Human rights - health and reproduction in Europe Dr.Gunta Lazdane Acting Regional Adviser Reproductive Health and Research EPF 2004

International Conventions  International Covenant on Economic, Social and Cultural Rights – ICESCR 1966  International Covenant on Civil and Political Rights – ICCPR 1966  UN Convention on the Rights of the Child – ICRC 1989  UN Convention on the Elimination of all Forms of Discrimination Against Women – CEDAW 1979 EPF 2004

Not ratified by countries in Europe  Andorra – ICESCR, ICCPR  Kazakhstan - ICESCR, ICCPR  Monaco – CEDAW  - not ratified  - signed but not ratified  Holy See – ICESCR, ICCPR, CEDAW EPF 2004

Different levels of obligations:  Treaties – binding on states parties  Declarations – non-binding (Declaration of Alma Ata 1978, World Health Declaration 1998)  Policy documents – non-binding (consensual UN global conferences action plans) EPF 2004

UN ICPD in Cairo - POA “…the right to of men and women to be informed and to have access to safe, effective, affordable and acceptable methods of family planning of their choice, as well as other methods of family planning of their choice for regulation of fertility which are not against the law, and the right of access to appropriate health-care services that will enable women to go safely through pregnancy and childbirth and provide couples with the best chance of having healthy infant.” Chapter VII, 7.2 EPF 2004

Fourth World Conference on Women – Beijing “The human right of women include the right to have control over and decide freely and responsibly on matters related to their sexuality, including sexual and reproductive health, free of coercion, discrimination and violence.” EPF 2004

Cairo + 5 (1999), Beijing + 5 (2000) The reproductive rights may be violated: 1) Direct action on the part of a state which interferes with one’s reproductive rights 2) Result from the state’s failure to meet the minimum core obligations of a human rights treaty 3) Result of patterns of discrimination EPF 2004

EUROPE  The European Convention for the Protection of Human Rights and Fundamental Freedoms  The European Social Charter EPF 2004

Mechanisms for Implementing Rights in the European Human Rights System  The Council of Europe: Committee of Ministers Parliamentary Assembly  European Union: European Parliament the Council the Court of Justice EPF 2004

The right to:  Life, survival, security, and sexuality  Reproductive self-determination and free choice of maternity  Health and the benefits of scientific progress  Non-discrimination and due respect for difference  Information, education, and decision- making EPF 2004

The right to life and survival The European Commission of Human Rights considered a complaint alleging a state’s violation of the right to life of a woman who had died in childbirth! To protect life against unintentional loss!!! EPF 2004

WHO: Indicators to determine how fully the substantive elements of the right to health services are satisfied:  availability  accessibility  acceptability  quality EPF 2004

Objectives and Targets  Reproductive Choice  Safe Motherhood  STI/HIV control  Sexual abuse and violence  Trafficking of women  Breast cancer  Adolescents’ SRH  Refugees and displaced persons  Migrant populations  Aging people

SRH Strategies in transition countries  Countries have RH strategies: ARM, AZE, BEL, BUL, CRO, EST, GEO, MDA, ROM, RUS, UKR, UZB  Countries that are developing RH strategy: KAZ, KGZ  Countries asking for assistance in development – LTU, SVK, SVN

Population living on < 2 USD a day (% of population) Source: World Bank, 2001

Unmet need for modern contraception (%) (CDC-RH, 2003) Ukraine Romania Armenia Kazakhstan Uzbekistan

No contraceptive use (% of sexually active 15-year old girls) HBSC survey, WHO, 2000

Induced abortion women < 20 years of age (ab/per 1000 women )

To create supportive legislative and regulatory frameworks:  to review laws and policies to ensure that they facilitate equitable access to RSH education, information and services  to ensure that regulations and standards are in place – necessary commodities are available on a consistent and equitable basis  to set performance standards for the provision of services EPF 2004