Embedded Files
manifestations specific to certain subgroups of women, such as cases of domestic violence resulting in unwanted pregnancy that leads to unsafe abortion. Emphasis should be given to finding ways to reduce the stigma in the clinical care context by ensuring respectful treatment of all women seeking services, irrespective of their reasons, circumstances or socioeconomic status. Health systems An assessment of the degree to which women’s rights are respected throughout the health system might be approached through an examination of barriers to the availability of care and of laws, policies and practices that might deter women from seeking care. There is need to examine the barriers to availability of abortion and abortionrelated services, such as: ● Lack of implementation of laws and policies that are beneficial to women’s health, such as failure to operationalize the rape indication for abortion. Book ch.02.qxd 11.2.2005 10:36 Page 28 ● Lack of skilled health personnel, due to legal prohibition or restriction of procedures or, for example, abuse of conscientious objection to participation in lawful services by health personnel. ● Lack of safe health care conditions, due to legal prohibition or restrictive indications for abortion or, for example, low priority of services in health facilities or in allocation of necessary budgetary resources. ● Gender barriers, such as lack of availability of services at times when it is convenient for women to attend, and lack of facilities to care for their young children while they receive counselling and treatment. ● Health laws and policies that require excessive qualifications for health care providers to perform abortion services. There is need to examine the deterrents to access to abortion services for women or certain subgroups of women. These include: ● Lack of protection of confidentiality, or perceived lack of protection. ● Poor quality of care, including providers’ disrespectful or punitive attitudes. ● Third-party authorization requirements, such as spousal authorization requirements (20). ● Failure to treat adolescent girls according to their “ evolving capacity ” to exercise mature choice in abortion care (21). ● Payment or co-payment requirements, particularly for adolescent girls. Social, economic and legal conditions Barriers to improving women’s health and access to safe abortion services are often rooted in social, economic, cultural and legal conditions that infringe upon women’s human rights. A human rights needs assessment might reveal that social factors, including lack of literacy and of educational or employment opportunities, deny young women alternatives to early unwanted or repeated pregnancy and deny them economic and other means of access to contraception. Women’s vulnerability to sexual and other abuses, in and out of marriage, increases the risks of unsafe pregnancy and mental illness (22). Social, religious and economic customs become embedded in the law and historically have been used to provide justification for discrimination against women. A gender-sensitive approach to social science and legal research can help to identify the ways underlying socio-legal conditions pos29 ABORTION, HUMAN RIGHTS AND THE ICPD Book ch.02.qxd 11.2.2005 10:36 Page 29 itively or negatively affect advances in women’s independence and access to safe abortion services. A human rights needs assessment would be able to examine the underlying conditions that increase risk factors for unwanted pregnancy and unsafe abortion that are common to women or certain subgroups of women. These include violence against women, sexual abuse, poverty, different forms of discrimination against women, and different social conditioning of women’s powerlessness. Several comparative studies provide information on laws in respective countries (23) and regions (24,25,26).* Legal research can help identify how laws advance or compromise women’s interests in their personal, family and public lives, with indirect effects on women’s health. Family law frequently expresses the basic cultural values of a community, such as the rights of inheritance of land. Cultures resistant to women’s equality with men have unself-consciously perpetuated women’s subordination and powerlessness as a “natural” condition of family life and social order so profoundly as to often render women’s disadvantage invisible. Where subordination and powerlessness are perceived, they are considered not just a feature but a necessary requirement of social order and stability. Laws that entrench women’s inferior status to men and interfere with women’s access to health services seriously jeopardize efforts to improve women’s health.
Google Sites
Report abuse