A/HRC/17/25 (b) Opportunities are required for the active and informed participation of individuals and communities in decision-making that has a bearing on their health; (c) Access to the minimum essential food which is nutritionally adequate and safe; (d) Access to shelter, housing and sanitation and an adequate supply of safe drinking water; (e) The provision of essential drugs; (f) Equitable distribution of all health facilities, goods and services.21 20. In respect of human rights more broadly, it has been noted that there was historically a lack of clarity concerning the content of human rights-based approaches. This was mitigated by the Common Understanding agreed upon by United Nations agencies in 2003. This document represents the achievement of conceptual consensus; however, it lacks detail and has been difficult to operationalize. United Nations agencies have employed the Common Understanding in inconsistent ways,22 and, outside the United Nations system, the definitions and uptake of human rights-based approaches vary even more widely. However, common elements can still be distilled from most approaches taken, and can be used to inform implementation of a right to health approach to development. 21. According to the Common Understanding, a human rights-based approach requires that each stage of development programming – that is, the goals, processes and outcomes of development – be informed by, and further, human rights:23 (a) Goals: All programmes, policies and technical assistance should further the realization of human rights; (b) Processes: Human rights standards and principles guide programming in all sectors and phases of the programming process; and (c) Outcomes: Development cooperation contributes to the development of dutybearers to meet their obligations and of rights-holders to claim their rights. 22. The following further elements have been identified by the United Nations as necessary, specific, and unique to a human rights-based approach to development: (a) Assessment and analysis in order to identify the human rights claims of rights-holders and the corresponding human rights obligations of duty-bearers as well as the immediate, underlying, and structural causes of the non-realization of rights; (b) Programmes which assess the capacity of rights-holders to claim their rights, and of duty bearers to fulfill their obligations, and the development of strategies to build these capacities; (c) Programmes which monitor and evaluate both outcomes and processes guided by human rights standards and principles; and 21 22 23 8 Committee on Economic, Social and Cultural Rights, general comment No. 14 (2000) on the right to the highest attainable standard of health. Sofia Gruskin, Dina Bogecho and Laura Ferguson, “‘Rights-based approaches’ to health policies and programs: Articulations, ambiguities, and assessment” Journal of Public Health Policy, vol. 31, No. 2 (2010), p. 134. United Nations, “The Human Rights Based Approach to Development Cooperation – Towards a Common Understanding Among UN Agencies”, p. 1.