence. In the event of the death of a beneficiary, social security benefits shall be applied to his dependents. In the case of persons who are employed, the right to social security shall cover at least medical care and an allowance or retirement benefit in the case of work accidents or occupational disease and, in the case of women, paid maternity leave before and after childbirth.”


86.              The starting point for social security legislation is the concept of contingency. This refers to a future event or situation, which, should it occur, will have harmful effect on the individual. It is therefore an event that is future and uncertain –but which has a high probability of occurring– that makes it necessary to protect the individual, or a group of individuals, from such an eventuality.[56]


87.              The protection of the social security system comes into effect once the contingency has arisen, having caused an individual, or members of the individual’s family, or both, to be negatively affected in terms of standard of living, as a consequence of either increased consumption, or decreased or suppressed income.


88.              Most bodies of legislation in Latin America and the Caribbean, divide contingencies into three categories: i) pathological contingencies: situations where protection is required against the eventuality of disease (health insurance), accident or occupational illness (pensions for invalidity or ill-health); ii) socioeconomic contingencies: this refers to security against the eventuality of loss of income (retirement or pension), lack of work (unemployment insurance) or due to “expansion of the family” as a result of a birth or dependent spouse (family benefits); iii) biological contingencies: precautions taken in active life in order to ensure the protection of rightful claimants (pension for surviving spouse or children who are minors), in the event of death (burial costs), or a pension for non-workers who lack resources (ex-gratia or non-contributory pensions).


89.              In all these cases what is “protected” is that which, if absent, is understood to constitute a lack or deprivation. Contingency is therefore indissolubly linked to lack, in the most traditional concept of social security, or to the State of need of the person, in the more modern vision. In either of these two cases, the protection must be linked to the coverage, that is, to what is needed to make up for the lack.


90.              As the right to social security developed and mechanisms were designed to ensure that benefits were effectively received, dependent workers and in some cases their family group were included. Coverage for the unwaged was limited to a number of well-defined contingencies, although in most cases protection was a consequence of voluntary adherence. In other words, the principle of universality has not been sufficiently developed, and it is still a requirement to demonstrate certain circumstances in order to accede to protection.[57]


91.              These particularities are provided for in the Protocol since it recognizes the difference in coverage between salaried workers and those not in paid employment. It should also be considered that, as a result of the reforms adopted by the region's countries during the last decade, the different forms of social security organization in each country have undergone substantial changes, especially in terms of access, coverage, and related rights.


92.              Strictly speaking, in addition to attempting to record degrees of realization of the right as well as conditions of access thereto, indicators should seek to collect more detailed information about the transformations that have occurred in systems of responsibility in order to identify with whom the obligation to safeguard the guarantee of social security cover rests; that is, is the State still the main guarantor -and provider- or has chief responsibility shifted to the private sector, through specific forms of private insurance?  Under the latter systems, the role of the State under domestic law has been reduced to that of protector, while in some countries’ legal frameworks their responsibilities are even less clear or further diminished. These circumstances are considered relevant for monitoring compliance with the Protocol.








- Date of ratification by the state of the following international treaties that recognize the right to social security:


a) ICESCR. Protocol of San Salvador.

b) CEDAW. Optional protocol.

c) ILO Conventions (35, 36, 38, 39, 40, 48, 67, 70, 71, 102, 118, 128, 131, 156, 157, 167, 165, 168, 183, among others).

d) 1951 Convention Relating to the Status of Refugees and Its 1967 Protocol

e) 1954 Convention Relating to the Status of Stateless Persons


 - Recognition in the constitution of the right to social security.  Scope and coverage.


- Specific legislation that recognizes the right to social security:


a) social security code;

b) special chapters or titles in the labor code;

c) sundry laws and regulations;

d) collective bargaining rules;

e) Other standards. State which.

 - organization of the social security system by type of coverage: for wage earners and family group; for the unwaged and persons in other circumstances; for the unemployed, by sex, nationality, legal status (refugee or stateless person), jurisdiction, and conditions of access.


- Conditions and requirements for social security access and coverage for groups not formally recognized in the labor market.  Scope and conditions.


- Trends in contingency coverage by type and level of coverage, population covered, conditions of entitlement.


- Social security benefit programs for informal workers.  Coverage, type of benefits, and jurisdictions involved.


- Specific contingency coverage for senior citizens without income or sufficient contributions.  Characteristics, scope, conditions of access, amounts.


- Number of reports and specific measures that the state has presented to international monitoring bodies on observance of the right to social security


- Number of shadow reports on social security presented by civil society organizations to treaty monitoring bodies.

- Pension gaps by age group


- Social security contributor gaps, by sex and age


Signs of progress

- Number of registered civil society organizations involved in the promotion and protection of the right to social security.


- Recognition of indigenous health systems.

- Existence of user satisfaction assessments with respect to the quantity and quality of social security coverage.







- Legal nature of the agencies that manage social security services:


·          Public

·          Private

·          Mixed

·          Union

·          Other. Describe type.


- Type of benefits they provide and population covered.

- Percentage of population with access to social security coverage.


- Number of social security plan participants, whether as contributors or beneficiaries, by age, sex, and occupational category.


- Number of workers covered against work accidents, by sex, age, nationality, legal status (refugee or stateless person), occupation or category, and branch of activity.


- Work accident trends by type of coverage, age, sex, nationality, legal status (refugee or stateless person), and branch of activity.


- Number of invalidity pensions granted in the past year, by sex, nationality, legal status (refugee or stateless person), and place of residence.

Percentage of population without social security coverage, by age, nationality, legal status (refugee or stateless person), activity status, ethnicity.


- Public-private social security coverage gap.


Signs of progress

- Existence of public policies on inclusion of nonparticipants in the social security system.


- Existence of institutional mechanisms to promote inclusion of groups without social security coverage.









- Forms of financing the social security system:


·    Percentage of contributions charged to employers and percentage charged to formal workers.

·    Percentage paid for with state funds.


- Ratio between contributions and the minimum wage.


- Percentage of the system under private management. Describe.


- Existence of solidarity funds. Describe.


- Use of extra-budgetary funds to finance the system or its deficit. Indicate if they come from international agency loans; borrowing, reserves, or other sources.

- Percentage of public social spending allocated to social security by geographic zone in the country (urban/rural) and by regions or provinces.


- Financing of maternity leave charged to: i) the social security system in full; ii) the employer in full; iii) other mechanisms. Describe which.


- Existence of a social security benefit update system. Parameters.


- Existence of mechanisms to take account of the male-female wage gap for social security purposes. Describe.


- Existence of mechanisms to offset the disparity in income and benefits in different geographic zone or region in the country. Describe.

- Male-female wage gap and its effect on the social security system.


- Types of non occupational illness, by sex, type of activity, and age.




Signs of progress

- Existence of estimates of the physical cost of social security reforms. Describe.







- Conditions and requirements for access to the social security system.


- Conditions and requirements for access to the system for indigenous peoples, afro-descendents, refugees, asylum seekers, and stateless persons.


- Conditions and requirements for access to the system for workers in domestic service.


- Conditions and requirements for access to the system for agricultural laborers.


- Social security benefits are calculated on the same basis for men as for women. Describe.


- Type and use of actuarial tables to calculate social security benefit (pension balance).


- In the case of divorce, family allowances are issued to the person with custody (if there are minor children).


- Existence of a mechanism for inclusion in contingency coverage of persons who engage in reproductive or domestic labor.

- Percentage of beneficiaries of a retirement pension, by sex and by age.


- Percentage of qualifying dependents who receive a pension or an allowance, by sex and by age.


- Percentage of immigrants, refugees, asylum seekers, and stateless persons. with social security coverage.


- Percentage of agricultural workers with social security coverage.

  Signs of progress      





- Existence of social security statistics disaggregated by sex, ethnicity, age, nationality, legal status (refugee or stateless person), public/private coverage, territorial distribution.


- Existence of surveys that measure contingency specificities (by gender, race).


- Frequency of reports sent to social security contributors, be they individual capital account holders or participants in the public pension system.


- Registration of work accident statistics by the state. Methodology, periodicity, and coverage.


- Measures to prevent work accidents.  State or private jurisdiction. Describe.


  Signs of progress

Existence of public awareness campaigns on social security rights. State responsibility, frequency, and target groups.


Measures by labor union to inform workers about guarantees to social security rights. Frequency and coverage.

- Distribution of information about rights to recipients of forms of ex-gratia or non-contributory pensions. Scope and limits.  





- Existence of pre-judicial mechanisms to lodge complaints alleging breach of social security obligations. Jurisdiction.


- Existence of state supervisory organs and operation of private social security benefits systems. Description, functions, jurisdiction.


 - Existence of complaint mechanisms for participants in individual capital account systems. Description, jurisdiction and functions.


- Number of complaints concerning the rights to social security received, investigated, and disposed of by the national human rights protection agency or other administrative mechanisms.


- Jurisdiction and oversight powers of the state with respect to management of individual capital funds by private entities. Scope and limits.


- Number of judicial decisions that to grant social security coverage.


- Number of complaints that have resulted in social security coverage granted to informal workers.


- Number of lawsuits that have resulted in a denial of a non-contributory pension.


  Signs of progress      


B.         Right to Health


93.              Article 10 of the Protocol of San Salvador provides with respect to this right that “Everyone shall have the right to health, understood to mean the enjoyment of the highest level of physical, mental and social well-being. In order to ensure the exercise of the right to health, the States Parties agree to recognize health as a public good and, particularly, to adopt the following measures to ensure that right: a) Primary health care, that is, essential health care made available to all individuals and families in the community; b) Extension of the benefits of health services to all individuals subject to the State's jurisdiction; c) Universal immunization against the principal infectious diseases; d) Prevention and treatment of endemic, occupational and other diseases; e) Education of the population on the prevention and treatment of health problems, and, f) Satisfaction of the health needs of the highest risk groups and of those whose poverty makes them the most vulnerable.”


94.              The Protocol refers to observance of the right in the framework of a health system that, however basic it may be, should ensure access to primary health care and the progressive development of a system that provides coverage to the country’s entire population. In turn, it should afford special assistance to vulnerable groups and those in a situation of poverty.


95.              The right to health has a large number of measurement instruments, in particular quantitative instruments. At the same time the right to health is addressed in three Millennium Development Goals (on child mortality, maternal mortality, and HIV/AIDS, malaria and other diseases), for which there is information available in most countries in the region. In these cases, it is up to the reporting State if it wishes to combine information on progress in the MDGs with the indicators suggested here.[58]


96.              In keeping with the aforesaid framework, for the purpose of monitoring the implementation process in terms of the scope of the provisions contained in the Protocol, the table below sets out the main (structural, process and outcome) indicators as well as qualitative signs of progress. We should reiterate that the indicators shown should be regarded as a guide for a broader process in which further indicators and more precise signs of progress are included.


97.              The table also includes indicators on crosscutting issues in order to demonstrate their importance and the possibility to have a combination of separate tables for all the rights contained in the Protocol (such as those mentioned in the first part of this document) with disaggregated information on crosscutting issues in the tables of indicators on specific rights.




- Ratification by the state of the following international treaties that recognize the right to health (indicate date of ratification):


a) ICESCR. Protocol of San Salvador

b) CEDAW. Optional protocol

c) CRC



- Recognition in the constitution of the right to health. Scope.


- For federal states: recognition and guarantees of the rights to health in subnational constitutions.


- Forms of and regulations on organization of the health system (public, private, health insurance). Describe and specify.


- Number of reports and specific measures that the state has presented to international monitoring bodies on the right to health.


- Number of shadow reports presented by civil society organizations to treaty monitoring bodies.


- Existence of programs that grant priority for health services to vulnerable sectors. Scope, population and territorial coverage, financing.


- Estimated percentage of births, marriages and deaths registered in a civil records system.


- Life expectancy by geographic zone in the country.


- Mortality rate by sex and age group.


- Mortality rate due to accidents, homicide, or suicide, by sex.


- Percentage of population with access to safe water.


- Percentage of population with access to basic sanitation services.


- Number of professionally attended deliveries.


- Percentage of women at reproductive age with anemia.




- The health system is organized according to the principle of universality or targeting criteria. Justify.


- Existence of national agencies or agreements on health system organization and operation. Describe.


- Number of registered civil society organizations involved in the promotion and protection of the right to health. Scope and territorial population coverage.


- Existence of user satisfaction assessments with respect to the quantity and quality of health services.  Main outcomes.







- Existence of official documents that recognize the fundamental concept of comprehensive and universal primary health care. List documents


- Existence of a national policy on drugs, including generic drugs. Scope, population and territorial coverage, operation mechanisms.


- Density of physicians per inhabitants.


- Density of nurses per inhabitants.



- The health services aim to provide universal coverage or only subsidize demand. Justify.


- Percentage of population with sustainable access to essential and/or generic drugs.


- Existence of significant public-private disparities in health spending and coverage. Justify.


- Percentage of public health services subcontracted to private companies or NGOs.


- Number of professional and auxiliary personnel per hospital beds.


 Primary health care program coverage.


- Coverage of the senior-citizen care program.


- Services utilization rate.


- Number of health-insured persons as contributors or beneficiaries.


- Comparative density of physicians in rural and urban areas.


- Hospital discharges, by cause, disaggregated by sex and age.



- Negotiation of international technical and financial assistance in health. Mention amounts, objectives, and applicant agencies.


- Existence of perception studies on access to healthcare.


- The State has designed institutional mechanisms that encourage citizen participation in decision-making in the public health sector. Describe.


- The entire population is ensured adequate access to timely, quality, and decent health care regardless of their capacity to pay. Justify.






- The health sector is financed:


·      Exclusively with budgetary resources. Indicate the percentage of public social spending allocated to health.

·      With extra-budgetary resources.  Source of financing, amounts, periods.


- Existence of incentives, tax allowances, and subsidies for the private health sector.  Amount, scope, and access requirements.


- Existence of government incentives for the private pharmaceutical industry. Quantity, requirement.


- Public health care spending per capita.


- Distribution of public social spending on health by geographic (urban/rural) zone in the country and by region or province.


- Percentage of funds used for training of human resources in health.



- Average expenditure on health as a percentage of household income.









- Rules on abortion.  Cases, scope, prohibitions.


- Existence of a law or national policy for persons with physical and mental disabilities.  Scope and coverage.


- Recognition of sexual and reproductive rights. Mention legal-regulatory instruments and their scope.



- Estimated number of abortions by age, place of residence (urban or rural) and socioeconomic status of pregnant woman.


- Percentage of population that uses indigenous or alternative health care systems.


- Existence and implementation of programs on sexual and reproductive health. Scope and coverage.



- Maternal mortality rate


- Distribution of maternal mortality by cause, disaggregated by age groups


- Percentage of persons with physical or mental disabilities who have access to services at public or social facilities


- Treatment of persons with disabilities at community facilities.


    Existence and availability of mental health services, by region.

- Food program coverage of boys and girls (%).


- Proportion of boys and girls who receive prenatal care and care up to age five.


- Births attended by skilled personnel.


- Percentage of pregnant women with HIV/AIDS tests


- Percentage of infants born to HIV-positive mothers who contract HIV/AIDS within the first two years of life. (reported number of vertically transmitted aids cases).


- Percentage of pregnant women who received prenatal care.


- Indicators for exclusive breastfeeding for four and six months.


- Perinatal mortality rate.


- Percentage of children under five years old who are underweight.


- Percentage of children with low birth weight (less than 2.5 kg).


- Rate of assistance due to domestic violence


- Composition by sex of reported cases of AIDS and HIV diagnoses.



- Estimated number of illegal abortions, by age, place of residence (urban or rural) and socio-economic circumstances of the pregnant woman, or other available data.




- Existence of public perception surveys on the relationship between fertility, child mortality, and maternal mortality.  Main findings.


- Existence of public perception studies on sexually transmitted diseases (inter alia, HIV/AIDS). Main findings.


- Existence of studies and estimates on illegal abortions disaggregated by age, place of residence (urban or rural), socioeconomic status of pregnant woman, or other available data.







- Existence of a health statistics system.  Territorial, thematic, jurisdictional, and population coverage.


- Existence of surveys that measure risk factors. Scope and limits.


- Statutory protection of personal health information. Scope and limits.


- Does the law require patient consent for treatment? Describe.


- Percentage of children and youth that receive health education.


- Percentage of health facilities with confidentiality protocols on health information.


- Government dissemination of information on sexual and reproductive health policy. Scope and coverage.


- Advisory services for pregnant women on mother-child HIV/AIDS transmission.


- Availability of information and awareness programs on the effects of alcohol, tobacco and other drug use.


- Existence at health facilities of translation services to and from other languages spoken in the country.   Scope  and territorial and ethnic coverage.


- Percentage of children born with fetal malformations caused by alcohol and other drug use.



- Existence of studies on health care needs.  Description and main findings.


- Existence of public awareness campaigns in this respect.  Scope.


Indicate which of the following mechanisms are used to disseminate information to the public about their health care rights:


a) government public awareness campaigns;

b) public awareness and action campaigns by civil society organizations;

c) community-based measures

d) print media

e) broadcast media

f) other media

g) mail shots

h) other





- Existence of pre-judicial mechanisms to lodge complaints alleging breach of obligations connected to the right to health. Jurisdiction and scope.


- Jurisdiction of government ministries to receive complaints from health system users. Scope and powers.


- Number of judicial decisions that have upheld guarantees in the area of health, in general, and in specific cases (inter alia, sexual and reproductive health, persons with HIV/AIDS).


- Number of complaints on the right to health received, investigated and disposed of by the competent national human rights protection agencies in the country.












98.              A methodology to monitor fulfillment of the rights and obligations contained in the Protocol such as the one proposed above, poses implications as regards the procedures for the preparation and evaluation of national reports.  Accordingly, the Inter-American Commission suggests a set of guidelines that it believes could help to establish a simple and effective procedure in that regard, and which might also serve as a model evaluation system for states.


99.              Some of these proposals are designed to contribute to the future activities of the Working Group to implement the reporting system, the composition and functioning of which were defined by the OAS General Assembly on June 5, 2007 (AG/RES. 2262).


100.          To that end, the Commission first sets out a number of general aspects regarding the procedure for reporting to the UN Committee on Economic, Social and Cultural Rights.  The purpose of this presentation is to draw attention to a number of lessons learned from this procedure that could be useful for the design eventually implemented in the inter-American context.  The aim, in particular, is to underscore possible differences between one procedure and the other and to endeavor to ensure that the monitoring systems do not needlessly duplicate efforts. Following that, the Inter-American Commission offers a number of observations on the use of a participatory procedure in the preparation of reports and on evaluation methodology.


A.        Considerations to Bear in Mind Based on the Experience of the United Nations Committee on Economic, Social and Cultural Rights


101.          Under Articles 16 and 17 of the International Covenant on Economic, Social and Cultural Rights, States parties undertake to submit reports on the measures which they have adopted and the progress made in achieving the observance of the rights recognized therein. These reports are initially examined by a Pre-Sessional Working Group composed of five members of the Committee,[59] who meet for one week before the plenary of the Committee examines the report. The principal purpose of the working group is to identify in advance the questions that will constitute the principal focus of the dialogue with the representatives of the reporting States. The group prepares a list of issues which are then transmitted to the reporting state, so that it might reply in writing before it appears before the Committee or at the public hearing.[60] The representatives of the States parties appear before the Committee, present the report, and answer questions.  The representatives are then given a period in which to answer questions posed or facilitate additional information.[61]  Finally, the Committee completes its examinations and publishes its “concluding observations” on the report.


102.          The Committee devotes three meetings (of three hours each) to its public examination of States parties’ reports. Finally, it holds a private session at which it adopts its concluding observations.


103.          In the course of its sessions in 2000, the Committee resolved that, as a general rule, a State party's next periodic report should be submitted five years after the Committee's consideration of the State's preceding report, but that the Committee may reduce this five-year period on the basis of the following criteria and taking into account all relevant circumstances: i) the timeliness of the State party's submission of its reports; ii) the quality of all the information submitted by the State party; iii) the quality of the constructive dialogue between the Committee and the State party; iv) the adequacy of the State party's response to the Committee's concluding observations; and, v) The State party's actual implementation of the Covenant.


104.          In situations in which the Committee considers that it is unable to obtain the information it requires, in accordance with Article 23 of the Covenant and the follow-up procedure in relation to the consideration of reports, it may request that the State party concerned accept a mission consisting of one or two members of the Committee.  Such a mission requires the approval of both ECOSOC and the State party concerned. The purpose of such missions is to enable the Committee to collect information to strengthen follow-up on its recommendations and provide technical assistance on specific issues.


B.         Participatory Procedure in the Preparation of Reports


105.          Given that monitoring compliance with obligations in the area of social rights is an especially complex task, since its first session in 1987, the Committee on Economic, Social and Cultural Rights has relied on information provided by official UN sources, specialized agencies, and nongovernmental organizations. Resolution 1296 (XLIV) introduced the participation of nongovernmental organizations in the work of the Committee. Furthermore, in 1993, the Committee approved a document entitled “Participation of non-governmental organizations in the Committee on Economic, Social and Cultural Rights.”[62]  Although a number of member states initially expressed their rejection of the use of information supplied by nongovernmental organizations, the Committee has vigorously defended the role of the information provided, especially since it can be compared with the original information provided by the State.  This process has led to various forms of civil society participation in the activities of the Committee, in particular through the submission of alternative, parallel, or shadow reports.


106.          The submission of a parallel or alternative report to that of the State is possible through coordination between the Committee and NGOs.  This participation is open to NGOs i) during consideration of State party reports, at which they may participate without voice; ii) on general discussion days, at which they have the opportunity to make oral presentations; and, iii) in the drafting of general comments. It has also been the practice of the Committee to permit participation of civil society organizations in the meetings at which the Pre-Sessional Working Group drafts the questions to be put by the Committee to the reporting state.  Some states provide specific procedures for civil society participation in the presentation of their respective reports to the Committee. 


107.          Moreover, civil society participation in the presentation of alternative reports to treaty-based monitoring bodies is a practice that already deserves the highest possible respect as a citizen oversight mechanism on state compliance with international obligations.


108.          In the framework of the inter-American system, the Permanent Council adopted a resolution that contains a series of guidelines on civil society participation in OAS activities,[63] which has prompted the registration, mobilization, and participation of nongovernmental organizations active in various fields.  In any event, this recognition of the necessary participation of civil society puts a seal of legitimacy on the activities of the Organization.


109.          The IACHR considers that the reporting procedure under the Protocol will be highly useful for ensuring adequate participation for civil society in the various stages. It is possible that many states will manage to ensure that participation in their internal procedures for drafting the reports to be submitted to the Working Group. In that connection, the IACHR considers that, generally speaking, the information collected for the report provided in the Protocol will be of a public nature or of public interest and that there should be no obstacles to limit participation and discussion forums with different societal stakeholders that represent the diverse sectors involved in the issues covered in the report.  The participation in the reporting and evaluation processes of the Working Group will make it possible to ensure greater transparency and legitimacy in the process, increase sources of information which the Working Group would be able to compare with the statistical and factual data provided by different states, and, finally, boost the effectiveness of follow-up on the observations of the Working Group. The social and policy dialogue that the Protocol monitoring process could trigger would certainly be a notable outcome in itself, as a strategy for ensuring social rights in States parties.


110.          In turn, the principle of participation requires that all procedures corresponding to the reporting system be governed by the principle of broad disclosure. As mentioned above, without prejudice to the fact that some information might be confidential, the type of information requested for the system of indicators and for the reporting on the situation of the social rights enshrined in the Protocol in general, is of a public nature or of public interest, and states should furnish and publicize it widely. Accordingly, the IACHR considers that the reporting to the Working Group should proceed in a framework that is as open to participation and as public as possible. 


C.         Monitoring Phases


111.          Discussions have been held in the framework of the Committee on Economic, Social and Cultural Rights as to whether it would be more suitable for reports presented to cover clusters of rights or all of the rights protected in the Covenant. While reports were initially submitted on clusters, it was later decided to have documents that examined all of the rights protected.


112.          The General Assembly resolution that contains the Reporting Guidelines does not lean toward any methodology in particular. It merely alludes to the possibility of grouping the rights protected according to thematic clusters and mentions the need to cross reference that information with information on the respective rights subject to special protection. However, there is no rule with respect to the ‘cluster reporting’ methodology.


113.          The Inter-American Commission considers that the implementation process for the reporting system should proceed as vigorously as possible while adhering to minimum requirements of reasonableness, in accordance with the institutional structure currently in place in the Organization for monitoring. Consequently, the Inter-American Commission proposes that the reporting system be implemented by stages that cover clusters of related rights and alternative strategic themes consistent with the needs and priorities of the region.


114.          It should be borne in mind that the report evaluation procedures are relatively short (60 days), with the result that the Working Group will not have enough time to analyze an overly extensive amount of information.  Therefore, the Inter-American Commission considers that to adopt a system of reports that cover all of the rights contained in the Protocol could lead to recommendations of an exceedingly general nature that fail to address areas of non-compliance in sufficient depth. The various proposals on clusters and procedure are designed to make reporting as suitable and effective as possible.


115.          As noted, the IACHR believes that a possible starting point would be the presentation of reports on crosscutting issues common to all of the rights and in the manner described in this document. The difficulty of submitting exhaustive reports on every component of each of the rights enshrined in the Protocol, justifies an approach that would initially provide information on the baseline situation in those settings that best encourage the judicial enforceability and political observance of social rights at the domestic level.


116.          In parallel to the indicators on crosscutting issues, at an ensuing stage it would be necessary to develop, in a participatory and deliberative manner, a set of indicators on the other social rights contained in the Protocol.


117.          Finally, a core aspect of the first phase is for each state to establish priority goals and objectives.  We have already mentioned the need that this process formally includes the participation of civil society.  Goal setting also requires the design of a precise strategy or plan for meeting those goals and a detailed timetable by which to monitor fulfillment of proposed objectives. Goals and objectives should be consistent with the level of development and available resources in each state and be designed with particular attention to the scope and content of each right in the Protocol, as determined by the case law of the inter-American system, the analogous implementation of the general comments and concluding observations of the UN Committee on Economic, Social and Cultural Rights, and the relevant case law of domestic tribunals.


D.        Design of Indicators in Accordance with Local Problems and Determination of Regional Needs and Priorities


118.          A system of indicators to analyze the observance of rights is technically a highly complex tool. One of the most useful strategies for reducing this problem is to adapt or adjust a set of general progress indicators to match local and/or regional issues to be examined in each period. This requires that, prior to the presentation of reports, the Working Group to implement the system prepare a preliminary analysis or outline of the problems in each country under review based on relevant information from specialized agencies, the government departments of the State in question, and consultations with civil society organizations. It might also be appropriate, for that purpose, to confer with the Inter-American Commission on Human Rights. The IACHR considers that, in addition to a set of general progress indicators, it would be advisable for the Working Group to specify which information is deemed relevant and to add or remove some of those indicators, as appropriate, in order to make it easier for the State to enhance the accuracy and utility of its reports. Accordingly, the IACHR recommends a preparatory activity of some description similar to that carried out by the UN Committee’s Pre-Sessional Working Group.


E.        Presentation of Reports to the Working Group and Their Evaluation. Need for a Tripartite Working Group


119.          It should be borne in mind that some of the procedures of the Committee on Economic, Social and Cultural Rights suffer from certain restrictions owing to the difficulty that this agency has in monitoring a rather high number of countries (more than 100).  The fact that there are fewer countries in the inter-American framework would make it possible to explore creative methodologies with respect to the evaluation of reports.  Following, we offer a number of suggestions on presentation, evaluation, and follow-up on implementation of recommendations.


120.          As regards evaluation of reports, it could be useful for the working group to have the possibility to make country visits -should it consider that necessary- to ensure direct contact with government agencies and greater participation on the part of the relevant civil society organizations. This initiative is in keeping with the constructive nature of the reporting system, which seeks to guide states in the adequate fulfillment of the Protocol.


121.          Evaluations should be conducted according to the principle of maximum disclosure and not be guided by the logic of secrecy. Evaluations should also take into account information supplied by nongovernmental organizations regarding reports submitted by states (alternative or supplemental reports). 


122.          Follow-up on implementation of recommendations is a task that should be globally supervised by the Working Group according to set deadlines at the domestic level. It should be kept in mind that the principle of reciprocation does not signify that reporting is limited simply to a dialogue between states and the Working Group without any form of coercibility or constraint.  Indeed, such procedures were abandoned by the Universal System in favor of the procedure of the ESCR Committee and the need to adopt concluding observations, the recommendations from which provide the framework for the presentation of ensuing reports.


123.          The members and procedures of the Working Group must safeguard the principles of autonomy, independence, and impartiality, in particular vis-a-vis governments. 


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[53] The Inter-American Convention on the Prevention, Punishment and Eradication of Violence against Women (Convention of Belem do Pará) creates the obligation for the State to “ensure research and the gathering of statistics and other relevant information relating to the causes, consequences and frequency of violence against women, in order to assess the effectiveness of measures to prevent, punish and eradicate violence against women and to formulate and implement the necessary changes.” (Art. 8 (h). As we shall see, this is a clear obligation to produce information and is enforceable as a right. 

[54] Office of the Special Rapporteur for Freedom of Expression, “Access to Public Information in the Americas.  Contributions of the Office of the Special Rapporteur for Freedom of Expression of the Inter-American Commission on Human Rights,” p. 12. This document also outlines discussions on legislative reforms in this area in the Americas. See also Article XIX, The Public´s Right to Know: Principles on Access to Information Legislation (June 1999), available at, The Johannesburg Principles on National Security, Freedom of Expression and Access to Information” (November 1996), available at http:  Kate Doyle, “Freedom of Information in Mexico”, May 2, 2002, available at http: Toby Mendel, ”Freedom of Information as an Internationally Protected Human Right”, Article 19, 2000, in La Información como herramienta para la protección de los derechos humanos”, CELS, 2004; and Statistical Conference of the Americas,

[55] In the comments submitted by the International Commission of Jurists (ICJ) and the government of Colombia during the consultation period for this document, it was suggested that the outcome indicators to be chosen for each of the rights selected should reflect at least those components of the rights expressly provided for in the text of the treaty that lend themselves to translation in quantitative terms, particularly -and at least-, as outcome indicators. Furthermore, the goal with each of the individual indicators included as qualitative signs of progress is to relate those signs of progress, in turn, to the crosscutting issues proposed, so as to link government policies and measures (or the absence thereof) to the objectives as regards implementation of the Protocol and of the development model adopted by each state.

[56] Laura Pautassi “El derecho a la seguridad social. Una aproximación a América Latina”, In: Abramovich, V.; Añón, M.; Courtis, C. (comps.), Derechos Sociales: instrucciones de uso. Doctrina Jurídica Contemporánea, Mexico, Fontamara Ediciones, 2003.

[57] In short, protected individuals are all those who are included in the system’s field of application, or in special regimes (professionals, armed forces). They are potential claimants of the benefits established, which will come into effect when the contingency occurs, provided that they meet the required conditions (age, illness, etc.). In order to be a beneficiary, however, it is not enough to come within the field of application of these regimes; it is always necessary to meet legal requirements to accede to the status of beneficiary. These requirements may refer to the objectivization of the contingency (degree of invalidity, for example) or to legal conditions (married status) or be related to the administrative and financial authority of the regime in question (length of membership or minimum contribution). Clearly, the system is not unconditionally accessible to all citizens.

[58] In its response to the consultation on the instant document, the PAHO indicated that, in addition to the MDGs as a measurement instrument, it was also necessary to include all the resolutions that concern the right to health, in particular on primary health care and protection of vulnerable groups, discussed and adopted by the OAS member states in the Directing Council and/or the Pan American Sanitary Conference of the PAHO in the context of the Constitution of the WHO. It mentioned, to that end, that it is crucial to offer states, civil society, and specialized inter-American agencies the possibility to measure the right to health in accordance with the guidelines that come out of the PAHO/WHO as the inter-American agency that is responsible for public health in the Hemisphere and which consists of a large number of offices that monitor state compliance with necessary measures to protect the right to physical and mental health of the most vulnerable groups.

[59] These persons are nominated by the Committee Chair, taking account of the desirability of a balanced geographical distribution and other relevant factors, such as the areas of expertise of the Committee members.

[60] The list of issues contains questions addressed in writing to the State party based on documents presented by it.  The list is prepared some 6 to 12 months before the Committee examines the report of the State party.

[61] In order to have available all the information necessary to evaluate reports, the Committee permits nongovernmental organizations to present information at any time during the review process and even allows the submission of alternative reports (commonly referred to as shadow reports).

[62] UN Doc. E/C.12/1993/WP.14 of 12 May 1993. See also, “NGO participation in the activities of the Committee on Economic, Social and Cultural Rights”, 7 July 2000 (E/C.12/2000/6).

[63] CP/RES.759 (1217/99).