1. The Futures Group International Research Triangle Institute The Centre for Development and Population Activities with Funding from the U.S. Agency for International Development P O L C Y I Reproductive Health And Human Rights

2. Outline of Presentation Human rights documents support reproductive rights Good human rights practices contribute to good RH Human rights tools Challenges for POLICY II

3. Key International Laws, Declarations and Consensus Statements 1945 1948 1982 1994 1995 Universal Declaration of Human Rights International Conference on Population and Development Fourth World Conference on Women United Nations Charter Convention for the Elimination of All Forms of Discrimination Against Women

4. Key International Laws, Declarations and Consensus Statements 1945 1948 1982 1994 1995 Universal Declaration of Human Rights International Conference on Population and Development Fourth World Conference on Women United Nations Charter Convention for the Elimination of All Forms of Discrimination Against Women

5. Key International Laws, Declarations and Consensus Statements 1945 1948 1982 1994 1995 Universal Declaration of Human Rights International Conference on Population and Development Fourth World Conference on Women United Nations Charter Convention for the Elimination of All Forms of Discrimination Against Women

6. Link Between Human Rights and Reproductive Rights at ICPD Reproductive rights reflect human rights that are already internationally recognized. 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.

7. Reproductive Rights are Human Rights RESPECT PROTECT FULFILL PROMOTE

8. RH Outcomes are Related to Adherence of Human/Reproductive Rights Rape, gender- based violence, trafficking of women & girls Unwanted pregnancy Miscarriage STI/HIV/AIDS Infertility Psychological trauma Difficulty with intercourse, obstructed childbirth, infection, infertility, RH- related emotional distress Female genital cutting, other harmful cultural practices

9. Care denied solely on HIV status RH Outcomes are Related to Adherence of Human/Reproductive Rights New or current HIV+ client denied access to care Inappropriate referrals to specialists Serious RH and other health risks for client, partner and others Client suffers further RH problems due to lack of timely care Provider claims insufficient HIV treatment expertise

10. Husbands consent necessary for womens medical treatment RH Outcomes are Related to Adherence of Human/Reproductive Rights Womans lack of access to FP methods/services Lack of access to emergency obstetric care Men are unable to access services Unwanted pregnancy Death in childbirth Poor reproductive heath for men and their partners STI/HIV/AIDS Services focused entirely on women to the exclusion of men

11. No privacy in counseling area of RH clinic RH Outcomes are Related to Adherence of Human/Reproductive Rights Client unable or embarrassed to ask questions about methods or services Non-use or incorrect use of methods or unnecessary discontinuation contributes to unwanted pregnancy Maternal/child morbidity or mortality Health centers are not equipped to handle emergency obstetric care (i.e., trained providers, supplies, equipment) Lack of access to emergency obstetric care

12. IPPF Rights of The Client Information Access Choice Safety Privacy Confidentiality Dignity Comfort Continuity Opinion

13. Governments Have the Duty to… Respect rights – not requiring authorization by husbands or partners for women to obtain RH services Protect rights – taking positive action against hospitals that perform FGC Promote/fulfill rights – implementing programs for women who are at high risk of contracting HIV/AIDS Source: CEDAW General Recommendation on Women and Health

14. Promoting womens full and equal access to and enjoyment of basic human rights (e.g., education, adequate standard of living, equal employment opportunity, equal rights during and after marriage, access to necessary medical care, and safety and security of person) is not only worthwhile but promotes womens ability to protect themselves from disease.Promoting womens full and equal access to and enjoyment of basic human rights (e.g., education, adequate standard of living, equal employment opportunity, equal rights during and after marriage, access to necessary medical care, and safety and security of person) is not only worthwhile but promotes womens ability to protect themselves from disease. Gostin and Lazzarini, 1997 Good Human Rights Practices Contribute to Good Reproductive Health

15. The most difficult issues of behavior or practices like rape, incest, female genital mutilation, the idea of female reproductive rights – all these concepts we would never have been able to discuss just a few years ago…. [This] is an indication of massive, massive change in thinking. Nafis Sadik 2000

16. Tools for Respecting, Promoting and Protecting Human Rights through Reproductive Health Laws Policies Regulation Advocacy Documentation Reporting

17. Laws, Policies, Regulations

18. Laws, Policies, Regulations: International Countries that ratified human rights treaties are required to report regularly

19. Laws, Policies, Regulations: National National laws, regulations, and policies reflect international human rights laws, conventions and declarations

20. Laws, Policies, Regulations: Operational Service delivery policies/guidelines respect clients rights to access to quality information and services free from bias, discrimination and violence

21. Advocacy, Documentation, & Reporting YOU can make a difference!!

22. P O L C Y I What Can POLICY Do to Improve Reproductive Health Using Human Rights Tools?

23. Health care policies/programs Equality in Access Protecting features distinctive to women Improve Access for Women & Men of All Ages P O L C Y I

24. Voluntary, non-coercive Informed consent Respects dignity Guarantees confidentiality Needs sensitive Gender-sensitive Ensure Quality Care P O L C Y I

25. During pregnancy, confinement, post-natal period Discrimination Against Women Due to Reproductive Function P O L C Y I

26. Zero tolerance in policies/programs Address in service provision; incorporate into counseling Incorporate GBV into all training Combat Gender-Based Violence P O L C Y I

27. Advocacy Participation Training Resources Research Nationally: P O L C Y I

28. Hold governments accountable for human/reproductive rights obligations Identify/document/report violations Advocate for changes in law Make complaints to HR commissions Offer direct legal services Ensure women access to courts Advocacy P O L C Y I

29. Emphasize -- Gender perspective Involve women Include men Include young adults Participation P O L C Y I

30. Comprehensive Mandatory Gender-sensitive Training for Health Workers P O L C Y I

31. Develop culture of respect - for human rights - for womens rights Create womens access to justice Teach women's rights in law schools Training for Judges P O L C Y I

32. Ensure that reproductive health care needs are equally represented with other health care needs in national budgets Resources P O L C Y I

33. Study the impact of human/ reproductive rights implementation on reproductive health outcomes Research P O L C Y I

34. What are the current human rights issues in your country related to reproductive health? What types of human rights activities could POLICY do in your country to address these issues? What are the constraints you face in implementing human rights activities? What types of resources would you need to implement these activities? Assessment Questions