In September 1994 in Cairo, 184 governments endorsed a historic plan to achieve a balance between the world's people and its resources. For the first time, an international agreement on population made the reproductive health and rights of women central. The International Conference on Population and Development agreed that universal access to reproductive health care should be achieved by the year 2015. The challenge before policy-makers, program managers and advocates is to persuade governments, energize donors, and enable women's groups and other non-governmental organizations to ensure that the agreements made in Cairo are fully implemented.
WHAT IS REPRODUCTIVE HEALTH CARE?
Reproductive health care seeks to meet the health needs of women and men associated with sexuality and child bearing. Program goals and the constellation of services encompass, and go beyond conventional family planning, and maternal-child-health care.
Components of reproductive health care include:
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Counseling about sexuality, pregnancy, contraception,
abortion, infertility, infection, and disease;
- Education on sexuality and gender relations;
- Prevention, screening and treatment of reproductive tract infections, sexually transmitted diseases (STDs), including HIV / AIDS, and gynecological problems;
- Fully informed, voluntary choice among a range of contraceptive methods;
- Prevention and treatment of infertility;
- Safe abortion services;
- Prenatal care, supervised delivery, and post-partum care; and
- Health services for infants and children.
Quality of care is a priority, and is ensured by:
- Maintaining high standards of technical competence;
- Treating clients with respect and compassion;
- Designing service delivery to meet clients' needs; and
- Providing follow-up care.
The International Conference on Population and Development estimated that $17 billion each year will be needed by the year 2000 to provide universal access to reproductive health services in resource-poor countries.
WHAT ARE REPRODUCTIVE RIGHTS?
Reproductive rights embrace existing human rights.
Reproductive rights include:
- The 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;
- The right to attain the highest standard of sexual and reproductive health, and the right to services and information that make this possible;
- The right to make decisions concerning reproduction free of discrimination, coercion, and violence.
HOW CAN REPRODUCTIVE HEALTH BECOME A REALITY?
By modifying existing family planning and health programs to:
- Expand services to address women's multiple reproductive and sexual health needs;
- Intensify staff supervision and training, and use systems that reward good quality care, not simply numbers of clients served;
- Design services to protect women's rights and foster their empowerment;
- Provide information and services to women who are older or younger than reproductive age, regardless of marital status;
- Encourage and support men to take their share of responsibility for sexual and reproductive behavior, prenatal, maternal and child health, child rearing, STD and HIV / AIDS infection, and violence;
- Invest in research to fill critical gaps in technology and services including *microbicides, methods for STD diagnosis, simple, inexpensive STD treatments, and emergency obstetric care.
By respecting certain principles:
- Programs and services must be designed to suit particular circumstances, and ensure that these services are accessible and affordable to all women;
- Program design and implementation must involve women at all stages;
- Programs should support both women and men to share responsibility for their sexual behavior, their fertility, and the heath and well-being of their partners and children.
By making better use of resources:
- It is not necessary to wait for new money, new data or additional staff;
- Existing resources can be used more imaginatively and efficiently;
- Services can be integrated and connected instead of separate;
- Budget priorities can be reordered.
HOW CAN REPRODUCTIVE RIGHTS BE ENSURED?
- Governments, donors and the community must take concerted actions to guarantee that all couples and individuals who want reproductive and sexual health services get them;
- Laws and policies must be established and enforced to prevent discrimination, coercion and violence associated with sexuality and reproduction;
- Women and men must work together to know their rights, hold their governments accountable for protecting these rights, and build support for these rights through public education and advocacy.
These concepts of reproductive health and rights are derived from the work of international women's health advocates worldwide.
* Microbicides are compounds capable, when applied intervaginally, of preventing the transmission of sexually transmitted agents, including bacteria, parasites and / or viruses, such as HIV, with or without spermicidal effect.
