C H A P T E R 3
Reproductive Health And Reproductive Rights
Mother and children in Brazilian slum.
Millions of poor women worldwide want to delay or avoid
pregnancy but lack access to family planning information and services.
The ICPD accepted that the right to reproductive and sexual health is included among
human rights. Human rights related to reproductive health include:
Reproductive decision-making on the basis of
equality between women and men,
including voluntary choice in marriage and determination of the number,
timing and spacing of one’s children;
Sexual and reproductive security,
including freedom from sexual violence and coercion,
and the right to privacy.
Universal access to quality services is a primary means to reproductive health and a
central goal of the ICPD Programme of Action. The need is as pressing today as it was in
1994:
Maternal mortality. More than 585,000 women die each year as a result
of pregnancy. 1 At least 7 million women
suffer serious health problems and as many as 50 million suffer some health consequences
after childbirth.
Unsafe abortion. Some 20 million unsafe abortions take place in
developing countries each year and as many as 70,000 women die, accounting for 13 per cent
of maternal deaths.2
Sexually transmitted disease. There are over 330 million cases of
treatable sexually transmitted diseases each year; 33.4 million persons are living with
HIV/AIDS, and there are 5.8 million new infections each year, or 11 a minute.
Unwanted pregnancy. Of the nearly 175 million pregnancies each year,
as many as half are unwanted or ill-timed. Around 120 million women do not want another
birth within the next two years or at all and are not using any method of family planning
because of lack of access, information or the support of families and communities. Over
350 million women do not have a choice of safe and effective contraceptive methods. Of the
nearly 130 million births each year, more than 60 million are not assisted by a trained
delivery attendant: over 98 per cent of these are in less-developed regions.
Gender-based violence exacts a heavy toll on mental and physical
health. Millions of women require medical attention or otherwise suffer the impact of
rape, incest and domestic violence; fear of violence inhibits discussion and constrains
the health choices and life opportunities of many millions more. More than half of all
women will suffer some form of gender-based violence at some time in their lives. More
than 2 million girls and women per year become involved in the sex industry, often from
coercion or desperation. Two million girls and young women are at risk of female genital
mutilation (FGM) each year and an estimated 130 million are already affected.
Adolescent reproductive health. Young girls are at particular risk of
reproductive ill-health. More than 14 million adolescent girls give birth each year. A
large proportion of these pregnancies are unwanted, and it is estimated by the World
Health Organization (WHO) that as many as 4.4 million abortions are sought by adolescent
girls each year. Harmful practices such as FGM and child marriage followed by expectations
of early childbearing further increase the risk of reproductive ill-health.
In most countries, family planning is still the central component of reproductive
health services. Five years after the ICPD, however, all countries have taken some steps
to ensure access to comprehensive sexual and reproductive health information and services.
Many countries have adopted the ICPD definition of reproductive health and are moving
towards a client-centred approach to meeting reproductive health needs. In some countries,
implementation is moving ahead rapidly.3
Less progress has been made in implementing integrated reproductive health programmes,
because service delivery infrastructures are weak and human and financial resources are
lacking.4
BOX
11
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The Right to Reproductive Health
Principle 8 of the ICPD Programme of Action states:
"Everyone has the right to the enjoyment of the highest attainable standard of
physical and mental health. States should take all appropriate measures to ensure, on a
basis of equality of men and women, universal access to health-care services, including
those related to reproductive health care, which includes family planning and sexual
health. Reproductive health-care programmes should provide the widest range of services
without any form of coercion."
Paragraph 7.3 of the ICPD Programme of Action states:
"[R]eproductive rights embrace certain human rights that are already recognized in
national laws, international human rights documents and other consensus documents. These
rights rest on the recognition of the basic right of all couples and individuals to decide
freely and responsibly the number, spacing and timing of their children and to have the
information and means to do so, and the right to attain the highest standard of sexual and
reproductive health. It also includes their right to make decisions concerning
reproduction free of discrimination, coercion and violence, as expressed in human rights
documents." |
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