Using Human Rights for Sexual and Reproductive Health: Improving Legal and Regulatory frameworks/Recours Aux Droits De L'homme Pour Promouvoir la Sante Sexuelle et Genesique : Amelioration Des Cadres Juridiques et reglementaires/Uso De Los Derechos Humanos En Pro De la Salud Sexual Y Reproductiva: Mejorar Los Marcos Juridicos Y Normativos
Cottingham, Jane, Kismodi, Eszter, Hilber, Adriane Martin, Lincetto, Ornella, Stahlhofer, Marcus, Gruskin, Sofia, Bulletin of the World Health Organization
The world health rePort2008 draws attention to the significance of policies for achieving primary health care objectives, including both those necessary to make health systems function properly and those beyond the health sector that contribute to health. (1) This emphasis is welcome, in particular the inclusion of policy beyond the remit of the health sector. The report adopts an inclusive approach to "policy"--incorporating not only policy but also law, regulation, intervention and even practice. While the term human rights is not used, a concern for human rights permeates much of what is presented both in terms of inequalities highlighted and the approaches suggested to address them.
Human rights increasingly form part of the language and approach of many international organizations, governments, nongovernmental organizations and civil society groups concerned with sexual and reproductive health. This application is now so widely accepted that human rights have been named as central to achieving the goals and targets of the Millennium Declaration, and also as guiding principles in the World Health Organization's (WHO's) 2004 Reproductive Health Strategy. (2) Yet it is only recently that there has been recognition of the range of human rights that combine to make up "reproductive rights". The international community's first affirmation that the enjoyment of reproductive health is based on these rights was made at the International Conference on Population and Development in 1994:
"Reproductive health ... implies that people are able to have a satisfying and safe sex life and that they have the capability to reproduce and the freedom to decide if, when and how often to do so.... Bearing in mind the above definition, reproductive 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 on 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." (3) (Emphasis added)
A major achievement of this conference was recognition of the responsibility of governments to translate international commitments into national laws and policies that promote sexual and reproductive health. Consequently, as recognized in The world health report2008, policies and laws that act as barriers to the availability, accessibility, acceptability and quality of sexual and reproductive health services (whether for the entire population or only for certain population groups), are a serious area of concern. (1)
Since 1994, human rights have been incorporated in diverse ways into the approaches used to address sexual and reproductive health, as well as other health issues including the provision of essential medicines, (4) HIV/AIDS (5) and child health. (6,7) Some organizations such as the Center for Reproductive Rights carry out fact-finding missions and strategic litigation, focusing on human rights violations such as forced sterilization of Roma women in Slovakia and high rates of maternal mortality due to unsafe abortion in Mexico. (8) Others develop and use what has been termed "a rights-based approach" to sexual and reproductive health programming. Organizations including United Nations agencies such as the United Nations Children's Fund (UNICEF) (9) and the United Nations Population Fund (UNFPA), (10) and nongovernmental organizations such as CARE (11) and Save the Children, (12) have generally focused on three key principles: the participation of affected communities; ensuring discrimination does not occur in programme design or implementation; and the existence of accountability mechanisms. …