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A Call for Action
Governments: Take Responsibility for Women’s Health!
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Primary Health Care and Women’s Reproductive
and Sexual Rights:
Where are we today?
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Women’s Access to Health Campaign:
Health For All—Health For Women!
From
2003 to 2005 the Coordination Office will coordinate the Women’s Access to Health Campaign, in close collaboration with the People’s
Health Movement. The 3-year core demand is that primary health care
be provided for all people and peoples everywhere, taking into account, in
theory and practice, women’s reproductive and sexual health needs.
Contact us if you would like more information or would like
to get involved.
See also the Sign-Up Postcard!
See p. 16 + 17 for ideas on what y o u can do!
The Call for Action is supported by
People’s Health Movement
Boston Women’s Book Collective, USA
CHETNA, India
Civil Liberties and Public Policy Program, Hampshire
College, USA
Committee on Women, Population and the Environment, USA
EDUC Actions, Cameroon
ISIS, Uganda
Latin American and Caribbean Women’s Health Network, Chile
Likhaan, Phillipines
PREPARE, India
WIPHN, Women’s International Public Health Network, USA
Women in Black, Yugoslavia
Women Living under Muslim Law, UK.
SAMA, India
MASUM, India
Forum for Women’s Health, India
WGNRR, Vrolikstraat
453 D, 1092 TJ Amsterdam, The Netherlands.
Tel: (31-20) 620 9672,
Fax: (31-20) 622 2450,
E-mail: office@wgnrr.nl
Website: www.wgnrr.org
This Call
for Action focuses on the promises of the Alma Ata
Declaration that held so much potential for improving the health of people worldwide. Why
were the promises never fulfilled? How have women’s reproductive and sexual
rights been integrated into the concepts of Primary Health Care? We join the People’s
Health Movement in promoting comprehensive Primary Health Care as a model for achieving health for all, health for
women. And we call on governments everywhere to take their responsibility for the
health of women.
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Governments: Take Responsibility
for Women’s Health!
Primary Health Care and Women’s Reproductive and Sexual Rights: Where are we today?
Women’s Access to Health Care Campaign for 2003
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The
Signatories of the Declaration of Alma-Ata (USSR), representing nearly all governments of the world
in 1978, made an international commitment to achieving Health for All (HFA) by the year 2000 (see our campaign
background booklet for the full text of the declaration or look at it on the web at:
www.who.int/hpr/archive/docs/almaata.html
).
Primary Health Care was identified as the key to attaining HFA as part of
overall development. The Alma Ata Declaration recognized that health is a fundamental
human right and that gross inequalities in health status are unacceptable.
At the same time the call for HFA was a societal response that acknowledged unity in
diversity and the need for social solidarity. "An acceptable level of health
of all people of the world by the year 2000 can be attained through a fuller and better use of
the world’s resources, a considerable part of which is now spent on armament and
military conflicts" (Alma Ata Declaration).1)
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As an approach PHC
used the language of social justice. It urged transformation of systems to
serve the neediest, challenged all actors to see health as a right, argued that a proper
analysis be made of the determinants of health, that root causes be addressed as
opposed to symptoms, stressed the need for community involvement and pushed for
an intersectoral approach. PHC was a radical departure from the status quo with the recognition
that without social justice, health for all could never be achieved. It offered a social analysis of
health, explaining that the causes of poor health were not diseases in themselves,
but a combination of prevailing socio-economic conditions, political structures and ideologies; as well as
the environment.
In
other words, eliminating socio-economic and political inequalities between populations
within a country and between countries were absolutely crucial to achieving health for all.
At the level of care PHC meant a system of health care based on the
needs of a given population, a system that kept a balance between hospital and community care, between medicalprofessional
led care and the effort to create environments that sustain health. Over the past 25 years PHC has offered
a conceptual framework for planning a more balanced health care system, making a concerted effort to move away
from hospital based care. It has meant a reorientation of the approach to health itself – a system that acknowledged
that in dealing with the health of a community a combination had to be made between curative care and preventative
care with a serious recognition of the social determinants of health – poverty, education, employment status,
environment etc.
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During the late 1970s Mozambique successfully implemented a
comprehensive PHC approach and was commended by the WHO for the achievement
of positive health outcomes. Mozambique was spending 11% of its budget on health, had achieved nearly
100% immunization and trained nearly 8000 mid level health workers. However,
the program never reached its full potential as civil war broke out. Community
health workers and community health posts, the backbone of PHC, became targets
of the militia forces, destabilizing any advances that had been made.2)
The Alma Ata Declaration of "Health for All"
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Fundamental elements of Primary Health Care (PHC) according
to the Alma Ata Declaration:
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Universally accessible health care
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Community participation
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Equity and social justice
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Affordable and appropriate services
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Integral to social and economic
development
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Inclusion of prevention, promotion
and curative care
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Inter and multi-sectoral collaboration
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There
is no doubt that the call to provide Primary Health Care to the entire population of the
world by the year 2000 was laudable. Looking back at the Declaration we find the shift in perspective from a
medicalised health
care approach to a more socio-political approach to health as a tremendous move
forward. We are also aware that the specific health needs of women were far from
the common agenda except in women’s capacity as reproducers and even then
only in terms of mother and childcare and family planning.
The women’s movement of the 1970’s and 1980’s played a
crucial role in highlighting women’s realities. It was owing to their struggles that
the specific needs of women began to be put on the agenda at different levels
from the local to the national and international. What became clear was that
whether it was tuberculosis, malaria or other parasitic infections, mental health or
malnutrition and anemia – women’s lives were differently impacted by these
diseases than the lives of men. And women demanded special attention for their needs.
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Definition of Reproductive
Health, according to the WHO, reproductive health is the ability to have a safe, responsible and
fulfilling sex life, the freedom to decide if, when and how often to have children and to avoid to
become ill or die due to a reproductive cause."
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The PHC approach benefitted men and women alike because of
its inclusion of health as a right and the recognition that it was embedded
in the socio-political context of people everywhere. However it was
only in the 1990’s with the International Conference for Population and Development
in Cairo 1994 and the International Women’s Conference of the UN held in Beijing in 1995
that women’s health and reproductive rights were placed squarely on the international
agenda.
The rising pressure of women’s organizations all over the world finally paid off in Cairo
where a strong recommendation was made to all governments to make reproductive health
accessible to all before the year 2015 through the PHC
system. However, implementing these recommendations has been problematic.The 1990s
witnessed cuts in health budgets in the name of health sector reforms, tied
to IMF and World Bank loans making it nearly impossible to make the
recommendations a reality.
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The Platform for Action of the Conference on Women held in
Beijing in 1995 reiterated the language of Cairo where the autonomy, empowerment and
self-determination of women in all spheres of life, especially in sexuality and
reproduction was the essential cornerstone of all health and population programmes. The
Platform for Action also proposed a life cycle approach to
women’s health, bringing out for the first time the health concerns of women
through out their lives. Here again there were difficulties – for
instance, women’s groups argued that the life cycle approach does not
necessarily address the issues of class, caste or race (work, marriage, pregnancy or sexuality
does not mean the same thing for all girls or women of a particular age).
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In Cairo a strong recommendation
was made to all governments to make reproductive health accessible to all before the year 2015
through the primary health care system. However, implementing these recommendations has been
problematic due to various reasons including: health sector reforms including privatization, and insufficient
planning on where the finances would come from for the recommended changes.
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Twenty five years later
Twenty-five
years after the World Health Assembly’s declaration of Health For All by the year 2000, we have reached not one
crossroad but a myriad of intercepting highways and dirt tracks. The ambitious call of
"Health
for All" was
based on two rallying points: the fact that provision of health care was the state’s obligation
towards its citizens; and that primary health care through community based health workers
was strategically possible. However, in reality, health cannot be delivered
through health services alone. Health is an indicator of the quality of a person’s
or people’s lives. To ensure health for all citizens, political changes need to be made
in favor of marginalized groups within a country and throughout the world.
Unfortunately the last two decades have seen the simultaneous rise of privatization,
structural adjustments, unfair trade agreements, patents of drugs on the one hand
and religious fundamentalism, right wing politics’ sanctions against nations, terrorism
and genocide of people on the other hand. In addition "selective" PHC
programs quickly replaced the original concepts of comprehensive PHC—a shift from a
holistic to a vertical approach.
Public health systems in the developing world were already
deteriorating as a result of economic recessions, cuts in health budgets, and
health system reforms that were tied to loans from the IMF and World Bank. By the
1980’s the Structural Adjustment Programmes had undermined the health of the
people, and in certain cases health infrastructure, so much that in the decade of
the 1990s the deterioration had become widespread and continues to give cause for grave
concern today.3) Resurgence of communicable diseases in many parts
of the world is an indicator of the downward spiral of our quality of life and
the failure of our health services. Not surprisingly therefore, we have neither health
for all nor health care for all by the year 2003.
People’s movements all over the world are protesting
against the privatization of essential natural resources, from South Africa to Ecuador to
Micronesia. Most recently citizen groups have mobilized in Ghana to protest
the IMF and World Bank loan conditions that their government agreed to
including the privatization of water. Women in particular are susceptible to water
borne
diseases because of their greater exposure to water through household duties and
sustenance agriculture, which is mainly performed by women. Recent outbreaks of
cholera in South Africa and Latin America have been linked to the privatization of
water.4) Having clean water supply could greatly impact the health of
the world’s poor. But DALYS, (Disability Adjusted Life Years) the measurement
tool that WHO and the WB have adopted to measure the effectiveness of health
interventions, make an economic calculation to determine cost effective health
interventions. Thus sanitation and clean water are not identified as possible
interventions as they are "too expensive".
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The challenge before us is to question politics at the
household, community, national and international levels and ask hard questions about why
governments are pulling out of health, and education while inflating their
defense budgets year after year. Most
countries spend nowhere close to the WHO recommendation of five percent of its Gross Domestic Product (GDP) on health
services. User fees are being introduced in the public and NGO sector paving the
soft road to privatization of health services. It is important to note as well that the
the private and public sectors generally favour curative care over health promotion and prevention.
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Women’s Health and the Primary Health Care Approach
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It
was the thrust from the women’s movement that identified the needs of women and
also where change came from within the PHC approach. It has been found for instance, that
the geographic (distance from health post), cultural (e.g. menstruation is a shameful business and needs to be hidden) and the
social and economic (discrimination by health personnel based on caste or class,
sex-preference and poverty) barriers are among the principle factors that
affect women’s access to health care. And the same factors also limit women’s
possibilities to stay healthy. For example women in some countries are the last to eat
within an household and get the least amount of food; they need the permission
of their husbands/ partners to use a contraceptive or get an abortion; they are
the last member in the family to seek health care and more often than not have no
say in how the health budget is allocated at the local or the national level.
And when women’s needs have been recognized within the PHC
structure as is the case for contraception or maternity care, the quality of
care has been so poor that it remains a cause of concern even today. In many
African countries for example in Uganda, women who go to a hospital to deliver a
baby must bring their own latex gloves, water, soap, syringes and a plastic
sheet. Hospitals do not carry any of these supplies.5) In countries where PHC was
once free and where user fees have been introduced, there have been dramatic
drops in health care use and simultaneous rises in maternal mortality.6) Health
budgets in most countries have been drastically cut with the introduction of
structural adjustment programs. For example in the Philippines between 1991 and 2000
the
health budget fell from 3.7% to 1.78%, most of which was targeted to
hospitals and not to preventative care.7) When we
consider that reproductive health services
are often the first services to be cut when health budgets are slashed, it
is clear that reproductive and sexual rights are simply unattainable for many of the
world’s women. For example contraception in the Ukraine
costs 40-60 % of a family’s monthly salary, making it quite simply a
non-option.8) In Latin America there has been a
decrease in the standards of public health
services and a lack of medical supplies for antenatal care, delivery and post
delivery care. This combination has had a disastrous effect on the rates of maternal
mortality and morbidity. 9)
Primary Health Care And Abortion Services
Few issues within the range of women’s health raise as
many hackles as abortion does and for a complexity of reasons. There have been
various ups and downs on the abortion rights front for women everywhere. At one end
of the spectrum women are denied the right to abortion because of religious
fundamentalist beliefs and on the other hand coercive or eugenic population policies have made
abortion and sterilization compulsory for some women within
a country. For instance during the period when both Poland and Romania were
Communist, the states’ responses to abortion were diametrically opposed.
Abortion was legally available in Poland and sex-education was provided in
schools. The Solidarity government that replaced the Communist government severely
restricted women’s access to abortion and sought a ban on sex-education in
schools. On the other hand in Romania because of the government’s pro-natalist
policy, abortion was criminalized during the Communist period but was legalized within three days of the
change of government.
Women’s rights to control their own bodies has been and remains a contentious issue
with heads of religion and governments – most of whom are men.
Even
when abortion is legalized there are many obstacles preventing women from accessing safe services.
The consequence of the lack of an open approach to the right to abortion has resulted,
and continues to result, in thousands of women losing their lives due to botched
back street abortions. Hundreds of thousands more women suffer all their lives from complications
resulting from a poorly performed abortion.10) Nigeria, for instance, documents
610,000 unsafe abortions annually, the highest rate in the world. Kenya ranks second
with a third of maternal deaths attributed to unsafe abortions.11) In
Eastern Europe 25% of all maternal deaths are attributed to complications related to
abortion. The US gag rule, which was reactivated by George W. Bush on
his first day of office, restricts international family planning organizations that
receive US funding from providing any kind of information or services
(including referrals) related to abortion. Recent reports from Peru, where many leading
government officials are members of the Opus Dei, have refused to accept
international assistance for any programmes that promote reproductive health
services.12)
In addition every country has its own laws regarding legal
abortion. Legal does not necessarily mean available or accessible. Procedural
requirements can delay the access to an abortion. In Zimbabwe for instance a
lengthy criminal process often makes abortion impossible. Similarly, in Ethiopia even
if the law codifies the rape and incest exemption, it is hard to prove these crimes
or may take so long that the abortion may no longer be possible.13)
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There is a crying need
to interpret the Convention on the Elimination of Discrimination
Against Women (CEDAW) as well as those conventions that deal with
socio-economic and cultural rights to convert reproductive and sexual
rights into actual entitlements for women, so that nowhere can the
church or the state take these rights away.
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Women and Communicable Diseases
Within the PHC structures there has been an increased effort
to set up programmes for the control of communicable diseases like malaria and
tuberculosis. And these diseases are rampant today in many parts of poorer
regions of the world particularly in Africa where TB is reported to be the single biggest
killer in women.14) However, what
was not and is still often not taken into
account is that these diseases produce a larger burden of disability for women. And in
combination with other illnesses, such as with HIV-AIDS, severely undermine
women’s health and reproductive capacities. PHC
structures have yet to develop programmes oriented to women’s needs that would not just help to reduce the
disease burden of women but also ensure better preventive care is made available.
Similarly the care of women with sexually transmitted
diseases (STDs) is an area that requires sensitive handling and can best be treated
only in combination with treating the male partner of the woman concerned. Sexually
transmitted diseases (not including HIV-AIDS), like clamydia, syphilis, gonorrhea
and others, account for 1.4 % of the global disease burden. In urban populations
in developing countries it has increased to 15 per cent. Women are
disproportionately affected by STDs. Sexual taboos and prejudices negatively impact women’s
access to health care. Health provider biases against women with STDs can result in women being
denied treatment.15) Stigmatization and social rejection of
women still remains a big problem. PHC structures are far from being equipped to deal with
women who come in – if and when they do muster the courage to come in for treatment at all.
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While quality interventions in home based birthing has still not become a reality for many rural
women in poor countries, the unprecedented challenges such as home-based care for people dying
with HIV-AIDS has become a necessity. Women,
whether as patients or as carers of husbands and children, are tremendously at
risk of repeated infections, including drug resistant tuberculosis. Most AIDS patients in poor countries
still die of the same infections that the poorest of the community die from: TB, pneumonia
and diarrhea. In many sub-Saharan African countries especially Central and East Africa the incidence
of TB has increased with the advent and increasing occurrence of HIV seropositivity. In a number
of countries mentioned above one in three women die from TB due to neglect, since given the stigma
Rural Health and Education service Trust, Nepal attached to women with TB is
so strong that they are either
isolated or divorced.16)
It is predicted that the incidence of HIV-AIDS will rise
worldwide. Already women in some countries are more affected than men. And the
numbers are expected to increase dramatically by the year 2020. As HIV gets to be
more rampant we will not be able to separate the treatment of TB or pneumonia or
diarrhea from this infection. And the fact that community level health workers
are at risk of contracting the illness will only complicate matters further. The
various kinds of discrimination that poor and minority women face when they do approach
primary health care posts has been a long standing complaint of poor
women both from rural and urban areas in different parts of the world. The socio-cultural barriers
are many and need to be broken if all women are to get the
care they deserve.
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Violence Against Women
The issue of violence against women is another complex issue
that does not get the attention it deserves at the different levels of health
care. Although the situation is beginning to change as a result of mobilization by the
women’s movement. The link between violence and women’s health status has
been well established (bruises, assaults, depression, suicides etc)
and yet few policies or programmes have been developed to counter it or to care for
the women so affected. There still remains a social constraint against women
talking about sexual assaults within or outside the home. In addition most health
workers are not trained to recognize or address issues related to violence against
women. Pregnancy increases the risk of domestic violence, as does the
disclosure or diagnosis of illness. 17)
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Looking back, looking forward –
Where are we today and where do we go from here? |
Added to the violence at the domestic level there is also
state sanctioned violence against women. The number of "honor killings" in
Pakistan, Yemen and Jordan for instance are a terrible display of socially acceptable
violence where the chastity of the woman is put to question. In Nigeria the state has
adopted the Sharia law as state law allowing women to be severely punished for
"unchaste" behavior. There is also the violence used against women from minority
communities in communal conflicts. One example is the recent communal
attacks by Hindus in the state of Gujarat, India, where pregnant Muslim women
were violently attacked and killed.
Growing poverty worldwide and the rise in wars and conflict
situation has resulted in a tremendous increase in violence directed at women.
There is little public acknowledgement of this and very few programmes, aside from those set up by
women, have been developed to deal with traumatized women in
times of conflict. Few health care structures in any part of the world have
built in systems to deal with the physical and mental effects that women face as a
result of such violence.
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In
advocating PHC the Alma Ata Declaration affirmed that health is determined mainly by factors
lying outside the medical or public health services. It
became clear over time that countries and regions that achieved the greatest
and most durable improvements in health tend to be those with a commitment to equitable development
that is broad based and multi-sectoral – for example countries like
Sri Lanka, China, Costa Rica. These countries showed that investment in the social sectors and
particularly in women’s education, health and welfare has a very positive
impact on health and social indicators of the population as a whole.18)
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The Center for Reproductive Rights, a New York based group
of women’s rights advocates, states that many countries have updated their
health priorities in light of the two major international review conferences related to
the 1994 ICPD and the Beijing UN Women’s Conference of 1995. Many governments of Anglophone
Africa have had to assess current programmes and in their
follow-up adopted reproductive health and rights as a main strategy in
reconceptualizing national policies and programmes.19) They quite explicitly
incorporated the language of the international documents into domestic instruments. The report
goes on to state that "Without exception, every national health policy stresses a new
multi sector primary health approach to service provision and a commitment to improved
quality, access and affordability. They also plan to integrate reproductive health into primary
health care, drawing on existing infrastructure and community based services."
These important changes in the national laws and policies are to be commended
and definitely show an advance in terms of the desires of the different governments
to take women’s needs into account.
The reality on the ground however, is depressing. We have
just touched upon the kind of problems and discrimination women face in different
parts of the world with regard to their health. What we would like to highlight
is that the PHC approach is very suited to take up the health needs of women. It
needs to look closely at the problems women face and find ways to address these
needs in a manner that is both poor and women friendly.
We join the People’s Health Movement for the next three
years in demanding primary health care for all peoples everywhere. Within that demand
we would like to highlight for the year 2003 that governments
take their responsibility for the health of women.
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Many governments claim that their hands are bound by
international policies and institutions. However, it should never be forgotten that as
government representatives, (supposedly) representing their people, they should put
people’s interests first. Health is clearly an essential component of this interest. The
health of the people, and women in particular, is a clear indicator of the success of a
government to indeed represent its population. Ensuring health for all is a moral governmental
obligation and is also explicitly mentioned in several national constitutions and international
covenants.
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"Governments have a responsibility for the health
of their people which can be fulfilled only by the provision of adequate health and social measures."
(Alma Ata Declaration, Article V)
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This year our call is to governments:
Governments: Take Responsibility for Women’s Health!
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We demand that the Alma Ata Declaration of
1978 be used to bring a woman friendly approach into Primary Health Care
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We demand that the elements that are highlighted by the Alma
Ata Declaration be included in all policies and programmes that are to be
implemented within the health and social systems, keeping the need for gender
equity as the central focus:
We furthermore demand that :
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governments
take responsibility for the health of their
populations --they have an obligation to guarantee health as a right of all
people within their national borders. They must create or maintain special bodies that look into
women’s health as a right, and develop ways to implement policies that will have positive
results;
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governments
set up mechanisms to ensure that women participate at all levels of decision-making
to
ensure that women are able to live healthy lives i.e. provision of clean water; sanitation facilities; basic education etc.
Women should also have an influence on the kind and quality of provision of
health care in their areas;
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governments
ensure that all plans made for people’s health take into account social and economic conditions,
class, caste, religion, and
sexual preferences. This is very important to prevent the provision of health
services from becoming a top down affair with little attention for the real needs
of disadvantaged women;
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governments
ensure that comprehensive primary health care entails preventive, promotive and curative care
from a gender sensitive point of
view. The government has a responsibility to see that the spread of infectious
and parasitic diseases are brought under control and, in the case of the AIDS
epidemic to set up preventive and promotional material and programmes that are women
friendly;
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governments
recognize health as the interaction of socio-economic and political factors and address women’s
needs holistically. Violence
against women for instance cannot be reduced unless men and women are engaged
in the process of prevention and treatment. The multi-sectoral approach is
crucial to the improvement of understanding and improving women’s health;
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governments
make health care universally available and free of cost for
women who cannot afford to pay.
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What you can do: What you can do:
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Popularize the Alma Ata declaration and the call for
Health for All and bring women’s perspectives within it.
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Use the People’s Charter for Health (available to
down load at www.phmovement.org ) to mobilize and educate
community members, policy makers, government representatives about people’s right to health, and as an advocacy tool at
the local, national and international level;
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Call on the government representatives at your village,
district or national level and demand that they improve primary
health care provision within the Alma Ata framework keeping women’s health needs a priority;
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Demand that your government ratify and abide by the
CEDAW convention;
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Join up with other groups working on health issues and
raise the demands listed above with them at all levels;
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Participate in community efforts at building the
foundation for comprehensive women’s health care;
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Assert women’s and girls’ right to adequate and good
quality health care services at all levels;
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Demand that the government increase the budget for
ensuring women’s health;
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Demand that governments regulate the prices of drugs and
medicines in such a way that they are available, affordable
and women-friendly;
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Demand that governments institute mechanisms for women’s
active participation in the planning, monitoring and
evaluating of health programmes;
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Demand women’s right to work and labour benefits such
as the right to breastfeed, maternity leave etc;
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Demand that governments implement stricter measures for
the protection of food and water sources, especially for the
poor;
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Demand that governments downsize military budgets and
that more public money is put into health and education
programmes for women and girls;
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Demand that your government develop health care
services that are affordable, accessible, woman-sensitive
and humane;
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Demand that governments stop the promotion of unsafe
contraceptive and sterilisation methods and see that guidelines set up to protect women’s interests are strictly followed;
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Actively struggle against violence against women in all
spheres – from wars and conflict situations to within the
household. Women and girls must be free to live their lives without
violence or the threat of violence;
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Document how primary health care is being implemented in
your community/region/country and how reproductive and
sexual rights is (or is not) being integrated.
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So let’s Act, Organize and Mobilize!
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Inform WGNRR of any activities/initiatives BIG or small
that
you undertake related to the campaign or this call for
action.
So we can spread the word!
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Join the Working Circle for Women’s Health by
contacting us at
wahc@wgnrr.nl or by sending us a postcard.
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Books and references:
Declaration of Alma Ata,
International Conference on Primary Health Care, Alma-Ata, USSR, 6-12 September 1978. Available at :
www.who.int/hpr/archive/docs/almaata.html
Key Readings Relevant to the Politics of Health. Compiled by International People’s Health
Council and HealthWrights available at www.healthwrights.org/politics/polreadlist.htm
Sanders, David. Revitalization
of Primary Health Care. Background
Document for 20th Anniversary of Alma Ata Conference. 27-28 November 1998. Public Health Programme
University of the Western Cape, South Africa.
Towards Women’s Health Progammes and Policy. Edited by Renu Khanna, Mira Shiva, Sarala
Gopalan. Society for Health Alternatives (SAHAJ) and Women and Health (WAH). 2002.
Werner, David , David Sanders et al. .
Questioning the Solution. The Politics of
Primary Health Care and Child Survival. HealthWrights. Palo Alto. 1997.
Whatever Happened to Health for All by 2000 AD. Prepared
and published by the National coordination Committee for the Jan Swasthya
Sabja. Available on the internet to download at www.sochara.org
(listed under Campaigns, People’s Health Watch)
Women’s Health Journal. Health:
A Human Right, A Civil Right. Latin
American and Caribbean Women’s Health Network. April –June 2002.
For further information or for networking you can contact:
Asian-Pacific Resource & Research Centre for Women (ARROW) Ground Floor, Block G, Anjung
Felda, Jalan Maktab
54000 Kuala Lumpur, Malaysia
Tel: (603) 2692 9913
Fax: (603)2692 9958
E-mail: arrow@arrow.po.my
Homepage: www.arrow.org.my
The Association for Women’s Rights in Development (AWID)
96 Spadina Ave., Suite 401
Toronto, ON M5V 2J6 Canada
Tel: (416) 594-3773
Fax: (416) 594-0330
Website: www.awid.org
Has useful list of publications and resources including description of the CEDAW Convention,
and the Optional Protocol and how it can be used and on the International Covenant on
Economic, Social and Cultural Rights www.awid.org/publications/primers/factsissues2.pdf
www.awid.org/publications/primers/factsissues3.pdf
Center for Health and Gender Equity
(CHANGE)
6930 Carroll Avenue, Suite 910, Takoma Park,
MD 20912 USA
Tel: (301) 270-1182
Fax: (301) 270-2052
email: change@genderhealth.org
Website: www.genderhealth.org/index.php?
Center for Reproductive Law and Policy
The Center for Reproductive Rights
120 Wall St.
New York, NY 10005
Tel: (917) 637-3600
Fax: (917) 637-3666
E-mail: info@reprorights.org
Website: www.crlp.org
The Hesperian Foundation
1919 Addison Street, Suite 304 - Berkeley, CA
94704 USA
Tel:(510) 845-1447, Fax: (510) 845-9141
E-mail: hesperian@hesperian.org
Website: www.hesperian.org/
International Women’s Rights Action Watch-Asia Pacific ( IWRAW)
2nd Floor, Block F, Anjung FELDA, Jalan
Maktab
54000 Kuala Lumpur, Malaysia
Tel: (603)2691 3292
Fax: (603) 2698 4203
E-mail: iwraw@po.jaring.my
Website: www.iwraw-ap.org
Mahila Sarvangeen Utkarsh Mandal (MASUM)
Manisha Grupte
11 Archana apts, Kanchanjunga Archade,
163 Solapur Road, Hdapsar, Pune 411 028,
Maharashtra, India
E-mail : masum@vsnl.com
Peoples Health Movement
Ravi Narayan, PHM Secreteriat
367 Srinivasa Nilaya- Jakkasandra I Main
I blok, koramangala- Bangalore 560 034,India
Email: secretariat@phmovement.org
Website: www.phmovement.org
The People's Movement for Human Rights Education (PDHRE) / NY Office
526 West 111th Street, New York, NY 10025
tel: 212.749-3156; fax: 212.666-6325;
e-mail: pdhre@igc.apc.org
Website: www.pdhre.org/rights/
Rights and Reforms Women’s Health Project
PO Box 1038 Johannesburg 2000 South Africa
Tel: 27-11 489 9903
Fax: 27-11 489 9922
E-mail:Rightsandreforms@sn.apc.org
Website: http://www.wits.ac.za/whp/rightsandreforms/
Call for Action 2003
The text of the 16th Call for Action has been
jointly written by Manisha Gupte, MASUM , India, Sumati Nair and Melina Auerbach at the
Coordination Office of WGNRR, Amsterdam, the Netherlands. Elizabeth Eising has coordinated
this year’s Call.
Get in touch
We would appreciate receiving your reports, pictures,
posters, newspaper clippings etc. for inclusion in our report on the Day of Action in the
WGNRR Newsletter. You can also request more copies of the Call in English, Spanish and French
from our office.
WGNRR, Vrolikstraat 453 D,
1092 TJ Amsterdam, The Netherlands.
Tel: (31-20) 620 9672,
Fax: (31-20) 622 2450,
E-mail: office@wgnrr.nl
Website: www.wgnrr.org
Notes
1) WHO, reproductive health/publications/RHR_99_7_chapter4.en.htm
2) Gloyd, Steve. "NGOs and the "SAP"ing of
Health Care in Rural Mozambique" in Women’s Global Network for Reproductive
Rights Newsletter 55/56. July –December 1996. p.26-28.
3) For more information see Impact of Health Sector Reform on Reproductive Health, ARROWS
for Change, Vol. 6, No. 3, 2000.
4) Sara Grusky, Bearing the Burden of IMF and World Bank Policies: Privatization Tidal Wave
IMF/World Bank Water Policies and the Price Paid by the Poor. Public Citizen Web Site.
http://www.citizen.org/cmep/Water/cmep_Water/wbimf/articles.cfm?ID=7802
5) Nanda, Priya. "Gender dimensions of user fees:Implications for Women’s Utilization of Health
Care", Reproductive Heralth Matters, 2002: 10 (20), p. 127-134.
6) Ibid.
7) Simbulan, Nymia. "How the Structural Adjustment Program Saps the Philippine Health Care Delivery
System" HAI News. October 2001, March 2002. p. 17- 18.
8) Sadavisdam, Bharati, Ed. Risks, Rights and Reforms, A 50 Country Survey assessing Government
Actions Five Ears After the International Conference on Population and Development, WEDO, New York,
1999.
9) Bianco, Mabel. Cost Benefit and economic approach related to health care services system. As cited
on www.un.org/womenwatch/daw/csw/cost.htm
10) www.who.int/reproductive-health/publications/MSM_97_16/MSM_97_16_chapter2.en.html
11) Center for Reproductive Law and Policy. Women of the World: Anglophone Africa Laws And Policies
Affecting Their Reproductive Lives. Progress Report 2001. http://www.reproductiverights.org/pub_bo_wowafrica.html
12) Center for Health Equity (CHANGE). "Government Extremists in Peru Further Undermine
Reproductive Rights", press release, Nov.21 2002, www.genderhealth.org
13) Center for Reproductive Law and Policy. ibid
14) Amazigo, Uche. Women’s Health and Tropical Diseases: a focus on Africa.
www.un.org/womenwatch/daw/csw/tropical.htm
15) Nanda, Priya. Global Agendas, Health Sector Reforms and Reproductive Health and Rights:
Opportunities and challenges in Zambia. Center for Health and Gender Equity.
16) Amazigo, Uche, Ibid.
17) PAHO. Domestic Violence During Pregnany Fact Sheet. Women Health and Development Program.
http://www.paho.org/english/hdp/hdw/violencepregnancy.PDF
18) Halstead S.B., Walsh JA, Warren KS, eds. Good Health at Low Cost. Conference Report, New York.
1985.
19) Center for Reproductive Law and Policy. ibid
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The International Day of Action for Women's Health
|
At a meeting of members of the Women's Global Network for
Reproductive Rights (WGNRR) in Costa Rica on 28 May 1987, following from the 5th International Women and Health Meeting, the
decision was taken to proclaim May 28 as an International Day of Action
for women's Health.
In 1988 and 1989, two special publications were made for May
28 on maternal mortality and morbidity by WGNRR and the Latin
American and Caribbean Women's Health Network. Since then, the WGNRR Coordination Office has published annually a Call for Action
for May 28. Until 1996, these Calls focussed on various aspects
of the prevention of maternal mortality and morbidity. After evaluation among
the respective groups in different regions, the focus has
shifted to a critical examination of the impact of global neoliberal policies –
particularly of the IMF and the World Bank – on women's health and women's
access to quality health care, and a demand for health and
development policies which are gender sensitive, and which enhance poor women's
and men's standard of living, and improve the accessibility and
quality of health care services. Since 1997, the Latin American and
Caribbean Women's Health Network has also begun publishing a Call for
Action oriented towards their network.
Since its inception, the International Day of Action for Women's Health on 28 May, has become widely known and celebrated. In 1999,
it was officially recognised by the government of South Africa. May
28 has become the day on which many women's groups and
organisations from all over the world carry out a wide variety of activities
– from street theatre and demonstrations to discussions with parliamentarians –
calling for attention to the unsatisfactory state of health care for
women and demanding improvements.
Women’s Global Network for Reproductive Rights Vrolikstraat 453 D, NL 1092 TJ Amsterdam, The Netherlands
office@wgnrr.nl / www.wgnrr.org
In collaboration with
www.phmovement.org
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