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UNFPA Global Population Policy Update
Laws and Policies in Brazil, Chile, Peru, Mexico and Nicaragua
ISSUE 92 - 12 August 2010
This issue of the UNFPA Global Population Policy Update chronicles important laws and policies relating to access to voluntary family planning amended and adopted in 2009 and 2010 in the Latin America region.
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Brazil Regulates Private Health Care to Provide for Family Planning On 11 May 2009, Brazil amended Article 36-C of Law No. 9656, which sets forth provisions regulating private health care plans and insurance. The amendment ensures that all contracts for private health care plans and insurance include coverage for family planning. Resolution No. 192 of 27 May 2009 of the Ministry of Health describes in detail the nature of family planning services to be covered under this programme. The article recommends that these services consist of procedures that would guarantee equal rights for procreation and for limiting or increasing the number of children for women, men, and couples. It also provides for counselling, education, and clinical treatment for this purpose. Not covered in the article are the provisions of assisted reproduction services or medicaments that can be freely obtained in pharmacies for home use without professional supervision.
http://www6.senado.gov.br/legislacao/ListaPublicacoes.action?id=258764
http://www.ans.gov.br/portal/upload/instanciaparticipacao/transparencia_consultas_publicas/consulta31_DocApoio_RN192_Planejamento%20Familiar.pdf
http://www.ans.gov.br/portal/upload/instanciaparticipacao/transparencia_consultas_publicas/consulta31_DocApoio_RN192_Planejamento%20Familiar.pdf
Chile Adopts Law Guaranteeing Education and Information on, and Access to, Family Planning Methods, Including Access to Emergency Contraception
On 18 January 2010, Chile enacted Law No. 20.418, establishing norms on information, orientation and the provision of family planning methods. The law guarantees every person’s right to decide freely and responsibly on the family planning method of their choice. It aims to combat teenage pregnancy, sexually transmitted infections, and sexual violence and their consequences. To give effect to this right, the law codifies each individual’s right to receive comprehensive and unbiased information, education and orientation on family planning methods. It also guarantees each person’s right to privacy and confidentiality regarding their family planning method of choice.
On 18 January 2010, Chile enacted Law No. 20.418, establishing norms on information, orientation and the provision of family planning methods. The law guarantees every person’s right to decide freely and responsibly on the family planning method of their choice. It aims to combat teenage pregnancy, sexually transmitted infections, and sexual violence and their consequences. To give effect to this right, the law codifies each individual’s right to receive comprehensive and unbiased information, education and orientation on family planning methods. It also guarantees each person’s right to privacy and confidentiality regarding their family planning method of choice.
Under the terms of the law, the State must take appropriate measures to ensure access to all modern family planning methods, including hormonal and non-hormonal contraception and hormonal emergency contraceptive pills. The law excludes from the definition of contraception any method whose direct objective is to induce an abortion, which is illegal in Chile in all circumstances.
When an individual seeks emergency contraception (EC) and the health-care worker attending the patient suspects that the person seeking EC is a victim of sexual assault, the worker is required to inform the Public Prosecutor’s office of the situation. In the case of children under the age of 14 seeking access to EC, public and private health-care personnel are required by the law to provide access to EC, but must inform the child’s parent or guardian after the fact. The law does not establish any exceptions to these reporting requirements.
The law also provides that all accredited secondary schools provide sexuality education programmes that include information on approved and available family planning methods. This requirement, however, does not set minimum requirements for the sexuality education programme; instead the curricula are to be developed according to the convictions and beliefs of each educational institution.
Peruvian Ministry of Health Issues Resolution on Free Distribution of Emergency Contraception Pills in the Public Health System
On 8 March 2010, the Peruvian Ministry of Health issued a resolution affirming that emergency contraceptive pills are not abortifacients and re-establishing free of charge access to emergency contraception (EC) through the public health system. Under Peru’s national family planning programme, public health institutions must provide access to all available contraceptive methods. Resolution No. 167-2010/MINSA affirms that emergency contraception (EC) is a family planning method under the terms of the programme. The resolution also calls for the dissemination of these findings to raise public awareness and dispel misconceptions that EC is an abortifacient and can cause harmful or deadly side effects.
This resolution followed the October 2009 decision by Peru’s Constitutional Court banning the free distribution of emergency contraceptives by the State. In Peru, abortion is permitted only when necessary to save a woman’s life or to avoid a serious and permanent injury to her health. In its decision, the Court also stated that the Peruvian body charged with drug approvals would have to ensure, without a doubt, that EC did not produce deadly or harmful side effects.
Following the Constitutional Court’s decision, the Peruvian Ministry of Health requested an expert opinion from the Pan American Health Organization (PAHO), a regional affiliate of the World Health Organization, clarifying how emergency contraceptive pills acted to prevent pregnancy. In response, PAHO issued a communication, stating that EC can prevent either the release of an egg from the ovary (ovulation) or the union of the sperm and the egg (fertilization), but that there is no scientific evidence to support a claim that EC affects fertilized eggs. Based on PAHO’s report, the Peruvian National Institute of Health and the Peruvian Medicines, Supplies, and Drugs Administration concluded that current scientific evidence clearly establishes that EC is not an abortifacient. These findings laid the legal groundwork for the Ministry of Health to issue this resolution reinstating the free distribution of emergency contraceptive pills as a family planning method.
Mexican Supreme Court Upholds Regulation Mandating Access to Emergency Contraception for Sexual Assault Victims
On 27 May 2010, the Supreme Court of Mexico upheld a federal regulation establishing comprehensive guidelines for medical responses to gender-based violence, including a provision that requires hospitals to offer emergency contraception to victims of sexual assault.
The regulation, NOM-046-SSA2-2005 (Interfamilial Violence, Sexual Violence, and Violence against Women: Criteria for Prevention and Attention), was published by Mexico’s Secretary of Health in April 2009. The regulation—which is mandatory for all public and private health-care providers nationwide—establishes guidelines for medical providers on preventing, detecting, and providing medical attention to victims of physical, psychological and sexual abuse. In particular, the guidelines provide for education to prevent abuse and referrals to resources for psychological counselling and other social services, and establish a standard of care for treating abuse victims.
Under the terms of the regulation, providers are obliged to report situations of suspected domestic or sexual violence to the public prosecutor. The regulation also obligates health-care providers to offer female victims of sexual assault access to emergency contraception (EC) up until 120 hours after rape, and to ensure that they receive complete information about EC to facilitate free and informed decision-making about its use.
The Governor of the state of Jalisco challenged the regulation on the basis that it infringed on states’ rights on several grounds. The legal challenge alleged, inter alia, that the Secretary of Health did not have the authority to instruct states on how to care for victims of crime, and that the obligatory provision of EC to rape victims violated state constitutional and penal norms. Jalisco’s Constitution protects a right to life “from conception to natural death," and, while Jalisco does not criminalize abortion in cases of rape, the Penal Code requires appropriate authorities—not medical practitioners—to establish that a rape has occurred before a woman can access an abortion on this ground.
The Jalisco Governor’s argument rested on an assumption that EC was an abortifacient, a contention that the Mexican Supreme Court rejected based on “international scientific evidence.” The Court reasoned that, as EC was not an abortifacient, the regulation did not interfere with Jalisco’s penal code or constitutional right to life.
The Court further held that the regulation was part of the public health policy—a domain which the federal Secretary of Health has the authority to regulate—and, accordingly, that the regulation did not infringe on states’ rights.
The decision of the Supreme Court is available at:
http://www.scjn.gob.mx/Documents/PR_CC_54_09.pdf.
The regulation is available at:
http://www.salud.yucatan.gob.mx/images/stories/pdf/Nom046_PublicacionDiarioOficial_16%20Abril_09_VIOLENCIA.pdf.
http://www.scjn.gob.mx/Documents/PR_CC_54_09.pdf.
The regulation is available at:
http://www.salud.yucatan.gob.mx/images/stories/pdf/Nom046_PublicacionDiarioOficial_16%20Abril_09_VIOLENCIA.pdf.
Nicaragua Provides Protection to Low-Income Family During Multiple Births
On 5 May 2010, Nicaragua approved Law No. 718, which aims to provide special protection to low-income families where multiple births are expected. The law calls for all government agencies to : a) follow such families in order to ensure that their basic needs for social protection are met; b) provide prenatal care to mothers in such families; c) guarantee that such women are allowed to provide maternal care without adverse consequences for their labour status; d) provide such women with two additional weeks of postnatal leave for each additional child born resulting from a single pregnancy; e) guarantee such families with a supply of milk regardless of whether it has social security insurance; f) pay such women additional maternity benefits; and g) give priority in housing to such families.
On 5 May 2010, Nicaragua approved Law No. 718, which aims to provide special protection to low-income families where multiple births are expected. The law calls for all government agencies to : a) follow such families in order to ensure that their basic needs for social protection are met; b) provide prenatal care to mothers in such families; c) guarantee that such women are allowed to provide maternal care without adverse consequences for their labour status; d) provide such women with two additional weeks of postnatal leave for each additional child born resulting from a single pregnancy; e) guarantee such families with a supply of milk regardless of whether it has social security insurance; f) pay such women additional maternity benefits; and g) give priority in housing to such families.
All previous issues of the UNFPA Global Population Policy Update can be found on UNFPA's website at:
http://www.unfpa.org/public/parliamentarians/pid/3615.
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This newsletter is issued by the United Nations Population Fund (UNFPA) in its capacity as the secretariat for the biennial International Parliamentarians' Conference on the Implementation of the ICPD Programme of Action (IPCI/ICPD). The first IPCI/ICPD was held in November 2002 in Ottawa, Canada; the second in October 2004 in Strasbourg, France; the third in November 2006 in Bangkok, Thailand; and the fourth in November 2009 in Addis Ababa, Ethiopia. These dispatches are intended to highlight important developments taking place around the world so that parliamentarians can stay informed of and learn from the successes, setbacks and challenges encountered by their fellow counterparts in other countries and regions in their efforts to promote the implementation of the Programme of Action of the International Conference on Population and Development (September 1994, Cairo, Egypt). It should be noted that UNFPA does not necessarily endorse the policies described in this newsletter.
Please send mailing list update information to Ragaa Said at said@unfpa.org. If you have any questions or comments on the content of this newsletter, please contact Ms. Said at said@unfpa.org, Nobuko Takahashi at takahashi@unfpa.org or Safiye Cagar at cagar@unfpa.org.
This newsletter is issued by the United Nations Population Fund (UNFPA) in its capacity as the secretariat for the biennial International Parliamentarians' Conference on the Implementation of the ICPD Programme of Action (IPCI/ICPD). The first IPCI/ICPD was held in November 2002 in Ottawa, Canada; the second in October 2004 in Strasbourg, France; the third in November 2006 in Bangkok, Thailand; and the fourth in November 2009 in Addis Ababa, Ethiopia. These dispatches are intended to highlight important developments taking place around the world so that parliamentarians can stay informed of and learn from the successes, setbacks and challenges encountered by their fellow counterparts in other countries and regions in their efforts to promote the implementation of the Programme of Action of the International Conference on Population and Development (September 1994, Cairo, Egypt). It should be noted that UNFPA does not necessarily endorse the policies described in this newsletter.
Please send mailing list update information to Ragaa Said at said@unfpa.org. If you have any questions or comments on the content of this newsletter, please contact Ms. Said at said@unfpa.org, Nobuko Takahashi at takahashi@unfpa.org or Safiye Cagar at cagar@unfpa.org.
