Why has the United States of America not ratified the United Nations Convention on the Rights of the Child? The veto fulcrum as a new health policy analysis framework.

چکیده اصلی

BACKGROUND: The United Nations Convention on the Rights of the Child (CRC) enshrines health as a human right among other rights for children, fulfilled by each member state legally endorsing its principles through ratification of the Convention. Only the United States of America of all of the UN state parties has not ratified the CRC. OBJECTIVE: This study aimed to determine the reason(s) the CRC has not been ratified by the USA. METHOD: Method design involved a mapping literature search and in-depth interviews with key stakeholders in the fields of global health, child rights, health policy, and US law. Implementing the health policy triangle systematized themes into content, context, processes, and actors as opposition or proponents of ratification. RESULTS: While most published opinions favour ratification of the CRC, critically, the literature focuses on pros and cons of ratification, rather than reasons why the US has not ratified. Interview informants expanded themes revealing a status quo of non-ratification which has become increasingly challenging to overcome. Drawing on veto player theory to explain the status quo and introducing a new policy analysis framework of a veto fulcrum reveals that within the process of ratification, single powerful actors at a veto fulcrum have made undemocratic decisions, obstructing CRC ratification. CONCLUSION: This research has forged a new policy framework, the veto fulcrum, which examines political systems where political actors as veto players have extraordinary power to make executive decisions against public opinion, and against good health policy.

متن کامل اصلی