Reclaiming & Redefining Rights – ICPD+15: Status of Sexual & Reproductive Health & Rights in Asia

A comprehensive monitoring report of 15 years of ICPD implementation in 12 Asian countries, this report covers areas of women’s empowerment, reproductive health, reproductive rights, sexual health and sexual rights. This monitoring report on the status of sexual and reproductive health and rights in Asia paints a picture of uneven progress across 12 countries. Without full implementation of the ICPD Programme of Action, it will not be possible to Achieve Goal 5: reducing maternal mortality and ensuring universal access to reproductive health; and other Milennium Goals that are inextricably linked to PoA.

Download the full copy of Reclaiming & Redefining Rights – ICPD+15: status of Sexual and Reproductive Health and Rights in Asia.

Download the copy by chapters:

• ICPD+15 – Chapter 1: Introduction
• ICPD+15 – Chapter 2: Setting the Context
• ICPD+15 – Chapter 3: Reproductive Health and Reproductive Rights
• ICPD+15 – Chapter 4: Sexual Health and Sexual Rights
• ICPD+15 – Chapter 5: Recommendations
• ICPD+15 - Annex of Tables 

Chapter 3: Section 1

Population and Development & Economic- Social-Cultural-Political Context.

• Total Population;
• Population by sex;
• Percentage of population aged 0-14; by sex
• Percentage of Population aged 15-24; by sex
• Percentage of population below poverty line by region/state, sex ; poverty rates amongst women taken from smaller studies;
• Gross Domestic Product (GDP);
• Gross DP per capita; not likely. Per capita spending on health in PPP dollars; govt/public spending as % of total health expenditure, private spending as % of total health expenditure.
• Government expenditure on health
• % of women’s earnings to men’s earnings
• GEM in addition to hdi and GDI and HDU
• % population below $1 and $2 poverty lines, and % in human poverty
• female labour force participation as % of male labour force participation rate
• GINI index – level of income inequality
• health financing % public and private, and various public and private 

Except health financing all available in UNDP human development report. Health financing world health statistics

•   (Endorsed the final declaration)International conferences and declarations?  

1. International Conference on population and Development (ICPD);
2. Beijing Platform for Action;
3.  Is there a National ICPD Plan of Action? Is it monitored regularly? Are women NGOS and SHRH NGOs involved with Governments in monitoring? Were there any reservations to the Programme of Action ( POA)? Are any NGOs attempting to lift them? How Successful have they been?

• International treaties and conventions signed by the country? Please also indicate country reservations on treaties.

1. Universal Declaration on Human Rights; Vienna Declaration and Programme of Action (1993) (This is not a treaty)
2. International Covenant on Economic, Social and Cultural Rights;
3. International Covenant on Civil and Political Rights;
4. Convention on Elimination of All Forms of Discrimination Against Women;
5. Convention on the Rights of the Child;
6. Convention on the Rights of Persons with Disabilities;
7. Maternity Protection Convention, 2000 ILO.

If the country has not ratified the international documents, please document civil society efforts in order to do so and the extent of their success and mention the main barriers to the acceptance of these documents.

• Is there a human rights (HR) commision? Has it taken up SRHR rights ? Have NGOs submitted violation of SRHR rights to it or to other HR bodies like the UN?
• Does the country have policies which affirm women’s SRHR? Which year passed? Are they being implemented well?

1. National policy/law on SRHR;
2. National Policy/law on Women/Gender equality;
3. National Policy/law on Young People SRHR;
4. National Policy /law on Violence Against women (VAW), Rape, Sexual Harassment / Trafficking.

For each policy, please document the process which ensured the policy was adopted into legislation with emphasis on NGO efforts. Please document the main actors behind this initiative – donors, NGOs, govt.  If the policy has not been legislated, please document the efforts/process to do so and the reasons for it being stalled.

• If there are new policies since ICPD, who were the movers…… (GO,UN, donors or NGOs( which ones?)

 

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* Indicators in bold and italic are inputs from Rashidah Abdullah

* Indicators in blue are inputs from Ranjani K.Murthy

* Indicators in red are inputs from Sundari Ravindran

* Indicators in green are inputs from Neha Sood

[1] All indicators will be monitored in 2-3 periods in time where common and comparative data is available.

Chapter 3: Section 2

Women’s Status in the Country

(Sub-headings for the indicators will be useful in this section)

• Life expectancy at birth male/female.
• Under-five mortality rates boys/girls. Comment if there are any unusual trends and probable reasons for this. (This is not a sensitive indicator. Better to ask for 0-1 m/f mortality and compare to 1-4 m/f or 1-5 m/f mortality separately.
• Literacy rate among population aged 15 and older, male/female.
• School (primary, secondary and tertiary) gross enrolment rates girls/boys. Comment if any incongruities exist and why.
• Singulate mean or median age at marriage, male/female; Is there a legal age for marriage? Is it enforced or not, please comment.
• Labour force participation, male/female/transsexual. Is data available for informal/formal sectors, gender disaggregated? If so please specify. Within the formal sector, is data available for percentage of women in decision-making roles? Definitions may vary. Ask for work participation rates
• Is there a policy on maternity leave and for how long, paternity leave, and provision of crèche, and breastfeeding breaks at workplace? Is this in accordance with ILO standards? Are there any incongruities e.g. groups of women who may not be covered by the policy?
• Unemployment rates, male/female/transsexual. (Not useful because only those registered in employment exchange is counted)
• Incidence of Violence Against Women (VAW)- different aspects. Is it increasing or decreasing? [ VAW is a key indicator of women's status].
• New laws on VAW? The movers and how well they are being implemented. [ source for this is NGO CEDAW reports and ESCAP]
• Use of CEDAW ; Are CEDAW NGO alternative reports done ? Do they include a strong SRHR section? Has there been any action from government as an outcome of CEDAW recommendations to government?
• New laws or policies on gender equality and discrimination? [ ESCAP women's section will have data]
• National Action Plans on Women after Beijing. How well are they monitored and implemented
• Percentage of seats held by women in national government. (What is the difference from below?)
• Percentage of parliamentary seats occupied by women. (What is the difference from above?)
• Identify the different marginalised groups of women in your country.
• Identify current threats to women’s sexual and reproductive health and rights, communal conflicts, tribal situations, caste/class struggles. (Not clear; too vague)
• Are there national and provincial commissions on women or human rights to protect and promote women’s rights?
• Is there adequate representation of women’s NGOs in governmental commissions/ boards/ councils which protect and promote women’s rights and SRHR? Please comment.
• Have there been good practices/ pilot projects in SRHR pioneered by NGOs which have been upscaled/ adopted by the government?
• A summary comment. Overall, how has the status of women changed since ICPD—- what are the trends and who have been the movers? The role of women NGOs and SRHR NGOs.

Chapter 4: Section 1

Reproductive Health Services

Indicators

• What is the range of reproductive health services, including family planning and sexual health services available in the primary health care system?
•  How does this range compare with ICPD recommendations?

Chapter 4: Section 2

Contraception

Indicators

• Total Fertility Rates by age-groups
• Contraceptive Prevalence Rates by age-groups; reasons for non-use of contraception. Comment on % showing lack of power/control
• Unmet Need for Contraception by age-groups; from unmet need statistics, comment on availability and affordability of contraceptive choices
• Use of male contraception in context of increasing men’s equal responsibility for sharing contraception. (Male contraception as % of total contraception)
• Access to full range of affordable contraceptives choices, including emergency contraception (What indicator? Better to ask for evidence from studies) (including male condoms, oral contraceptive pills, diaphragms, internal condoms, IUDs, etc)
• Availability of services to adolescents , single women, male, female and transsexual workers, widows and homosexuals(Difficult to know. Can only comment on policy. Also if any small studies exist)
• Absence of requirement that clients have permission of spouse or mother-in-law (for married women) and parents (for adolescents)
• Availability  and use of condoms both for women and men(What is the meaning of availability?)
• Non-stigmatising attitudes towards clients (e.g., unmarried female clients with STIs, homosexuals, sex workers, post-abortion care clients, adolescents, drug users). (from available studies)
• For all the above, what has the changing trend been like since ICPD? ( especially, referring to ICPD POA 7.5, 7.6, 7.8, 7.12, 7.16, 7.17, 7.19, 7.21)

Chapter 4: Section 3

Maternal Health

Indicators

• Lifetime risk of maternal death (this information is not readily available)
• Maternal Mortality Ratio per 100 000 live births
• Percentage of pregnant women with anemia
• Percentage of young girls with anemia (define young – give specific age group)
• Antenatal care coverage (define coverage – one visit, three visits? Which components included?)
• Percentage of births attended by trained attendants (ask for how trained is defined)
• Availability of Basic and Emergency Obstetric Care services (means what)?
• Maternal morbidity, to comment on incidence based on studies and causes

Chapter 4: Section 4

Abortion

• Grounds on which abortion is permitted (based on categorisation developed by Centre for Reproductive Rights.) Please identify the grounds on which abortion can be performed in your country. Is abortion for rape and incest survivors interpreted as permissible?
• Change in law or policy or available information on abortion since ICPD and the movers for this.
• Extent to which the law is known, accepted and acted on by health providers and the public.[e.g. sometimes the law is restrictive but the practice much better, e.g. Bangladesh. Sometimes very liberal e.g. India and Malaysia, but practice more conservative]

            

Prohibited altogether	To save the women’s life	To preserve physical health	To preserve mental health	Socioeconomic grounds	Without restriction as to reason (on request)

• Percentage of maternal deaths as a result of abortion
• Estimate of number of abortions occuring annually , both safe and unsafe
• Ob-gyn admissions due to abortion(If unavailable comment on laws/rules and regulations which may be hindering management of post abortion care (ask for available data from small studies)
• Abortion seeking behaviour , trends in morbidity etc,  comment based on studies[ This indicator is vague and general, needs to be more specific]
• Percieved barriers to reviewing the abortion law and providing more accessible services.
• Extent of training of providers in abortion services- did this improve since ICPD? [ICPD+5 recommendation]
• Are all methods of abortion available including medical abortion?
• Is there evidence from studies of discriminating and judgemental attitudes to women seeking abortion services?
• Restrictions on access to abortion based on age of client

Chapter 4: Section 5

STI/HIV/AIDS

• HIV Prevalence rates (total , male, female, transsexuals, pregnant women) and trends. Number of people with HIV and AIDS. (sometimes not available in this way for children, but only for > 18 years)
• Policy of the government on HIV/AIDS, links with SHRH and womens’ rights. Gender sensitive?;comment on any shortcomings (spell out which comments you’re looking for)
• Feminisation of HIV/AIDS, Comment. (Indicator to replace with a much more specific indicator—  Trends in HIV among women?)

Chapter 4: Section 6

Young People’s SRHR ( The age definition of young people is 10-24 yrs (source United Nations))

Adolescents:10-19 years of age;Youth: 15-24 years of age;Young People: 10-24 years of age.(source AFC, Vol 10, No.3, 2004)

• Is the incidence of unwanted pregnancies or babies among young people increasing or decreasing?
• Studies on sexual activity of young people before marriage – increasing or decreasing?
• Access to youth-friendly services including contraception and abortion by young people, comment. Comment on how youth-friendly the services are
• Young people accesssing services
• Comment on status of realisation of sexual and reproductive rights by young people.
• Access to information, sexuality education by young people. If possible comment on sexuality content in institutional curriculum
• Sexuality education in school curricula and how effective is the content
• Youth representation/participation in policy making bodies.
• Comment on extent of advocacy by young people themselves on SRHR issues.
• accessibility and affordability of FP information, services and supplies among sexually active young people (in urban poor communities): 

1. civil status (married, single, separated)
2. price (purchased, subsidized or free)
3. gender
4. constellation of services

Changes in national health and population policies vis-a-vis raising awareness of young people on SRHR and recognizing the rights of young people to have access to safe, effective and affordable FP methods

* Please note that:

Rashidah’s comments are in bold and italic

Prof Elizabeth’s comments are in red

Chapter 4: Section 7

Sexual Rights (still in discussion)

• Analyse data on VAW, Rape, Sexual Harassment, trafficking and marital rape.What are the trends -increasing or decreasing? [if VAW sexual violence here, then battering under status of women?]
• Is there recognition of transsexual identities?
• Are there laws on child abuse?
• Are there laws governing homosexuality, same sex marriage, sexual orientation, dressing? Any changes since ICPD? Do they respect sexual rights ? Have they been acted on and people charged?
• Is there recognition of intimate relationships without the framework of marriage (‘live-in relationships’)
• Laws governing women’s rights to marriage, divorce and re-marriage. Are they adequate, discriminatory ? Any changes?
• Comment on the cultural definition of feminity, virginity, desire, multiple partners, same sex desires[ from studies ideally on perceptions].This is a big indicator and seems a number of indicators actually. Is it more the cultural definition /understanding of sexuality and desire?
• Laws governing women’s rights to marriage, divorce and re-marriage, adequate, discriminatory?
• Has there been any social or moral reform that focuses intensively on women; especially on women’s roles and control of sexuality ; traditional ideology of secondary status of women; obedience to husband; dress code; mobility of women; policy reform. Which groups have been the movers behind this, both conservative and progressive?